Gestational age and socioeconomic status as mediators for the impact of prenatal alcohol exposure on development at 6 months

Coles, Claire D.; Kable, Julie A.; Granovska, Irina V.; Pashtepa, Ala O; Plotka, Larisa; Dolhov, Victor B; Wertelecki, Wladimir; Jones, Kenneth Lyons; Chambers, Christina D.; Cifasd,

doi:10.1002/bdr2.1408

Cited by 5 publications

(5 citation statements)

References 17 publications

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“…Consistent with previous research, results of our study demonstrated a negative association between PAE and gestational age at delivery. Not surprisingly and consistent with other studies (Coles et al, 2019;Kesmodel et al, 2000;Srikartika & O'Leary, 2015), the strongest effect was observed between the intensity of alcohol use (amount of alcohol per drinking day) and reduced gestational age at delivery, while average alcohol amount in both periconceptional period and during pregnancy also demonstrated an inverse relationship with gestational age. These effects on reduced gestational age remained significant after adjusting for tobacco coexposure and sociodemographic characteristics in multivariable modeling.…”

Section: Discussionsupporting

confidence: 91%

Dose–response effect of prenatal alcohol exposure on perinatal outcomes

Bakhireva,

Ma,

Wiesel

et al. 2024

Alcohol, Clinical and Experimental Research

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BackgroundA better understanding of the effects of lower levels of prenatal alcohol exposure (PAE), as a common exposure, is needed. The goal of this study was to examine the effects of mild–moderate PAE and episodic binge drinking on perinatal outcomes.MethodsThe data were obtained from three prospective cohorts with a combined sample of 281 participants: 125 with PAE and 156 without PAE. Alcohol‐related measures included the Alcohol Use Disorders Identification Test, timeline follow‐back questionnaires (covering the periconceptional period, mid‐gestation, and late gestation), and biomarkers. Absolute alcohol per day (AAD) and per drinking day (AADD), number of binge episodes, and maximum number of drinks in a 24‐h period were estimated. Perinatal outcomes included gestational age and anthropometric measures. Data were analyzed using correlation and multivariable regression analysis.ResultsAmong women with PAE, average alcohol consumption across the periconceptional period and pregnancy was 0.37 oz ± 0.74 AA/day (~5 drinks/week). After adjusting for tobacco co‐exposure and sociodemographic characteristics, significant associations between all alcohol measures and gestational age at delivery were observed, including cumulative measures of AAD (β = −0.58; 95% CI: −0.98; −0.17) and AADD (β = −0.58; 95% CI: −0.90; −0.26) during pregnancy and the periconceptional period. A significant association between the maximum number of drinks in a 24‐h period and birth length percentile (β = −0.70; 95% CI: −1.36; −0.04) was observed in the final model. PAE was associated with lower birth weight percentile in univariate analyses only.ConclusionsResults of this study demonstrate a negative association between mild–moderate PAE and episodic binge drinking with gestational age at delivery and birth length percentile after controlling for other factors. Robust negative effects of PAE, including in the periconceptional period before pregnancy recognition, on duration of gestation highlight the need for primary prevention efforts aimed at PAE in persons of reproductive age.

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Section: Discussionsupporting

confidence: 91%

Dose–response effect of prenatal alcohol exposure on perinatal outcomes

Bakhireva,

Ma,

Wiesel

et al. 2024

Alcohol, Clinical and Experimental Research

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“…In addition, those children who are classified as ARND based on their cognition are more likely to have been born preterm and to have lower birthweight than all other groups. Although these conditions are well‐known risk factors for developmental problems, both lower birthweight (Day et al, 1989) and preterm birth (Coles et al, 2019) have been shown to be associated with PAE (Carter et al, 2016). Thus, prenatal exposure may be exerting an effect here even when these perinatal factors are not in a range that is typically associated with later risk.…”

Section: Discussionmentioning

confidence: 99%

Characterizing Alcohol‐Related Neurodevelopmental Disorder: Prenatal Alcohol Exposure and the Spectrum of Outcomes

Coles

Kalberg

Kable

et al. 2020

Alcoholism Clin & Exp Res

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Background: The effects of prenatal alcohol exposure (PAE) are conceptualized as fetal alcohol spectrum disorder, with fetal alcohol syndrome (FAS) as the most severe. Many find it more difficult to characterize behavioral and cognitive effects of exposure on the central nervous system when physical signs are not present. In the current study, an operational definition of alcohol-related neurodevelopmental disorder (ARND) was examined to determine its usefulness in discrimination of children classified as ARND based on behavior (ARND/B) and cognition (ARND/C) from children in 4 contrast groups: (i) children exposed to study-defined "risky drinking"; (ii) children with any reported PAE; (iii) children classified as "Higher Risk" for developmental problems; and (iv) children classified as "Lower Risk."Methods: A total of 1,842 children seen as part of a surveillance study (J Am Med Assoc, 319, 2018, 474) were evaluated for alcohol exposure and physical characteristics of FAS, and completed neurodevelopmental testing. Ninety-one were identified as either ARND/B or ARND/C and contrasted with other groups to further identify distinguishing patterns. Multinomial logistic regression (MLR) was used to examine the accuracy of classification and to identify factors contributing to such classification.Results: Children described as ARND/C were distinct from other groups based on cognition and behavior as well as demographic factors (e.g., age, race, SES), child characteristics (e.g., gestational age; sex), and other drug exposures, while those described as ARND/B differed only on behavior and other drug exposures. MLR models successfully discriminated ARND groups from children in other groups with accuracy ranging from 79% (Higher Risk) to 86.7% (Low Risk).Conclusions: ARND has been a subject of debate. This analysis suggests the effects of alcohol on behavior and cognition even in the absence of the characteristic facial features and growth deficiency that can be identified. The results also indicate that it may be possible to distinguish such children from those in other high-risk groups.

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“…Our findings are consistent with prior studies. This study demonstrated a robust association between prenatal alcohol consumption and preterm birth (Bada et al, 2005; Coles et al, 2018; Jackson et al, 2007). Greater maternal, prenatal alcohol consumption was associated with greater odds for preterm birth.…”

Section: Discussionmentioning

confidence: 61%

“…While common teratogenic effects of prenatal alcohol exposure are often a reduction of length of gestation (Coles et al, 2018) and LBW (Hoyme et al, 2016), gestational age and birthweight have received relatively little attention in epidemiology studies as possible early life indicators for FASD. Although studies have linked prenatal alcohol exposure to birth outcomes, few studies have attempted to link preterm and/or SGA to specific FASD diagnostic outcomes later in childhood.…”

Section: Introductionmentioning

confidence: 99%

Gestational age and birth growth parameters as early predictors of fetal alcohol spectrum disorders

Hasken

Marais

Vries

et al. 2021

Alcoholism Clin & Exp Res

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Objective To investigate gestational age and growth at birth as predictors of fetal alcohol spectrum disorders (FASD). Methods The sample analyzed here comprises 737 randomly selected children who were assessed for growth, dysmorphology, and neurobehavior at 7 years of age. Maternal interviews were conducted to ascertain prenatal alcohol exposure and other maternal risk factors. Birth data originated from clinic records and the data at 7 years of age originated from population‐based, in‐school studies. Binary linear regression assessed the relationship between preterm birth, small for gestational age (SGA), and their combination on the odds of a specific FASD diagnosis or any FASD. Results Among children diagnosed with FASD at 7 years of age (n = 255), a review of birth records indicated that 18.4% were born preterm, 51.4% were SGA, and 5.9% were both preterm and SGA. When compared to non‐FASD controls (n = 482), the birth percentages born preterm, SGA, and both preterm and SGA were respectively 12.0%, 27.7%, and 0.5%. Mothers of children with FASD reported more drinking during all trimesters, higher gravidity, lower educational attainment, and older age at pregnancy. After controlling for usual drinks per drinking day in the first trimester, number of trimesters of drinking, maternal education, tobacco use, and maternal age, the odds ratio of an FASD diagnosis by age 7 was significantly associated with SGA (OR = 2.16, 95% CI: 1.35 to 3.45). SGA was also significantly associated with each of the 3 most common specific diagnoses within the FASD continuum: fetal alcohol syndrome (FAS; OR = 3.1), partial FAS (OR = 2.1), and alcohol‐related neurodevelopmental disorder (OR = 2.0). Conclusion SGA is a robust early indicator for FASD in this random sample of children assessed at 7 years of age.

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Gestational age and socioeconomic status as mediators for the impact of prenatal alcohol exposure on development at 6 months

Cited by 5 publications

References 17 publications

Dose–response effect of prenatal alcohol exposure on perinatal outcomes

Dose–response effect of prenatal alcohol exposure on perinatal outcomes

Characterizing Alcohol‐Related Neurodevelopmental Disorder: Prenatal Alcohol Exposure and the Spectrum of Outcomes

Gestational age and birth growth parameters as early predictors of fetal alcohol spectrum disorders

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