Light drinking in pregnancy and mid-childhood mental health and learning outcomes

Section of Developmental Psychiatry, University of Nottingham, E Floor, South Block, Queen's Medical Centre, Nottingham NG7 2UH, UK
Archives of Disease in Childhood (Impact Factor: 2.9). 02/2013; 98(2):107-11. DOI: 10.1136/archdischild-2012-302436
Source: PubMed


To investigate whether light drinking in pregnancy is associated with adverse child mental health and academic outcomes.
Using data from the prospective, population-based Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the associations between light drinking in pregnancy (<1 glass per week in the first trimester) and child mental health (using both parent and teacher rated Strengths and Difficulties Questionnaires (SDQs)) and academic outcomes based on Key Stage 2 examination results at age 11 years.
11-year-old children from ALSPAC with parent (n=6587) and teacher (n=6393) completed SDQs and data from Key Stage 2 examination results (n=10 558).
39% of women had consumed <1 glass per week and 16% ≥1 glass per week of alcohol during the first trimester (45% abstaining). After adjustment, relative to abstainers, there was no effect of light drinking on teacher-rated SDQ scores or examination results. In girls, although there was a suggestion of worse outcomes (adjusted regression coefficient=0.38; 95% CI 0.01 to 0.74) on the parent-rated total SDQ score in those exposed to light drinking compared to abstainers, no dose-response relationship was evident.
Although the pattern of findings involving parent ratings for girls exposed to light drinking is consistent with earlier findings from this cohort, the overall lack of any adverse effects of light drinking is similar to findings from other recent cohort studies. Light drinking in pregnancy does not appear to be associated with clinically important adverse effects for mental health and academic outcomes at the age of 11 years.

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Available from: Ron Gray, Jan 28, 2014
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    • "First trimester—information about drinking in the first trimester was also collected at 18 weeks gestation using the same frequency/quantity response categories as described above. Based on our previous work, for analyses, the groups consuming ≥1 glasses per week during the first trimester were combined [21]. "
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    ABSTRACT: The objective of the study is to investigate whether episodic binge pattern of alcohol consumption during pregnancy is independently associated with child mental health and academic outcomes. Using data from the prospective, population-based Avon Longitudinal Study of Parents and Children (ALSPAC), we investigated the associations between binge patterns of alcohol consumption during pregnancy (≥4 drinks per day) and child mental health [as rated by both parent (n = 4,610) and teacher (n = 4,274)] and academic outcomes [based on examination results (n = 6,939)] at age 11 years. After adjusting for prenatal and postnatal risk factors, binge pattern of alcohol consumption (≥4 drinks in a day on at least one occasion) during pregnancy was associated with higher levels of mental health problems (especially hyperactivity/inattention) in girls at age 11 years, according to parental report. After disentangling binge-pattern and daily drinking, binge-pattern drinking was independently associated with teacher-rated hyperactivity/inattention and lower academic scores in both genders. Episodic drinking involving ≥4 drinks per day during pregnancy may increase risk for child mental health problems and lower academic attainment even if daily average levels of alcohol consumption are low. Episodic binge pattern of drinking appears to be a risk factor for these outcomes, especially hyperactivity and inattention problems, in the absence of daily drinking. Electronic supplementary material The online version of this article (doi:10.1007/s00787-014-0599-7) contains supplementary material, which is available to authorized users.
    European Child & Adolescent Psychiatry 09/2014; 23(10). DOI:10.1007/s00787-014-0599-7 · 3.34 Impact Factor
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    • "Where one problem with the observational literature is that only a limited number of variables are controlled for, another reason for the ambiguity in the literature could be attributed to the division of the intake groups. The abstaining group is most often not subdivided on the basis of pre-pregnancy abstinence (Sayal, 2007; Kelly et al., 2009; Rodriguez et al., 2009; Sayal et al., 2013). However, one thorough study did report that the socio-economic profile of mothers in the pregnancyabstaining group was more advantaged than the all-time abstaining group (Kelly et al., 2012). "
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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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    ABSTRACT: The impact of low-to-moderate levels of alcohol consumption during pregnancy on child cognitive outcomes has been of recent concern. This study has tested the hypothesis that low-to-moderate maternal alcohol use in pregnancy is associated with lower school test scores at age 11 in the offspring via intrauterine mechanisms. We used data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a birth cohort study based in the South West of England. Analyses were conducted on 7062 participants who had complete data on: maternal and paternal patterns of alcohol use in the first trimester and at 18 weeks' gestation, child's academic outcomes measured at age 11, gender, maternal age, parity, marital status, ethnicity, household crowding, home ownership status and parental education. We contrasted the association of mother's alcohol consumption during pregnancy with child's National Curriculum Key Stage 2 (KS2) test scores with the association for father's alcohol consumption (during the time the mother was pregnant) with child's National Curriculum Key Stage 2 (KS2) test scores. We used multivariate linear regression to estimate mean differences and 95% confidence intervals [CI] in KS2 scores across the exposure categories and computed f statistics to compare maternal and paternal associations. Drinking up to 1 unit of alcohol a day during pregnancy was not associated with lower test scores. However, frequent prenatal consumption of 4 units (equivalent to 32 grams of alcohol) on each single drinking occasion was associated with reduced educational attainment [Mean change in offspring KS2 score was -0.68 (-1.03, -0.33) for maternal alcohol categories compared to 0.27 (0.07, 0.46) for paternal alcohol categories]. Frequent consumption of 4 units of alcohol during pregnancy may adversely affect childhood academic outcomes via intrauterine mechanisms.
    PLoS ONE 10/2013; 8(10):e74844. DOI:10.1371/journal.pone.0074844 · 3.23 Impact Factor
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