The Early Developmental Outcomes of Prenatal Alcohol Exposure: A Review

Abstract

Aim: This paper systematically reviews the literature on the effects of prenatal alcohol exposure on early child development from birth to 5 years with the aim to synthesize the developmental outcomes associated with prenatal alcohol exposure, and inform further research to improve our knowledge of the manifestations of prenatal alcohol exposure.Methods: Electronic databases (MEDLINE, Psych INFO, and Psych ARTICLES) were searched to find papers on the developmental outcomes of prenatal alcohol exposure in neonates, infants and toddlers and pre-school aged children. Studies were selected based on participants self-reporting alcohol consumption during pregnancy (either prospectively or retrospectively) and/or children being diagnosed with FASD based on a standardized assessment that includes a dysmorphology examination. The search was limited to peer-reviewed, English language studies involving human subjects, up to 5.5 years old.Results: Out of the 1,684 titles screened, a total of 71 papers were identified as relevant and included in this review. The majority of studies were prospective longitudinal studies. A range of assessment modalities (or tools) was used to determine neurodevelopmental outcomes of prenatal exposure to alcohol in the age group under review, the most frequently described being the Bayley Scales of Infant and Toddler Development (BSID) (n = 19). Studies varied in terms of the dose, frequency, and timing of alcohol consumption during pregnancy and methodology used to assess alcohol consumption. Findings demonstrate extensive evidence for poor global developmental outcomes in children prenatally exposed to alcohol, particularly with moderate to severe levels of prenatal alcohol exposure.Conclusion: The outcomes related to lower levels of prenatal alcohol exposure as well as outcomes in specific developmental domains, are poorly understood. Further research should aim to clarify the more subtle or less easily measurable manifestations of prenatal alcohol exposure on early development when the potential for greatest impact of interventions is highest.

Maternal alcohol intakes before and during pregnancy: Impact on the mother and infant outcome to 18 months

“…Next, there is evidence of delays in motor skills and language with heavy PAE but less evidence with light PAE. A review by Subramoney et al (2018) concluded heavy PAE was associated with impaired motor skill development in young children, and other reviews have drawn similar conclusions for older children (Bay & Kesmodel, 2011;Doney et al, 2014). The association is less certain for light to moderate PAE (Hutchinson et al, 2019).…”

Prenatal Environment That Affects Neuronal Migration

“…Alcohol consumed by a pregnant woman can easily cross the placenta, and increases fetal blood alcohol concentrations to the levels equivalent to those in maternal side within 2 h of ingestion (Burd et al, 2012). Affected individuals of FASD display a spectrum of defects, including facial malformations and neurobehavior impairments (Subramoney et al, 2018).…”

Influences on drinking choices among Indigenous and non-Indigenous pregnant women in Australia: A qualitative study

“…The severity of any of these outcomes depends on the level and gestational pattern of alcohol exposure and is also likely influenced by other maternal factors, such as nutrition, stress and genetics, as well as the postnatal psychosocial environment. Despite many longitudinal studies focussing on this topic, recent systematic reviews still find that the literature on child outcomes with lower levels of exposure is inconclusive [1][2][3]. The ongoing debate of whether there is a 'safe' level of alcohol use in pregnancy has resulted in many official guidelines applying the precautionary principle and recommending complete abstinence in pregnancy.…”