The effects of low to moderate alcohol consumption and binge in early pregnancy on selective and sustained attention in 5-year-old children

Department of Public Health, Section of Epidemiology, Aarhus University, Aarhus, Denmark.
BJOG An International Journal of Obstetrics & Gynaecology (Impact Factor: 3.45). 06/2012; 119(10):1211-21. DOI: 10.1111/j.1471-0528.2012.03396.x
Source: PubMed


The aim was to examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on children's attention at 5 years of age.
Prospective follow-up study.
Neuropsychological testing in four Danish cities 2003-2008.
A cohort of 1628 women and their children sampled from the Danish National Birth Cohort.
Participants were sampled based on maternal alcohol consumption during pregnancy. At 5 years of age, the children were tested with the recently developed Test of Everyday Attention for Children at Five (TEACh-5). Parental education, maternal IQ, maternal smoking in pregnancy, the child's age at testing, gender, and tester were considered core confounding factors, whereas the full model also controlled the following potential confounding factors: maternal binge drinking or low to moderate alcohol consumption, age, body mass index (BMI), parity, home environment, postnatal smoking in the home, child's health status, and indicators for hearing and vision impairments.
TEACh-5 attention scores.
There were no significant effects on test performance in children of mothers drinking up to 8 drinks per week compared with children of mothers who abstained, but there was a significant association between maternal consumption of 9 or more drinks per week and risk of a low overall attention score (OR 3.50, 95% CI 1.15-10.68). No consistent or significant associations were observed between binge drinking and attention test scores.
The findings suggest an effect of maternal consumption of 9 or more drinks per week on attention functions in children, but the study detected no effects of lower levels of maternal consumption and no consistent effects of maternal binge drinking.

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Available from: Ulrik Schiøler Kesmodel, Oct 04, 2014
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    • "Currently, findings from such observational studies are ambiguous. Sometimes they report a negative association between prenatal exposure to low doses of alcohol and mental health development in childhood (Olson et al., 1997; Sood et al., 2001; Sayal et al., 2007), but sometimes they do not (O'Leary et al., 2009; Rodriguez et al., 2009; Skogerbo et al., 2012; Underbjerg et al., 2012; Sayal et al., 2013). Very often they even report a J-shaped association (Kelly et al., 2009, 2012; Robinson et al., 2010), where exposure to lower doses of alcohol apparently acts as a protective factor for the development of mental health problems in childhood. "
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    ABSTRACT: Studies investigating associations between prenatal exposure to low-moderate doses of alcohol and mental health development in childhood are inconsistent. The aim of the present study was to compare women who drink and who do not drink alcohol in pregnancy on a number of potential confounding variables, and to investigate whether any latent variables could be identified among these. Data were obtained from the Danish National Birth Cohort. Exposure: cumulated alcohol intake in full pregnancy (n = 63,464). The women were subdivided into intake groups 0, >0-10, >10-30, >30-90 and >90 units of alcohol in full pregnancy. Hereafter, the abstainers were subdivided into an all-time and a pregnancy-abstaining group, and the high intakers (>90) were subdivided into a high (>90-180) and a very high (>180) intake group. Outcome: self-reported and register-based information on socio-demographic and lifestyle factors, and latent variables from an exploratory factor analysis. Significant differences were observed between the intake groups on virtually all parameters. Significant differences were observed between the abstaining groups and the high-intake groups. The exploratory factor analyses identified a number of latent variables between the potential confounding variables. Differences on confounding factors may in part explain the lack of consistency in the literature investigating prenatal exposure to low-moderate doses of alcohol and mental health development. It is cautiously concluded that the failure to control for these factors introduces residual and/or unmeasured confounding into the analyses, and thus masks the potential (small) effect of being exposed to low doses of alcohol in pregnancy. It is recommended that future studies control for factor scores rather than for the observed variables as is practice today.
    Alcohol and Alcoholism 10/2013; 49(3). DOI:10.1093/alcalc/agt141 · 2.89 Impact Factor
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    • "In a review of published studies, Henderson and colleagues concluded that there is no consistent evidence of the harm caused by small to moderate amounts of alcohol consumed during pregnancy [3]. Further studies on specific outcomes published after the review support this conclusion [4-6]. However, no level of alcohol consumption has been determined as completely safe during pregnancy. "
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    ABSTRACT: There is a paucity of research on predictors for drinking during pregnancy among women in Sweden and reported prevalence rates differ considerably between studies conducted at different antenatal care centres. Since this knowledge is relevant for preventive work the aim of this study was to investigate these issues using a multicenter approach. The study was conducted at 30 antenatal care centers across Sweden from November 2009 to December 2010. All women in pregnancy week 18 or more with a scheduled visit were asked to participate in the study. The questionnaire included questions on sociodemographic data, alcohol consumption prior to and during the pregnancy, tobacco use before and during pregnancy, and social support. Questionnaires from 1594 women were included in the study. A majority, 84%, of the women reported alcohol consumption the year prior to pregnancy; about 14% were categorized as having hazardous consumption, here defined as a weekly consumption of > 9 standard drinks containing 12 grams of pure alcohol or drinking more than 4 standard drinks at the same occasion. Approximately 6% of the women consumed alcohol at least once after pregnancy recognition, of which 92% never drank more than 1 standard drink at a time. Of the women who were hazardous drinkers before pregnancy, 19% reduced their alcohol consumption when planning their pregnancy compared with 33% of the women with moderate alcohol consumption prior to pregnancy. Factors predicting alcohol consumption during pregnancy were older age, living in a large city, using tobacco during pregnancy, lower score for social support, stronger alcohol habit before pregnancy and higher score for social drinking motives. The prevalence of drinking during pregnancy is relatively low in Sweden. However, 84% of the women report drinking in the year preceding pregnancy and most of these women continue to drink until pregnancy recognition, which means that they might have consumed alcohol in early pregnancy. Six factors were found to predict alcohol consumption during pregnancy. These factors should be addressed in the work to prevent alcohol-exposed pregnancies.
    BMC Public Health 08/2013; 13(1):780. DOI:10.1186/1471-2458-13-780 · 2.26 Impact Factor
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    • "Some individual children escape diagnoses within the FASD continuum in spite of substantial prenatal alcohol exposure (Abel, 1998; May et al., 2013a; Skogerbø et al., 2012; Underbjerg et al., 2012). Maternal risk to the fetus involves the interaction of biological, familial, historical, social, and psychological influences (Gomberg, 1993), and the relative importance of these co-factors to FAS or other diagnoses within the FASD continuum has been demonstrated elsewhere (Abel and Hannigan, 1995; May et al., 2011, in press). "
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    ABSTRACT: Concise, accurate measures of maternal prenatal alcohol use are needed to better understand fetal alcohol spectrum disorders (FASD). Measures of drinking by mothers of children with specific FASD diagnoses and mothers of randomly-selected controls are compared and also correlated with physical and cognitive/behavioral outcomes. Measures of maternal alcohol use can differentiate maternal drinking associated with FASD from that of controls and some from mothers of alcohol-exposed normals. Six variables that combine quantity and frequency concepts distinguish mothers of FASD children from normal controls. Alcohol use variables, when applied to each trimester and three months prior to pregnancy, provide insight on critical timing of exposure as well. Measures of drinking, especially bingeing, correlate significantly with increased child dysmorphology and negative cognitive/behavioral outcomes in children, especially low non-verbal IQ, poor attention, and behavioral problems. Logistic regression links (p<.001) first trimester drinking (vs. no drinking) with FASD, elevating FASD likelihood 12 times; first and second trimester drinking increases FASD outcomes 61 times; and drinking in all trimesters 65 times. Conversely, a similar regression (p=.008) indicates that drinking only in the first trimester makes the birth of a child with an FASD 5 times less likely than drinking in all trimesters. There is significant variation in alcohol consumption both within and between diagnostic groupings of mothers bearing children diagnosed within the FASD continuum. Drinking measures are empirically identified and correlated with specific child outcomes. Alcohol use, especially heavy use, should be avoided throughout pregnancy.
    Drug and alcohol dependence 08/2013; 133(2). DOI:10.1016/j.drugalcdep.2013.07.013 · 3.42 Impact Factor
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