Peer-reviewed article
Clinical Features of Typically Developing Children with and without Prenatal Alcohol Exposure.
Philip A May, Barbara Tabachnick, Julie M Hasken, Anna-Susan Marais, Marlene M de Vries et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This study compared first-grade children with fetal alcohol spectrum disorders, children exposed to alcohol prenatally but developing typically, and unexposed children. Children with prenatal alcohol exposure showed physical differences in height, weight, and facial features compared to unexposed children, even when they met typical developmental norms. Cognitive and behavioral differences appeared when all three groups were compared together, but not between exposed and unexposed children who developed typically. The findings suggest that prenatal alcohol exposure affects child development across multiple domains.
Key points
- Exposed children without FASD diagnosis differed significantly from unexposed children in height, weight, BMI, and facial measurements
- Fewer male offspring were born to mothers who consumed 6 or more drinks per occasion during pregnancy
- Neurobehavioral differences appeared in three-group comparisons but not in direct two-group comparisons of typically developing exposed and unexposed children
- Trends in expected direction were observed for nonverbal IQ, attention, and growth measurements across exposure groups
- Physical and developmental differences persisted even after adjusting for socioeconomic factors
Limitations
The study does not specify which countries the data comes from or the sample size. The study cannot establish whether observed trends in cognitive and behavioral outcomes represent clinically meaningful differences or predict long-term outcomes beyond first grade.
Abstract
OBJECTIVE: To determine if prenatal alcohol exposure (PAE) affected physical and cognitive/behavioral outcomes in apparently typically developing, first-grade children. STUDY DESIGN: Three groups were compared: children with fetal alcohol spectrum disorders (FASD), children with PAE without FASD, and children without PAE. RESULTS: The 3 groups were significantly different on most physical traits and fewer neurodevelopmental traits. Two-group comparisons of exposed and unexposed, non-FASD groups were statistically different on: height, weight, body mass index (BMI), and palpebral fissure length. Neurobehavioral outcomes were significant in three-group, but not 2-group comparisons. Few sex differences were observed; however, sex ratios indicated fewer male offspring in first grade among women who consumed 6+ drinks per occasion during pregnancy. For weight, head circumference (OFC), BMI, rural residence, and drinking measures, mothers of exposed children without FASD were intermediaries between, and significantly different from, the other maternal groups. Adjusted for socioeconomic covariates, multivariate ANCOVA, three-group comparisons of the children were significantly different for cognitive/behavioral variables (P < .001); however, 2-group neurobehavior comparisons for children without FASD were not significant (P ≥ .05). Physical trait multivariate ANCOVA comparisons of the non-FASD groups were significant only for weight (P < .004) when tested univariately and through stepdown analysis. Socioeconomic-adjusted trend plots were in the expected direction for nonverbal IQ, attention, height, weight, OFC, palpebral fissure length, and total dysmorphology score. CONCLUSIONS: Even when meeting developmental norms, children with PAE exhibited trends of poorer growth and cognitive/behavioral traits than children without PAE. These findings support the notion that abstinence during pregnancy is best.