Study Highlights the Role of Socioeconomic Vulnerability
(Newswise) — A new study addresses the puzzle of why heavy drinking throughout pregnancy leads to widely varying outcomes for children. Even in the context of heavy and consistent prenatal alcohol exposure (PAE), children may be severely affected, less affected, or seemingly not affected at all.
Some of the variation can be explained by the quantity, frequency, and gestational timing of drinking during pregnancy, and genetic variations affecting mothers’ alcohol metabolism. For the study in Alcohol: Clinical & Experimental Research, investigators aimed to define the range of physical, cognitive, and behavioral outcomes in children exposed to heavy, frequent PAE and identify factors that influenced the risk.
They worked with data relating to 225 mothers who’d used alcohol during pregnancy and their first-grade children. The participants were mostly of mixed race and lived in the Western Cape Province of South Africa, a community with limited socioeconomic opportunities and one of the highest global prevalences of PAE. Through previous studies, the mothers were known to be candid about their alcohol use in pregnancy, with their self-reports supported by biomarkers.
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Eighty-seven percent of children met criteria for a fetal alcohol spectrum disorder (FASD): 53% had fetal alcohol syndrome (FAS), 17% partial FAS, and 17% alcohol-related neurodevelopmental disorder; 12% were developing typically at an average of six years of age. The severity of physical and neurobehavioral anomalies varied substantially.
Mothers of children with FAS, the most severe diagnosis, had reported higher alcohol use on drinking days in the second and third trimesters and more drinking days per week in the third, compared to other participants.
Older maternal age and a higher number of past pregnancies were linked to increased risk for children. Higher maternal weight and BMI, and more years of formal education (a marker of socioeconomic status) were associated with reduced risk. Drinking more in the third trimester was strongly linked to the severity of physical growth and development problems in children.
Severe outcomes are likely to be predicted by inadequate nutrition in mothers, resulting in lower BMI. The findings support interventions such as promoting nutritional diets and prenatal vitamins, as well as education, especially for women in their later years of childbearing.
