Greater prenatal alcohol exposure trajectories linked to impaired growth and neurodevelopment
[2 minute Medicine, 1/4/19] Prenatal alcohol exposure is known to cause growth and neurodevelopmental disorders in infants, but less is known about the relationship between PAE trajectory and its harmful effects. In this prospective cohort study, researchers interviewed pregnant women in Ukraine between 2008 and 2012 on alcohol use and measured infant neurodevelopment at 6 and 12 weeks postpartum to compare growth and neurodevelopment of infants with different PAE trajectories. Researchers grouped mothers’ alcohol use into 5 trajectories, described as minimal to no PAE throughout gestation, low-to-moderate PAE with discontinuation early in gestation, low-to-moderate PAE sustained across gestation, moderate-to-high PAE with reduction early in gestation, and high PAE sustained across gestation. Greater PAE was associated with reduced birth weight and length, as well as lower neurodevelopmental scores at 6- and 12-month follow-up. These differences persisted when controlling for multiple demographic and health factors.
These findings are limited by recall bias and a high study drop-out rate. Furthermore, researchers did not collect or control for physiologic factors, such as placental functioning, and certain sociodemographic factors may vary throughout pregnancy but were only measured once. Nonetheless, the study is strengthened by its large sample and long follow-up. For physicians, these findings highlight the importance of screening for and reducing prenatal alcohol exposure, especially among women who consume high amounts of alcohol or do not reduce use early in pregnancy.
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