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Cognitive and behavioral sequelae of prenatal alcohol exposure (PAE) continue to be prevalent in the United States and worldwide. Because these sequelae are also common in other neurodevelopmental disorders, researchers have attempted to identify a distinct neurobehavioral profile to facilitate the differential diagnosis of fetal alcohol spectrum disorders (FASD). We used an innovative, individual participant meta‐analytic technique to combine data from six large U.S. longitudinal cohorts to provide a more comprehensive and reliable characterization of the neurobehavioral deficits seen in FASD than can be obtained from smaller samples. Meta‐analyses were performed on data from 2236 participants to examine effects of PAE (measured as oz absolute alcohol/day (AA/day)) on IQ, four domains of cognition function (learning and memory, executive function, reading achievement, and math achievement), sustained attention, and behavior problems, after adjusting for potential confounders using propensity scores. The effect sizes for IQ and the four domains of cognitive function were strikingly similar to one another and did not differ at school age, adolescence, or young adulthood. Effect sizes were smaller in the more middle‐class Seattle cohort and larger in the three cohorts that obtained more detailed and comprehensive assessments of AA/day. PAE effect sizes were somewhat weaker for parent‐ and teacher‐reported behavior problems and not significant for sustained attention. In a meta‐analysis of five aspects of executive function, the strongest effect was on set‐shifting. The similarity in the effect sizes for the four domains of cognitive function suggests that PAE affects an underlying component or components of cognition involving learning and memory and executive function that are reflected in IQ and academic achievement scores. The weaker effects in the more middle‐class cohort may reflect a more cognitively stimulating environment, a different maternal drinking pattern (lower alcohol dose/occasion), and/or better maternal prenatal nutrition. These findings identify two domains of cognition—learning/memory and set‐shifting—that are particularly affected by PAE, and one, sustained attention, which is apparently spared. We used an innovative, individual participant meta‐analytic technique to combine data from six large U.S. longitudinal cohorts to provide a more comprehensive and reliable characterization of the neurobehavioral deficits seen in FASD than can be obtained from smaller samples. Prenatal alcohol exposure (PAE) effects on cognitive function were stronger than for behaviour problems or sustained attention. This analysis identified two domains of cognition—learning/memory and set‐shifting—that are particularly affected by PAE, and one domain, sustained attention, which is spared.

Retrospective neuroimaging studies have suggested an association between early cannabis onset and later neurocognitive impairment. However, these studies have been limited in their ability to distinguish substance use risk factors from cannabis-induced effects on neurocognition. We used a prospective cohort design to test whether neurocognitive differences preceded cannabis onset (substance use risk model) and if early cannabis use was associated with poorer neurocognitive development (cannabis exposure model).

No prospective study of maternal alcohol use has focused on age at transition to motherhood as a predictor of trajectories of risky drinking. The goal of this study was to examine the impact of maternal age at first birth on trajectories of alcohol use beyond recommended levels over a 17‐year span. Pregnant women (N= 456) were recruited at an urban prenatal clinic. The women (13 to 42 years old; 64% African American, 36% White) were interviewed about alcohol use during pregnancy and at 6, 10, 14, and 16 years postpartum. Growth mixture modeling (GMM) was used to identify trajectories of risky drinking. Maternal age at first birth was then regressed onto trajectory class membership. The GMM on maternal alcohol use identified 3 groups of mothers as a function of alcohol use before, during, and after the pregnancy. The majority of mothers (66%) were identified as having low‐risk trajectories of alcohol use over the 17‐year span. However, 2 groups were in the higher‐risk categories, with 23% identified as being in a long‐term high‐risk trajectory, and 11% in a short‐term high‐risk trajectory group. Maternal age at first birth predicted membership in a high‐risk group: Younger mothers were more likely to be classified into a long‐term high‐risk alcohol use group. Younger mothers were more likely to engage in risky drinking early in pregnancy, continuing 6 to 14 years postpartum. These results can help physicians target mothers who are likely to exceed current NIAAA guidelines of abstinence during pregnancy, and no more than 7 drinks per week in the postpartum. These findings predict which women are more likely to exhibit risky drinking before, during and after a pregnancy, and ultimately, who is at greater risk of alcohol use disorder. Younger mothers and those who used marijuana during pregnancy were more likely to be long‐term high‐risk drinkers (see trajectory groups in Figure Maternal risky alcohol use trajectories.). These results can help physicians target the women most likely to exceed current NIAAA guidelines of abstinence during pregnancy and 7 drinks per week for non‐pregnant women.

This paper reviews results from published, in press, and conference proceedings from 2007 and 2008 that link in-utero tobacco exposure to neurodevelopmental outcomes in exposed offspring.

Background: Alcohol use and depression each adversely affect birth outcomes, but the impact of their co‐occurrence among pregnant women is not well understood. In this study, we examined factors associated with alcohol use, depression, and their co‐occurrence during pregnancy.

Background: The effects of prenatal alcohol exposure (PAE) on measures of intelligence have been well documented in children with fetal alcohol syndrome. However, deficits in general intellectual ability in children with low to moderate PAE are less well understood. The objective of this study was to assess the association between moderate PAE and cognitive ability in children at age 10 controlling for other prenatal and birth factors, maternal and child psychosocial factors, and environmental characteristics.

Background: High rates of comorbid depression and alcohol use disorders have been reported in epidemiological studies; little work has considered comorbidity in women during the perinatal period. The goal of this work was to identify prenatal factors (at each trimester) that predicted postpartum comorbid depressive symptoms and alcohol use in women.

The association between prenatal exposure to alcohol and growth is linear, and effects have been measured at levels of exposure that are considerably below one drink per day. Thus, with respect to growth deficits, there is no safe level of drinking during pregnancy. Alcohol exposure during gestation causes growth deficits among the offspring at birth and during infancy. At older ages, however, growth deficits are reported in some, though not all, studies. Exposed offspring who grow up in more privileged environments are apparently able to make up their growth deficits, while those raised in less optimal circumstances do not. This means that there is an interaction between the environment in which a child is raised and the expression of the effects of prenatal alcohol exposure. The long-term implications of growth deficits are not yet well understood. © 2004 Wiley-Liss, Inc.

Abstract: Background: This study investigated the effects of moderate prenatal alcohol exposure on learning and memory in 14‐year‐old adolescents. The Children's Memory Scale was used to assess learning and memory function in the verbal/auditory and visual/spatial domains. In addition, both short‐ and long‐term memory function were assessed.

Abstract: This article presents the proceedings of a workshop at the 2003 Research Society on Alcoholism meeting in Fort Lauderdale, Florida. The organizers and chairs were Vivian Faden and Nancy Day. The presentations were (1) Lessons Learned From the Lives Across Time Longitudinal Study, by Michael Windle and Rebecca Windle; (2) Methodological Issues in Longitudinal Surveys With Children and Adolescents, by Joel Grube; (3) The Pittsburgh ADHD Longitudinal Study: Methodological and Conceptual Challenges, by Brooke Molina, William Pelham, Elizabeth Gnagy, and Tracey Wilson; and (4) Lessons learned in Conducting Longitudinal Research on Alcohol Involvement: If Only I Had Known Before Hand! by Kristina Jackson and Kenneth Sher.

Using data from a longitudinal study of prenatal cocaine exposure, we demonstrate that women who use cocaine during pregnancy differ in demographic, substance use, and environmental characteristics from women who do not use cocaine. Each of these characteristics affects the child's development independent of cocaine exposure, and it is not appropriate to draw conclusions regarding the effects of cocaine use per se without taking into consideration the ways in which women who use cocaine differ from women who do not use. We present statistical examples where the effect of prenatal cocaine use was not significant after control for extraneous variables and examples where the effects remained significant after control. Thus, it is necessary to identify which variables are extraneous variables and to explore the effects of these variables on the findings. Failure to control for these variables can lead to inaccurate conclusions regarding the effects of prenatal cocaine exposure.

Background:This longitudinal study examines the effects of alcohol use during pregnancy on the growth and gestational age at birth of 413 offspring of adolescents.

The Maternal Health Practices and Child Development Project is a longitudinal study of the effects of prenatal exposure to alcohol and other substances. Women were selected from a prenatal clinic and interviewed at the 4th and 7th months of pregnancy. Their offspring were examined at delivery, at 8 and 18 months, and at 3, 6, and 10 years. This report examined 610 offspring, at age 10, who were exposed prenatally to alcohol. Most alcohol use in this low‐income cohort was light to moderate, although the entire spectrum of alcohol use is represented. The weight, length, head circumference, and skinfold thickness of the offspring were measured. At each assessment phase, we found a significant association between size and prenatal exposure to alcohol. At age 10, the children who were prenatally exposed to alcohol continued to be significantly smaller in weight, height, head circumference, and skinfold thickness. These results indicate that prenatal alcohol exposure has a long‐term impact on offspring growth.

• We present a first comprehensive description of the clinical features of patients with organic delusional syndrome. This description is based on information from 39 patients with organic delusional syndrome among 14 889 patients who presented for initial evaluation over a 5-year period at our institution. This description includes an enumeration of the common clinical symptoms of this syndrome and the respective prevalence and mean severity of each symptom. The severity of the symptoms of organic delusional syndrome are compared with those of schizophrenia to determine which symptoms distinguish between these two diagnostic categories. Patients with organic delusional syndrome demonstrated significantly more symptoms of "acquired intellectual impairment," "impaired sensorium," and "hallucinations of smell, taste, or touch," while schizophrenic patients demonstrated more "flat affect," "emotional coldness," and "thought disorganization." In addition, associated factors are presented concerning demographics, modes of treatment, level of functioning, and current physical problems associated with organic delusional syndrome.

Purpose. Little is known about the prevalence and patterns of smoking among pregnant teenagers. We provide a comprehensive description of the prevalence, patterns and correlates of smoking from a recent sample of 199 pregnant adolescents.

Neonatal EEG and sleep findings are presented from a longitudinal study of the effects of maternal alcohol and marijuana use during pregnancy. Infant outcome has been examined relative to the trimester(s) of pregnancy during which use occurred. Disturbances in sleep cycling, motility, and arousals were noted that were both substance and trimester specific. Alcohol consumed during the first trimester of pregnancy was associated with disruptions in sleep and arousal, whereas marijuana use affected sleep and motility regardless of the trimester in which it was used. Although these findings are preliminary and based on a small sample of women exhibiting only moderate substance use during pregnancy, they do suggest that specific neurophysiological systems may be differentially affected by prenatal alcohol or marijuana exposure even in the absence of morphological abnormalities. (Pediatr Res 24: 101–105, 1988)

ABSTRACT: Neonatal EEG and sleep findings are presented from a longitudinal study of the effects of maternal alcohol and marijuana use during pregnancy. Infant outcome has been examined relative to the trimester(s) of pregnancy during which use occurred. Disturbances in sleep cycling, motility, and arousals were noted that were both substance and trimester specific. Alcohol consumed during the first trimester of pregnancy was associated with disruptions in sleep and arousal, whereas marijuana use affected sleep and motility regardless of the trimester in which it was used. Although these findings are preliminary and based on a small sample of women exhibiting only moderate substance use during pregnancy, they do suggest that specific neurophysiological systems may be differentially affected by prenatal alcohol or marijuana exposure even in the absence of morphological abnormalities.

-We agree with Dr Mc- Kenna that research is begging in the field of organic delusional syndrome (ODS) and for organic brain syndromes in general. We also agree that phenomenologic descriptions of these syndromes based on empirical data are woefully lacking.This lack has crucial implications concerning proposed fundamental changes in the diagnostic classification system for the organic brain syndromes in the upcoming DSM-IV. Specifically, Spitzer et al1 have suggested that diagnostic categories such as ODS should be broken off from the traditional" group of organic brain syndromes (dementia, delirium, and amnestic disorder) to be reclassified in the major diagnostic class with which they share phenomenology. They have also suggested that the term symptomatic replace the term organic for these syndromes. For example, ODS would be grouped with the psychotic disorders in the DSM-IV rather than with the Organic brain syndromes, as is now the case, and would be