Clinical Features of Typically Developing Children with and without Prenatal Alcohol Exposure.

Abstract

To determine if prenatal alcohol exposure (PAE) affected physical and cognitive/behavioral outcomes in apparently typically developing, first-grade children. Three groups were compared: children with fetal alcohol spectrum disorders (FASD), children with PAE without FASD, and children without PAE. 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. 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.