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Objective. Evidence that mothers report higher levels of drinking retrospectively than during pregnancy has led some investigators to suggest that women systematically underreport alcohol antenatally and that alcohol-related deficits may actually reflect heavier prenatal exposure. This study is the first to compare the validity of antenatal and retrospective reports of pregnancy drinking, drug use, and smoking in relation to effects on infant neurobehavioral outcomes. Methodology. Three hundred fifty-four inner-city mothers were interviewed regarding their alcohol, drug use, and smoking during pregnancy and retrospectively at 13 months' postpartum. Their infants were assessed at 6.5, 12, and 13 months on a large battery of neurobehavioral assessments. Results. Although higher levels of alcohol were reported retrospectively, the correlations of prenatal alcohol exposure with infant outcome were as strong or stronger for the antenatal measures and only the antenatal reports predicted poorer cognitive performance on the Bayley Scales and symbolic play, slower processing speed on the Fagan Test of Infant Intelligence and cross-modal transfer, and slower infant reaction time. Women also reported higher levels of cocaine and marijuana but not cigarette smoking retrospectively. Relations between cocaine use and smoking on birth size and gestational age were as strong for either report. No effects were detected in relation to either report of marijuana use during pregnancy. Conclusions. These findings suggest that antenatal alcohol interviews provide the most valid information and demonstrate the importance of assessing prenatal alcohol use during pregnancy to minimize the risk of failing to detect neurobehavioral deficits. Adverse effects were consistently seen at levels as low as 0.5 oz absolute alcohol/day (the equivalent of 7 drinks per week) based on maternal antenatal report. These data suggest that alcohol-related deficits do not reflect heavier prenatal exposure than that reported during pregnancy and that threshold values derived :from antenatal reports are reasonably accurate. Pediatrics 2002;109:815-825; alcohol, cocaine, smoking, infant development, prenatal exposure., The growth in research on the effects of prenatal exposure to alcohol and drugs on infant and child development has led to an increased concern with how accurately alcohol and [...]

Breast-feeding provides both nutritional and medical benefits, such as protection against infection and allergy. The incidence of breast-feeding increased between 1965 and 1985, primarily among white, older, and married women and those with some college education as compared with mothers who did not complete high school, had a low income, or belonged to an ethnic minority group. The incidence of breast-feeding declined by 1989, particularly among black women. Most studies have examined the influence of demographic factors and attitudes on the decision to breast-feed. One study showed that breast-feeding mothers scored higher than mothers who fed their infants by bottle on tests of intelligence, and also provided a more enriched and less authoritarian home environment. A healthy ego is also important in the relation between a mother and infant and development of feelings of nurturance, empathy, and enjoyment of children. The effects of cognitive ability and personality characteristics on the decision to breast-feed were assessed among 137 black inner-city mothers and 50 predominantly white mothers. Breast-feeding was chosen by 21.9 percent of black women and 58 percent of white subjects. Breast feeding was associated with high levels of ego and intellect, as determined by standardized tests of these variables. Women with a mature ego may have stronger feelings of empathy or nurturance, increased awareness of medical benefits of breast-feeding, and be less influenced by social trends associated with a decline in breast-feeding. These features may be more prevalent among white middle class women than black inner-city mothers. (Consumer Summary produced by Reliance Medical Information, Inc.)

BACKGROUND: Although both fetal and long-term growth restriction are well documented in fetal alcohol spectrum disorders, effects on pattern of growth trajectory have not been characterized. Furthermore, the degree to which growth trajectories are related to fetal alcohol-related neurocognitive deficits is unknown. METHODS: Ninety-three heavy drinking pregnant women and 64 controls were recruited at initiation of prenatal care in Cape Town, South Africa. Small for gestational age (SGA) was defined as birth weight <10th percentile. Length/height, weight, and head circumference were measured at 6.5 and 12 months and 5, 9, and 13 years. Four growth trajectories were identified: SGA with long-term postnatal growth restriction (length/height-for-age <10th percentile through 13 years); SGA with catch-up growth; no SGA or postnatal growth restriction; and late-onset postnatal stunting. IQ was assessed at 5 and 10 years, and learning, memory, and executive function at 10 years. RESULTS: Children born SGA with postnatal growth restriction were most heavily exposed. Exposure was intermediate for those born SGA with catch-up growth and lowest for those without prenatal or postnatal growth restriction. Effects on neurocognition were strongest in children with both prenatal and long-term growth restriction, more moderate in those with fetal growth restriction and postnatal catch-up, and weakest in those without growth restriction. CONCLUSIONS: These findings validate the use of growth restriction in the diagnosis of fetal alcohol spectrum disorders and identify growth trajectory as a biomarker of which heavily exposed children are at greatest risk for cognitive developmental deficits. [ABSTRACT FROM AUTHOR]