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Background The association between fetal exposure to alcohol and congenital structural disorders remains inconclusive. The present study searched for relationships between maternal alcohol consumption during pregnancy and the risk of congenital malformations. Methods We evaluated the fixed dataset of a large national birth cohort study including 73,595 mothers with a singleton live birth. Information regarding the alcohol consumption of mothers was obtained from self-reported questionnaires. Physicians assessed for 6 major congenital malformations (congenital heart defects [CHDs], male genital abnormalities, limb defects, cleft lip and/or cleft palate [orofacial clefts (OFC)], severe brain abnormalities, and gastrointestinal obstructions) up to 1 month after birth. Multiple logistic regression analysis was performed to identify associations between maternal alcohol consumption during pregnancy and each malformation. Results The prevalence of maternal drinking in early pregnancy and until the second/third trimester was 46.6% and 2.8%, respectively. The onset of CHD was inversely associated with mothers who quit drinking during early pregnancy (OR 0.85, 95% CI 0.74–0.98). There was no remarkable impact of maternal drinking habit status on the other congenital malformations after adjustment for covariates. Conclusions Maternal alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital malformations of interest. Impact This large-scale Japanese cohort study revealed that no teratogenic associations were found between maternal retrospective reports of periconceptional alcohol consumption and congenital malformations after adjustment for covariates. This is the first nationwide birth cohort study in Japan to assess the effect of maternal alcohol consumption during pregnancy on major congenital malformations. Our finding indicated that maternal low-to-moderate alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital heart defects, male genital abnormalities, limb defects, orofacial clefts, severe brain abnormalities, or gastrointestinal obstructions.

Introduction: Maternal alcohol consumption during pregnancy and its effects on the developing fetus are a serious global healthcare issue. The damage caused by alcohol goes far beyond mother’s health and spreads to the child’s physical and mental health. Aim of Review: Analysis of existing approaches in organizing the necessary rehabilitation programs and preventing the consequences of drinking alcohol during pregnancy, assessing the potential socio-economic effect of organizing comprehensive prevention of fetal alcohol syndrome (FAS) and fetal-alcohol spectrum of disorders (FASD). Materials and Methods: Children with FAS and influence of consequences of FAS/FASD on the nation’s material well-being conducted in Russia and abroad were analyzed by studying various published literature. Necessary rehabilitation measures for children with FAS/FASD were identified; analyzed international studies on the economic implications of the FAS/FASD; economic costs for medical and correctional services for children with FAS/FASD in Russia were assessed. Results: This review found that the Not all children with FAS/FASD are mentally retarded, they have behavioral disorders and the development of the emotional-volitional sphere is significantly behind the age norms. So, at 10-12 years of age, these children are still not contractual and cannot remain without adult supervision even for several hours. They require ongoing parental or tutor support. The range of disorders in fetal alcohol syndrome is very diverse, therefore, each child requires an individual approach in the formation of a rehabilitation program, which significantly increases costs in general and requires the involvement of highly qualified specialists. Conclusion: There is a need for additional economic calculations to scale up a comprehensive prevention program throughout the country. It is also important to note that the implementation of preventive measures does not eliminate the need for organizing assistance programs for families raising children with FAS/FASD.

In this study, we aimed to explore regional differences in maternal lifestyle during pregnancy related to congenital heart defects (CHD) in Shaanxi province, Northwestern China. A large-scale epidemiologic survey of birth defects among infants born during 2010–2013, was conducted in Shaanxi province. Non-spatial and geographic weighted logistic regression models were used for analysis. The spatial model indicated that passive smoking frequency was positively associated with CHD for 43.3% of participants (P P P

Background Fetal alcohol spectrum disorder (FASD) is a leading cause of neurodevelopmental disorders. Children in foster care or domestically adopted are at greater risk for FASD. The aim of this study was to determine the prevalence or risk for FASD in a selected population of foster and adopted children. Methods Children between 2 and 12 years who were candidates for adoption in foster care were evaluated for clinical manifestations and historical features of fetal alcohol spectrum disorder based on established criteria for FASD. Results Of the 89 children evaluated, 18 had mothers with a confirmed history of alcohol consumption during pregnancy. Two children had fetal alcohol syndrome and one had partial fetal alcohol syndrome. In addition, five had alcohol-related neurodevelopmental disorder, one had alcohol-related birth defects, and a single child had manifestations of both. Of the 71 children in which fetal alcohol exposure could not be confirmed, many had manifestations that would have established a diagnosis of FASD were a history of maternal alcohol consumption obtained. Conclusions In a population of high-risk children seen in an adoption clinic, many had manifestations associated with FASD especially where prenatal alcohol exposure was established. The reported prevalence in this study is higher than that reported in our previous study of younger children. This is most likely due to the higher number of children diagnosed with alcohol-related neurodevelopmental disorders that typically manifest at an older age.

Aim: To investigate maternal alcohol intakes before and during pregnancy, their impact on mothers and infants to 18 months. Method: Prospective study of 504 New Zealand volunteers visited in months 4 and 7 of pregnancy, measurements taken, lifestyle details recorded including alcohol intake before and during pregnancy. Eighteen months after birth, 370 infants were measured, and infant development recorded. Results: Nineteen per cent of mothers never drank, 53% stopped when they knew they were pregnant, 29% continued to drink. Twenty-two per cent of drinkers binge drank (over 50 g alcohol per session) before pregnancy and 10% during pregnancy. Daily drinking was associated with increased obesity in mothers. Alcohol consumption before or during pregnancy was not associated with infant motor development, had a slight negative effect on growth, and a significant association with vocal ability to 18 months. Energy intake appeared to partially moderate this effect. Conclusion: Maternal alcohol consumption exceeding 50 g per session both before and during pregnancy was associated with decreasing vocal ability in the 18-month old infant.

Given the high rate of alcoholism throughout history, its effects on the fetus may have existed for millennia. But, the claim that Greeks and Romans were aware of fetal alcohol syndrome rests on incorrect citations. From 1725, maternal alcohol consumption was associated with retarded fetal growth and neurological anomalies. From 1809, scientists followed Lamarck’s theory that the disorders parents acquire during their lifetime are passed on to their offspring. Fetal effects were thought to be inherited mainly from the father. During the 19th century, parental alcoholism became associated with malformations. In 1915, Ballantyne distinguished genetic influence via germ cells from toxin’s effect on the embryo. Fetal alcohol syndrome was characterized by Rouquette [Influence de la toxicomanie alcoolique parentale sur le développement physique et psychique des jeunes enfants] in 1957 and Lemoine et al. [Ouest Medical. 1968;21:476–482] in 1968 as consisting of 4 features: (A) facial anomalies (narrow forehead, retracted upper lip, and cupped ears), (B) severe growth retardation (prenatal and postnatal), (C) malformations (limbs, cardiac, and visceral), and (D) central nervous system anomalies (hyperexcitability and mental retardation). But, their studies, written in French, remained disregarded. In 1973, Jones et al. [Lancet. 1973;302:999–1001] reported “the first association between maternal alcoholism and aberrant morphogenesis in the offspring.” The history of fetal alcohol syndrome reveals shortcomings in citation practice. Alleged quotations remained unverified, non-English publications neglected, and short quotations taken out of context. Prejudiced by religious and abstinence groups, reports on alcohol damage to the unborn were fraught with emotions, moralizing, social implications, and presentism, the interpretation of past events with present knowledge.

Our aim was to evaluate the possible correlation between maternal alcohol consumption during the first trimester and the risk of having an offspring with non-syndromic oral cleft. We electronically searched all published papers from 1950 to 2019 about maternal alcohol consumption and oral clefts in PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Institute for Scientific Information (ISI) databases. Descriptive and quantitative data were extracted from eligible studies for systemic evaluation and meta-analysis. A total of 12 publications met our inclusion criteria, and nine of them presented sufficient data for quantitative analyses. The overall odds ratio of the nine reports was 1.00 (95% CI 0.87 to 1.15) for cleft lip with or without cleft palate (CL/P) and 1.02 (95% CI 0.92 to 1.14) for cleft palate only, indicating no significant difference between drinking and non-drinking mothers in the risk of having a child with a non-syndromic oral cleft. We found no confirmatory evidence for the presence of a dose-response relation between alcohol consumption and increase in the risk of oral cleft. Nevertheless, four of the studies enrolled found significantly increased risk of CL/P among mothers in the groups that consumed the most alcohol. All but one of the four studies suggested a positive correlation between binge drinking and the occurrence of non-syndromic oral cleft. Although we found no concrete correlation between mild alcohol consumption during pregnancy and the occurrence of non-syndromic oral cleft, precautions should still be taken to avoid binge drinking during the first trimester.

Households experiencing intimate partner violence (IPV) and food insecurity are at high risk of lifelong physical and behavioral difficulties. Longitudinal data from a perinatal home-visiting cluster-randomized controlled intervention trial in South Africa townships were used to examine the relationships between household settings and mothers' histories of risk and children's behavior problems at 3 and 5years of age. IPV, food insecurity, maternal depressed mood, and geriatric pregnancy (at age of 35 or older) were consistently associated with children's internalizing and externalizing behavior problems. Aggressive behavior was more prevalent among 3- and 5-year olds boys, and was associated with maternal alcohol use. The effects of these factors on child behavior were more prominent than maternal HIV status. There is a continuing need to reduce IPV and household food insecurity, as well as supporting older, depressed, alcohol using mothers in order to address children's behavioral needs.

Background Exposure to early adversity has been associated with long-lasting risks for poor health and functioning. Prior research suggests that the hypothalamic-pituitary-adrenal (HPA) axis, and its main end-product glucocorticoid hormone cortisol, may be at play. This study tested whether an index of cumulative socioeconomic and psychosocial adversity assessed prospectively, from infancy to adolescence, was associated with hair cortisol concentration (HCC), and if this association differed by sex. Methods The sample comprised 556 adolescents (42.0% males) who provided hair for cortisol measurement at 17 years of age. Adversity indicators (young and single motherhood, low socioeconomic status (SES), maternal alcohol use, hostile-reactive parenting, and depressive symptoms, as well as peer victimization and neighborhood dangerousness) were repeatedly reported by mothers or youths between the ages of 5 months and 15 years. Results Chronic adversity was non-linearly associated with HCC; youth exposed to lower and higher levels of adversity had moderate-to-higher HCC compared to lower HCC noted in participants with moderate levels of adversity, for both males and females. None of the indicators taken separately, except the perception of neighborhood dangerousness, were significantly associated with HCC. Conclusion Our findings support the hypothesis that HPA axis activity varies according to cumulative adversity, albeit non-linearly, which may bear consequences for later health and functioning.

This chapter overviews current scientific evidence on the impact of maternal alcohol consumption on human milk composition and breastfeeding, including observational, experimental, and animal studies in the field. Specifically, the chapter includes four sections summarizing: (1) factors that influence the variability of alcohol in human milk; (2) current recommendations on the collection, storage, and management of human milk with regard to alcohol use; (3) methodological and analytical approaches, challenges, and recommendations; and (4) research gaps and recommendations for future research in the field. Taken together, this review highlights an emerging body of evidence on maternal alcohol consumption and its impact on human milk composition and processing. Moreover, significant knowledge gaps are identified across all areas reviewed, underscoring important directions for future research in the field.

Objectives Prenatal intake of alcohol and tobacco have been associated with negative outcomes in children. Consumption of alcohol while breastfeeding has also been associated with dose-dependent decreases in abstract reasoning ability and academic scores in children at later ages. Using longitudinal data from The Growing Up in Australia Study, the current study aimed to investigate whether intake of alcohol or tobacco while breastfeeding was related to later developmental health outcomes in children. Results Multivariable linear regression analyses were performed on a sample of 2008 babies who were actively breastfeeding at study entry and 4679 babies who had been breastfed at any time (actively breastfed babies combined with babies who had been previously breastfed). Only a diagnosis of Autism spectrum disorder and Attention deficit disorder were associated with lower developmental health outcomes. Neither maternal alcohol consumption nor tobacco smoking while breastfeeding were associated with developmental health outcomes at 6–7 years old or 10–11 years old for either sample group. A relationship between maternal consumption of alcohol or tobacco smoking while breastfeeding and later developmental health outcomes in children was not identified.

Aim: We aim to assess oculomotor behaviour in children adopted from Eastern Europe, who are at high risk of maternal alcohol consumption. Methods: This cross‐sectional study included 29 adoptees and 29 age‐matched controls. All of them underwent a complete ophthalmological examination. Oculomotor control, including fixation and saccadic performance, was assessed using a DIVE device, with eye tracking technology. Anthropometric and facial measurements were obtained from all the adopted children, to identify features of foetal alcohol spectrum disorders (FASD). Fixational and saccadic outcomes were compared between groups, and the effect of adoption and FASD features quantified. Results: Oculomotor performance was poorer in adopted children. They presented shorter (0.53 vs 1.43 milliseconds in the long task and 0.43 vs 0.82 in the short task) and more unstable fixations (with a bivariate contour ellipse area of 27.9 vs 11.6 degree2 during the long task and 6.9 vs 1.3 degree2 during the short task) and slower saccadic reactions (278 vs 197 milliseconds). Children with sentinel finding for FASD showed the worst oculomotor outcomes. Conclusion: Children adopted from Eastern Europe present oculomotor deficits, affecting both fixation and saccadic skills. We highlight prenatal exposure to alcohol as the main cause for these deficits.

Objective: Fetal alcohol spectrum disorder (FASD) is a medical term used to describe a range of mental and physical disabilities caused by maternal alcohol consumption. The role of alcohol as a teratogen and its effects on the cellular growth of the embryo and the fetus were not determined on scientific grounds until the late 1960s. However, the link between alcohol use during pregnancy and its harms to offspring might have been observed frequently over the many thousands of years during which alcohol has been available and used for social and other reasons. Methods and Results: Using sources ranging from the biblical Book of Judges (pre-1700) up until the first public health bulletin (1977), we seek to provide an overview of the academic debate around early historical accounts ostensibly attributed to the awareness of alcohol as a prenatal teratogen as well as to describe the social and political influences that sculpted developments leading to the public recognition of FASD. Conclusions: Our analysis provides a brief overview of the discourse regarding historical awareness of the detrimental effects of prenatal alcohol exposure on fetal development leading to the formal recognition of FASD as a distinct clinical entity. Further research will be required to fully appreciate the scientific, medical, and societal ills associated with prenatal alcohol exposure.

Objective:Fetal Alcohol Spectrum Disorder (FASD) is a preventable disorder caused by maternal alcohol consumption and marked by a range of physical and mental disabilities. Although recognized by the scientific and medical community as a clinical disorder, no internationally standardized diagnostic tool yet exists for FASD.Methods and Results:This review seeks to analyse the discrepancies in existing diagnostic tools for FASD, and the repercussions these differences have on research, public health, and government policy.Conclusions:Disagreement on the adoption of a standardised tool is reflective of existing gaps in research on the conditions and factors that influence fetal vulnerability to damage from exposure. This discordance has led to variability in research findings, inconsistencies in government messaging, and misdiagnoses or missed diagnoses. The objective measurement of the timing and level of prenatal alcohol exposure is key to bridging these gaps; however, there is conflicting or limited evidence to support the use of existing measures.

Background The early stage of embryo development is extremely vulnerable to various teratogenic factors, leading to congenital anomalies. In Ethiopia, a significant number of babies are born with congenital anomalies, but the risk factors for the anomalies have never been studied. Understanding the specific risk factors for congenital anomalies is very essential to provide health education that aims at creating awareness and establishing preventive strategic plan/s. The main objective of this study was to assess the risk factors associated with congenital anomalies in Addis Ababa and the Amhara Region, Ethiopia. Methods A case-control study was conducted from January 1- June 30, 2015. The participants were recruited at the purposively selected hospitals in Addis Ababa and the Amhara Region. A total of 207 cases and 207 controls were included in the study. Cases were neonates, infants, and children 0-11 months of age with external and internal major congenital anomalies diagnosed by pediatricians. Controls were neonates, infants, and children 0-11 months of age without external and internal anomalies. Data on sociodemographic characteristics, exposure to risk factors, and reproductive history were collected by face to face interviews with children’s mothers/caregivers using a structured questionnaire. Binary logistic regression was employed to explore risk factors associated with the occurrence of the problems. Results About 87.4% of the children were below 6 months, and 12.6% were between 6 and 11 months. The majority (59.9%) of the children were male, with the M: F sex ratio of 1.49. The mean age of the mothers was 26 years (16-45 years). Unidentified medication use during early pregnancy (AOR = 4.595; 95% CI: 1.868-11.301, P-value = 0.001), maternal alcohol drinking (AOR = 2.394; 95% CI: 1.212-4.726, P-value = 0.012), and exposure to chemicals (AOR = 9.964; 95% CI = 1.238-80.193, P-value = 0.031) were significantly associated with the occurrence of congenital anomalies. Iron folate use (AOR = 0.051; 95% CI: 0.010-0.260, P-value =

Alcohol is a teratogenic agent that can cause a wide range of developmental disorders, and sometimes, the effects persist throughout an individual's lifetime. Researchers have shown the involvement of epigenetic mechanisms in alcohol-mediated disorders. Non-coding RNAs are one of the major sources of epigenetic modifications, especially microRNAs. The association of microRNAs with alcohol consumption leads to a new focus on finding the molecular mechanisms of alcohol toxicity. It has been suggested that alcohol alters the relative expression of microRNAs and regulates target mRNA expression in both in vitro and in vivo models. Currently, we lack information regarding the relationship between altered microRNA expression and disease phenotypes in alcohol-mediated disorders. In this review, we tried to gather all of the available information about the alcohol-mediated dysregulation of microRNA expression in utero. We hope that our efforts will help future researchers identify major microRNAs in the field of prenatal alcohol toxicity and related therapeutics.

Empirical evidence suggests maternal behavioral health problems are significant predictors of child behavioral health difficulties, but it is unclear of the specific relation of maternal alcohol use problems and depression symptoms with child internalizing and externalizing behavior problems. The purpose of the study is to examine the impact of maternal depression symptoms and alcohol use problems on children’s internalizing and externalizing behavior problems over a period of 5 years. Implications for intervention may differ depending on which type of maternal behavioral health concerns predicts which child behavior problem. A total of 1874 families eligible for Early Head Start participated. Maternal depression symptoms and alcohol use problems were assessed when children were in preschool, and internalizing and externalizing behavior problems were assessed when children were in fifth grade. Clinical internalizing behavior problems was best predicted by maternal depression symptoms, whereas clinical externalizing behavior problems was best predicted by maternal alcohol use problems. Children were almost twice as likely to have clinical internalizing behavior problems when mothers exhibited very elevated depression symptoms compared to when mothers displayed minimal symptoms. A similar relation was found with maternal alcohol use problems and clinical externalizing behavior problems. Our findings highlight the importance of understanding and treating various kinds of behavioral health concerns in mothers of young children.

Fetal alcohol spectrum disorders (FASD) are caused by maternal alcohol consumption during pregnancy. They result in varied developmental and behavioral deficits. Often raised in suboptimal conditions, children with FASD face extra stresses during postnatal development. Maternal separation frequently follows, with many children entering childcare systems including unstable foster placements. This instability has the potential to cause more stress that may impact behavioral outcomes. Using our mouse model, we show that prenatal alcohol exposure combined with postnatal maternal separation results in specific learning deficits. Our results show that more research and attention toward the postnatal environment is necessary, not only for children diagnosed with FASD, but for all children. It supports the proposition that the postnatal environment has the potential to contribute to behavioral outcomes for all children.

Maternal alcohol consumption during pregnancy can significantly impact the developmental trajectory of the offspring, resulting in lifelong alterations to brain anatomy, function, and behavior. Fetal alcohol spectrum disorders (FASD) is an umbrella term used to describe the range of phenotypes that are observed in children who have been exposed to alcohol during the prenatal period. In this chapter, we highlight details from research focused on identifying alcohol’s effects on the developing brain and the mechanisms through which alcohol alters brain development. This chapter provides a discussion of the results from structural and functional brain imaging studies that reveal broad changes in anatomy and function of the brain in FASD patients as well as important data from animal research studies that address potential mechanisms underlying alcohol’s damaging effects.

Maternal alcohol consumption during pregnancy can lead to a wide range of physical and neurodevelopmental problems, collectively known as fetal alcohol spectrum disorders (FASD). In many cases, diagnosis is heavily reliant on the recognition of a set of characteristic facial features, which can be subtle and difficult to objectively identify. To provide an automated and objective way to quantify these features, this paper proposes to take advantage of high-resolution 3D facial scans collected from a high-risk population. We present a method to automatically localize anatomical landmarks on each face, and align them to a standard space. Subsequent surface-based morphology analysis or anatomical measurements demands that such a method is both accurate and robust. The CNN-based model uses a novel differentiable spatial to numerical transform (DSNT) layer that could transform spatial activation to numerical values directly, which enables end-to-end training. Experiments reveal that the inserted layer helps to boost the performance and achieves sub-pixel level accuracy.

We hypothesized that maternal alcohol use occurs in pregnancies that end prematurely and that in utero alcohol exposure is associated with an increased risk of morbidities of premature newborns.In an observational study of mothers who delivered very low birth weight newborns (VLBW) ≤1,500 g, maternal alcohol use was determined via a standardized administered questionnaire. We compared the effect of maternal drinking on the odds of developing late-onset sepsis (LOS), bronchopulmonary dysplasia (BPD), death, BPD or death, days on oxygen or any morbidity (either LOS, BPD or death). The effect of drinking amounts (light versus heavy) was also evaluated.A total of 129 subjects who delivered 143 VLBW newborns were enrolled. Approximately 1 in 3 (34%) subjects reported drinking alcohol during the first trimester ("exposed"). Within the exposed group, 15% reported drinking ≥7drinks/week ("heavy") and 85% of the subjects reported drinking7drinks/week ("light"). When controlling for maternal age, drug or tobacco use during pregnancy and neonatal gestational age, any drinking increased the odds of BPD or death and any morbidity. Furthermore, light or heavy drinking increased the odds of BPD or death and any morbidity, whereas heavy drinking increased the odds of LOS.In utero alcohol exposure during the first trimester occurred in 34% of VLBW newborns. Maternal drinking in the first trimester was associated with significantly increased odds of neonatal morbidity. Further studies are warranted to determine the full effect of in utero alcohol exposure on the adverse outcomes of VLBW premature newborns.

Background Exposure of alcohol and/or other addictive drugs in pregnancy is a documented risk factor for later neurological impairment. Aims The aim of the study was to determine whether infants suffering from prenatal exposure to addictive drugs and alcohol develop an abnormal motor behaviour at three to four months of age. Study design Controlled cohort study of infants exposed to alcohol and/or other addictive drugs in pregnancy who were recruited from a hospital follow-up programme. The control group consisted of healthy, unexposed infants. Subjects The study group of 108 infants exposed to alcohol and/or addictive drugs in pregnancy were enrolled based on referrals from primary health care. The control group included 106 infants who had not been exposed to the aforementioned substances. Outcome measures We assessed the general movements (Prechtl’s General-Movement-Assessment, GMA), the motor repertoire (Assessment-of-Motor-Repertoire, AMR), and the Alberta-Infant Motor-Scale (AIMS) in all infants at three to four months of age. Results None of the infants in either group had absent fidgety movements (FMs). In the study group 5(5%) had exaggerated FMs and 5(5%) had sporadic FMs; and 68(63%) infants in the study group displayed an abnormal movement character, compared to 23(22%) in the control group (p

Issue addressed The aim of this study was to assess potential barriers to the implementation of clinical guideline recommendations regarding maternal alcohol consumption by antenatal clinicians and managers. Methods Cross-sectional surveys of antenatal clinicians and managers employed in a New South Wales Local Health District were undertaken. Survey items were developed based on 11 domains of the Theoretical Domains Framework. Consistent with previous studies, a cut point of less than 4 was applied to mean values of survey items (range: 1-5) to identify domains representing barriers to the implementation. Results Thirty-three antenatal clinicians and eight managers completed the surveys. For clinicians, the domains with the lowest mean values included "environmental context and resources" (ie, complexity of appointments and availability of supporting systems) (mean: 3.13, SD: 0.93); "social influences" (ie, expectations of others that alcohol will be addressed) (mean: 3.33, SD: 0.68); "beliefs about capabilities" (ie, confidence in providing guideline recommendations) (mean: 3.51, SD: 0.67); and "behavioural regulation" (ie, planning and responding to feedback) (mean: 3.53, SD: 0.64). For managers, "emotion regulation" (ie, stress in managing change) (mean: 2.13, SD: 0.64) and "environmental context and resources" (ie, complexities of managing change) (mean: 3.13, SD: 0.83) were the lowest scoring domains. Conclusions The antenatal service environment and availability of resources appear to be primary barriers to both clinicians and managers implementing guidelines for maternal alcohol consumption. SO WHAT?: In the development of interventions to support the delivery of clinical guideline recommendations addressing alcohol consumption during pregnancy, a broad range of potential barriers at both the clinician and manager levels need to be considered and targeted by effective implementation strategies.

Several members of our research team read with interest the recent article by Gibson and Porter,1 entitled “Drinking or Smoking While Breastfeeding and Later Cognition in Children.” The authors suggest that this is the first article to report an association between maternal drinking during the period of breastfeeding and cognitive performance in children aged 6 to 7 years. They found a significant association between “increased or riskier… maternal alcohol consumption” in a child’s first year of life and child cognition as measured … E-mail: philip_may{at}unc.edu

To evaluate the relation between caregiver exposure to toxics during pregnancy and childhood and the child’s cognitive function in Lebanese children. This was a cross-sectional study conducted on Lebanese students in public and private schools from November 2017 to May 2018, enrolling 464 children. A first linear regression, taking the Cattell total score as the dependent variable and taking sociodemographic characteristics and the family history of the child as independent variables, showed that higher age (Beta = 1.65) was significantly associated with higher cognition, whereas a history of eczema in any of the parents (Beta = −7.32) was significantly associated with lower cognition in the child. A second linear regression, taking the Cattell total score as the dependent variable and taking sociodemographic characteristics and the family history of the child, and the exposure to toxics as independent variables, showed that maternal alcohol intake during pregnancy (Beta = −1.07) and detergent mixing (Beta = −1.48) were significantly associated with lower cognition in the child. A third linear regression, taking the Cattell total score as the dependent variable and taking sociodemographic characteristics and the family history of the child, the exposure to toxics and the diseases in the child as independent variables, showed that maternal alcohol intake during pregnancy (Beta = −1.07) and detergent mixing (Beta = −1.45) were significantly associated with lower cognition in the child, whereas a history of eczema in the child before the age of 2 years (Beta = 8.72) was significantly associated with higher cognition in the child. This study is the first to examine the association of a child’s prenatal exposure and their exposure during childhood to environmental toxicants with their cognitive function in Lebanon. We consider this study to be important as it shows the possible effect of cleaning products mixing and maternal alcohol consumption on cognitive functions among children in Lebanon.

Past cross-sectional research suggests that zero-tolerance messaging by parents of college students may be more effective than harm-reduction communication at reducing student alcohol risk. The current study employs longitudinal data to examine whether communication type interacts with student alcohol use to predict subsequent drinking outcomes. U.S. college students reported on their own exposure to zero-tolerance and harm-reduction maternal communication. Approximately seven months later, students completed measures of maternal alcohol approval and their own alcohol behaviors. The relationship between communication and subsequent alcohol behaviors depended on students' baseline drinking. For heavy drinkers, harm-reduction communication was associated with less alcohol use and consequences. For those who drank less than two drinks a week, zero-tolerance communication was associated with fewer negative consequences. Zero-tolerance communication was associated with perceiving mothers as less approving, while harm reduction communication was associated with perceiving mothers as more approving. There were indirect effects of communication on drinking through perceived maternal approval. While overall harm-reduction communication may lead students to perceive mothers as more approving of alcohol use, there may be contexts in which this type of communication is beneficial.

Prenatal alcohol exposure (PAE) can result in a range of anomalies including brain and behavioral dysfunctions, collectively termed fetal alcohol spectrum disorder. PAE during the 1st and 2nd trimester is common, and research in animal models has documented significant neural developmental deficits associated with PAE during this period. However, little is known about the immediate effects of PAE on fetal brain vasculature. In this study, we used in utero speckle variance optical coherence tomography, a high spatial- and temporal-resolution imaging modality, to evaluate dynamic changes in microvasculature of the 2nd trimester equivalent murine fetal brain, minutes after binge-like maternal alcohol exposure. Acute binge-like PAE resulted in a rapid (

Purpose: The Centers for Disease Control and Prevention has experienced a rough ride in the wake of new public health outreach defining “any alcohol use by women who are pregnant or might be” as drinking too much. Since half of US pregnancies are unplanned and effects of fetal alcohol exposure can be devastating, the guidance recommends that all women planning a pregnancy or not using reliable contraception abstain from alcohol. The CDC guidance presumes women who desire a pregnancy in the near term will abstain. We aimed to test this …

Prenatal exposure to alcohol has adverse ramifications on foetal development resulting in developmental abnormalities and major congenital anomalies. Experimental studies have documented effects on kidney structure and function among offspring exposed to alcohol during foetal life; however, human evidence is scarce. Thus, the present study aimed to determine the development of CKD among a cohort of 30-year-old Australian offspring whose mothers reported consumption of alcohol during pregnancy. The study sample comprised 1626 offspring of the birth the Australia cohort study (MUSP) who serum creatinine was assessed at 30 years old and CKD was categorised from stage 1 to stage 5 based on their level of eGFR following the CKD-EPI definition. Seven percent (n = 111) of offspring had mild to moderate (stage 2 and 3) CKD at 30 years. The overall adjusted odds of CKD were 2.01 (95% CI 0.97 to 4.13) for offspring of moderate to heavy drinking mothers in late pregnancy, 1.60 (0.70 to 3.37) for early pregnancy and 1.18 (0.72 to 1.94) for pre-pregnancy. The association was higher for female offspring-2.69 (1.02 to 7.14) for late pregnancy and 2.95 (1.12 to 7.80) for early pregnancy. Higher but insignificant odds were found for male offspring at late pregnancy 1.44 (0.46 to 4.47) only. Maternal alcohol exposure during early and late pregnancy is associated with development of mild to moderate CKD in their offspring at 30 years. This association is stronger for female than male offspring.