Prenatal alcohol exposure effects last well into childhood

By Piriya Mahendra, MedWire Reporter

Women who heavily expose their unborn child to alcohol risk restricting their child's growth until the age of 9 years, researchers say.

"Our findings… are consistent with other prospective studies examining children from economically disadvantaged populations and support the use of growth restriction at any age as one of the diagnostic criteria for fetal alcohol syndrome and partial fetal alcohol syndrome," comment Robert Carter (Children's Hospital Boston, Massachusetts, USA) and team.

Using multiple regression models adjusted for confounders, they found that the average weight of children born to mothers who were heavy drinkers, defined as having two or more drinks a day, was 0.6 standard deviations (SDs) lower than those born to light drinkers (<1 drink a day, no binging) or abstainers, from 6.5 months to 9 years of age.

The average height of babies born to heavy drinkers was 0.5 SD lower than those born to light drinkers or abstainers, and head circumference 0.9 SD lower from 6.5 months to 9 years.

These reductions were exacerbated by iron deficiency in infancy but were not modified by iron deficiency or measures of food security at 5 years.

Between the age of 12 months and 5 years, alcohol-exposed children had an increase in their average weight-for-age Z-score (WAZ) of 0.1, whereas control participants showed a decrease in WAZ of 0.1. This meant a postnatal delay in weight gain was seen between 6.5 and 12 months, but was no longer seen at the age of 5 years.

Although heavy alcohol exposure was not significantly associated with changes in body composition, children with fetal alcohol syndrome and partial fetal alcohol syndrome had lower percent body fat than heavily exposed nonsyndromal and control children, at 16.1% and 15.2% versus 19.2% and 19.0%, respectively. This finding "indicates lower body composition in the most affected children, the cause of which remains unclear," the authors report.

"Future studies are needed to examine the mechanisms underlying the alcohol-related growth retardation and changes in body composition observed in this cohort," they conclude in Alcoholism: Clinical and Experimental Research.

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