Kelly, Yvonne, Sacker, Amanda, Gray, Ron, Kelly, John, Wolke, Dieter and Quigley, Maria A.. (2009) Light drinking in pregnancy, a risk for behavioural problems and cognitive deficits at 3 years of age? International Journal of Epidemiology, Vol.38 (No.1). pp. 129-140. ISSN 0300-5771

Preview

PDF WRAP_Wolke_0671038-301008-Kelly_et_al_2008_Light_drinking_in_pregnancy.pdf - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader Download (133Kb)

Abstract

Background The objective of this study was to determine whether there was an association between mothers’ light drinking during pregnancy and risk of behavioural problems, and cognitive deficits in their children at age 3 years. Methods Data from the first two sweeps of the nationally representative prospective UK Millennium Cohort study were used. Drinking patterns during pregnancy and behavioural and cognitive outcomes were assessed during interviews and home visits. Behavioural problems were indicated by scores falling above defined clinically 15 relevant cut-offs on the parent-report version of the Strengths and Difficulties Questionnaire (SDQ). Cognitive ability was assessed using the naming vocabulary subscale from the British Ability Scale (BAS) and the Bracken School Readiness Assessment (BSRA). Results There was a J-shaped relationship between mothers drinking 20 during pregnancy and the likelihood of high scores (above the cut-off) on the total difficulties scale of the SDQ and the conduct problems, hyperactivity and emotional symptom SDQ subscales. Children born to light drinkers were less likely to score above the cut-offs compared with children of abstinent mothers. Children 25 born to heavy drinkers were more likely to score above the cut-offs compared with children of abstinent mothers. Boys born to mothers who had up to 1–2 drinks per week or per occasion were less likely to have conduct problems (OR 0.59, 95% CI 0.45–0.77) and hyperactivity (OR 0.71, 95% CI 0.54–0.94). These effects remained 30 in fully adjusted models. Girls were less likely to have emotional symptoms (OR 0.72, 95% CI 0.51–1.01) and peer problems (OR 0.68, 95% CI 0.52–0.92) compared with those born to abstainers. These effects were attenuated in fully adjusted models. Boys born to light drinkers had higher cognitive ability test scores [standard 35 deviations, (95% CI)] BAS 0.15 (0.08–0.23) BSRA 0.24 (0.16–0.32) compared with boys born to abstainers. The difference for BAS was attenuated on adjustment for socio-economic factors, whilst the difference for BSRA remained statistically significant. Conclusions Children born to mothers who drank up to 1–2 drinks per week or per occasion during pregnancy were not at increased risk of clinically relevant behavioural difficulties or cognitive deficits compared with children of abstinent mothers. Heavy drinking 5 during pregnancy appears to be associated with behavioural problems and cognitive deficits in offspring at age 3 years whereas light drinking does not.

Item Type:	Journal Article
Subjects:	R Medicine > RG Gynecology and obstetrics R Medicine > RJ Pediatrics
Divisions:	Faculty of Science > Psychology Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Pregnant women -- Alcohol use, Cognition disorders in children
Journal or Publication Title:	International Journal of Epidemiology
Publisher:	Oxford University Press
ISSN:	0300-5771
Date:	30 October 2009
Volume:	Vol.38
Number:	No.1
Number of Pages:	12
Page Range:	pp. 129-140
Identification Number:	10.1093/ije/dyn230
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access
Funder:	Economic and Social Research Council (Great Britain) (ESRC)
Grant number:	RES-596-28-0001
References:	1 Jones KL, Smith DW, Ulleland CN, Streissguth AP. Pattern of malformation in offspring of chronic alcoholic mothers. Lancet 1973;301:1267–71. 2 Gray R, Henderson J. Report to the Department of Health: Review of the Fetal Effects of Prenatal Alcohol Exposure. 75 University of Oxford: National Perinatal Epidemiology Unit, 2006. 3 Royal College of Obstetricians and Gynaecologists. Alcohol Consumption and the Outcomes of Pregnancy (RCOG Statement, No.5). London: Royal College of Obstetricians and 80 Gynaecologists, 2006. 4 HM Government. Safe. Sensible. Sociable. The Next Steps in the National Alcohol Strategy. London: Crown copyright, 2007. 5 85 NICE Clinical Guideline 62. Antenatal Care: Routine Care for the Healthy Pregnant Woman (2008 update). Available at: www.nice.org.uk/CG062fullguideline (accessed 25 July 2008). 6 Jones KL, Chambers CD, Hill LL, Hull AD, Riley EP. Alcohol use in pregnancy: inadequate recommendations 90 for an increasing problem. BJOG 2006;113:967–68. 7 Mukherjee RAS, Hollins S, Abou-Saleh MT. Low level alcohol consumption and the fetus. Abstinence from alcohol is the only safe message in pregnancy. Br Med J 2005;330:375–76. 95 8 Sayal K, Heron J, Golding J, Emond A. Prenatal alcohol exposure and gender differences in childhood mental health problems: a longitudinal population-based study. Pediatrics 2007;119:e426–34. 9 100 Sood B, Delaney-Black V, Covington C et al. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. Dose-response effect. Pediatrics 2001;108:1–9. 10 Jacobson SW, Jacobson JL, Sokol RJ, Chiodo LM. Preliminary evidence of primary socioemotional deficits in 7-year-olds prenatally exposed to alcohol. Alcohol Clin 105 Exp Res 1998;22:61A. 11 Linnet KM, Dalsgaard S, Obel C et al. Maternal lifestyle factors in pregnancy risk of attention deficit hyperactivity 10 INTERNATIONAL JOURNAL OF EPIDEMIOLOGY disorder and associated behaviors: review of the current evidence. Am J Psychiatry 2003;160:1028–40. 12 O’Connor TG, Heron J, Golding J, Beveridge M, Glover V. Maternal antenatal anxiety and children’s behavioural/ 5 emotional problems at 4 years. Report from the Avon Longitudinal Study of Parents and Children. Br J Psychiatry 2002;180:502–8. 13 D’Onofrio BM, Van Hulle CA, Waldman ID, Rodgers JL, Rathouz PJ, Lahey BB. Causal inferences regarding 10 prenatal alcohol exposure and childhood externalising problems. Arch Gen Psychiatry 2007;64:1296–304. 14 O’Callaghan FV, O’Callaghan M, Najman JM, Williams GM, Bor W. Prenatal alcohol exposure and attention, learning and intellectual ability at 14 years: a prospective long- 15 itudinal study. Early Hum Dev 2007;83:115–23. 15 Forrest F, Florey C du V, Taylor D, McPherson F, Young JA. Reported social alcohol consumption during pregnancy and infants’ development at 18 months. Br Med J 1991;303:22–26. 20 16 Olsen J. Effects of moderate alcohol consumption during pregnancy on child development at 18 and 42 months. Alcohol Clin Exp Res 1994;18:1109–13. 17 Jacobson JL, Jacobson SW. Drinking moderately and pregnancy. Effects on child development. Alcohol Res 25 Health 1999;23:25–30. 18 Fried PA, Watkinson MA. 36- and 48-month neurobehavioral follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol. J Dev Behav Pediatr 1990;11:49–58. 30 19 Fried PA, O’Connell CM, Watkinson MA. 60- and 72-month follow-up of children prenatally exposed to marijuana, cigarettes, and alcohol: cognitive and language assessment. J Dev Behav Pediatr 1992;13:383–91. 20 Streissguth AP, Barr HM, Sampson PD, Darby BL, 35 Martin CM. IQ at age 4 in relation to maternal alcohol use and smoking during pregnancy. Dev Psychol 1989;25:3–11. 21 Streissguth AP, Barr HM, Sampson PD. Moderate prenatal alcohol exposure: effects on child IQ and learning problems at age 7½ years. Alcohol Clin Exp Res 40 1990;14:662–69. 22 Jacobson JL, Jacobson SW, Sokol RJ, Ager JW. Relation of maternal age and pattern of pregnancy drinking to functionally significant cognitive deficit in infancy. Alcohol Clin Exp Res 1998;22:345–51. 45 23 Testa M, Quigley BM, Eiden RD. The effects of prenatal alcohol exposure on infant mental development: a metaanalytical review. Alcohol Alcohol 2003;38:295–304. 24 Parry GJ, Ogston SA. EUROMAC. A European concerted action: maternal alcohol consumption and its relation to 50 the outcome of pregnancy and child development at 18 months. Results – child development at age 18 months. Int J Epidemiol 1992;21:S72–78. 25 Mattson SN, Schoenfelt AM, Riley EP. Teratogenic effects of alcohol on brain and behavior. Alcohol Res Health 55 2001;25:185–91. 26 Rouse C, Brooks-Gunn J, McLanahan S. School readiness: closing racial and ethnic gaps. Introducing the issue. Future Child 2005;15:5–14. 27 Spira EG, Fischel JE. The impact of preschool inattention, 60 hyperactivity, and impulsivity on social and academic development: a review. J Child Psychol Psychiatry 2005; 46:755–73. 28 Pihlakoski L, Sourander A, Aromaa M, Rautava P, Helenius H, Sillanpaa M. The continuity of psychopathology from early childhood to preadolescence. A prospective 65 cohort study of 3-12-year-old children. Eur Child Adolesc Psychiatry 2006;15:409–17. 29 Dex S, Joshi H. Children of the 21st Century: From Birth to 9 months. Bristol: The Policy Press, 2005. 30 70 Goodman R. The strengths and difficulties questionnaire: a research note. J Child Psychol Psychiatry 1997;38:581–86. 31 Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Adolesc Psychiatry 2001;40:1337–45. 32 75 Elliott CD, Smith P, McCulloch K. British Ability Scales Second Edition (BAS II): Administration and Scoring Manual. London: NFER-Nelson, 1996. 33 Bracken B. Bracken School Readiness Assessment, Administrators Manual. The Psychological Corporation: Hardcourt Assessment Company, 2002. 80 34 Kessler RC, Andrews G, Colpe LJ et al. Short screening scales to monitor population prevalences and trends in nonspecific psychological distress. Psychol Med 2002;32:959–76. 35 Pianta RC. Parent-Child Relationship Scale. Charlottesville, VA: University of Virginia, 1992. 85 36 George A, Hansen K, Schoon I. Child behaviour and cognitive development. In: Hansen K, Joshi H (eds). Millennium Cohort Study Second Survey: A User’s Guide to Initial Findings. London: Centre for Longitudinal Studies, University of London, 2007. 90 37 Panico L, Kelly Y; on behalf of the ETHINC team. Ethnic differences in childhood cognitive development: findings from the Millennium Cohort Study. J Epidemiol Community Health 2007;61 (Suppl 1):A36. 38 95 Stockwell T, Donath S, Cooper-Stanbury M, Chikritzhs T, Catalano P, Mateo C. Under-reporting of alcohol consumption in household surveys: a comparison of quantity- frequency, graduated-frequency and recent recall. Addiction 2004;99:1024–33. 39 100 Corti B, Binns CW, Howat PA, Blaze-Temple D, Lo SK. Comparison of 7-day retrospective alcohol consumption diaries in a female population in Perth, Western Australiamethodological issues. Br J Addict 1990;85:379–88. 40 Jacobson SW, Chiodo LM, Sokol RJ, Jacobson JL. Validity of maternal report of prenatal alcohol, cocaine, and 105 smoking in relation to neurobehavioral outcome. Pediatrics 2002;109:815–25. 41 Alvik A, Haldorsen T, Groholt B, Lindemann R. Alcohol consumption before and during pregnancy comparing concurrent and retrospective reports. Alcohol Clin Exp Res 110 2006;30:510–15. 42 Bolling K, Grant C, Hamlyn B, Thornton A. Infant Feeding Survey 2005. London: The Information Centre, 2007. 43 Autti-Ra¨mo¨ I. Foetal alcohol syndrome – a multifaceted condition. Dev Med Child Neurol 2002;44:141–44. 115 44 Goodman R, Ford T, Simmons H, Gatward R, Meltzer H. Using the Strengths and Difficulties Questionnaire (SDQ) to screen for child psychiatric disorders in a community sample. Br J Psychiatry 2000;177:534–39. 45 120 Egger HL, Angold A. Common emotional and behavioral disorders in preschool children: presentation, nosology, and epidemiology. J Child Psychol Psychiatry 2006;47:313–37. 46 Hepper PG, Dornan JC, Little JF. Maternal alcohol consumption during pregnancy may delay the LIGHT DRINKING IN PREGNANCY 11 development of spontaneous fetal startle behaviour. Physiol Behav 2005;83:711–14. 47 Fergusson D, Woodward L, Horwood J. Maternal smoking during pregnancy and psychiatric adjustment in late 5 adolescence. Arch Gen Psychiatry 1998;55:721–27. 48 Weissman MM, Warner V, Wickramaratne PJ, Kandel DB. Maternal smoking during pregnancy and psychopathology in offspring followed to adulthood. J Am Acad Child Adolesc Psychiatry 1999;38:892–99. 10 49 Cummings EM, Davies PT. Effects of marital conflict on children: recent advances and emerging themes in process-oriented research. J Child Psychol Psychiatry 2002; 43:31–63. 50 Day NL, Zuo Y, Richardson GA, Goldschmidt L, Larkby CA, 15 Cornelius M. Prenatal alcohol use and offspring size at 10 years of age. Alcohol Clin Exp Res 1999;23:863–69.
URI:	http://wrap.warwick.ac.uk/id/eprint/268

Data sourced from Thomson Reuters' Web of Knowledge

Request changes to a record

Actions (login required)

View Item