INVESTIGATING THE EFFECTS OF LOW TO MODERATE LEVELS OF PRENATAL ALCOHOL EXPOSURE ON CHILD BEHAVIOUR: A CRITICAL REVIEW
Main Article Content
Keywords
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Abstract
Conflicting findings exist regarding the risks of low to moderate levels of alcohol use during pregnancy. A recent study from Australia has suggested that mild gestational drinking is not associated with adverse fetal effects, and may even be associated with favorable outcomes as compared to “no drinking”.The study may lead women to continue consuming alcohol throughout pregnancy, despite methodological limitations that render its conclusions uncertain. This review discusses the challenges of assessing longterm effects of moderate drinking during pregnancy. Recommendations are provided for researchers investigating the effects of prenatal alcohol consumption on subsequent developmental outcomes in children.
References
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33. Rodgers B, Parslow R, Degenhardt L. Affective disorders, anxiety disorders and psychological distress in non-drinkers. J Affect Disord 2007;99(1- 3):165-172.
34. Degenhardt L, Hall W, Lynskey M. Alcohol, cannabis and tobacco use among Australians: A comparison of their associations with other drug use and use disorders, affective and anxiety disorders and psychosis. Addiction 2001;96(11):1603–1614.
35. Rodgers B, Korten AE, Jorm AF, Jacomb PA, Christensen H, Henderson S. Non-linear relationships in associations of depression and anxiety with alcohol use. Psychol Med. 2000;30(2):421–432.
36. Skogen JC, Harvey SB, Henderson M, Stordal E, Mykletun A. Anxiety and depression among abstainers and low-level alcohol consumers. The Nord-Trøndelag Health Study. Addiction 2009;104 (9):1519–1529.
37. Staroselsky A, Fantus E, Sussman R, Sandor P, Koren G, Nulman I. Both parental psychopathology and prenatal maternal alcohol dependency can predict the behavioural phenotype in children. Paediatr Drugs 2009;11(1):22-25.
38. Cummings EM, Davies PT. Maternal depression and child development. J Child Psychol Psychiatry 1994;35(1):73–112.
39. Downey G, Coyne JC. Children of depressed parents: an integrative review. Psychol Bull 1990;108(1):50-76.
40. Orvaschel H, Welsh-Allis G, Ye WJ. Psychopathology in children of parents with recurrent depression. J Abnorm Child Psychol 1988;16(1):17-28.
41. Weissman MM, Prusoff BA, Gammon GD, Merikangas KR, Leckman JF, Kidd KK. Psychopathology in the children (ages 6-18) of depressed and normal parents. J Am Acad Child Psychiatry 1984; 23(1)78-84.
42. Beck CT. Maternal depression and child behaviour problems: A meta-analysis. J Adv Nurs 1999;29(3):623–629.
43. Kyskan CE, Moore TE. Global perspectives on fetal alcohol syndrome: assessing practices, policies and campaigns in four English-speaking countries. Can Psychol 2005;46(3):153-165.
44. National Health and Medical Research Council. Australian alcohol guidelines: Health risks and benefits. 2001, October. Available from: http://www.health.gov.au/nhmrc/publications/pdf /ds9.pdf
45. Najman JM, Williams GM, Nikles J, Spence S, Bor W, O'Callaghan M, et al. Mothers' mental illness and child behavior problems: Cause-effect association or observation bias? J Am Acad Child Adolesc Psychiatry 2000;39(5):592-602.
46. Cicchetti D, Cohen DJ. Perspectives on developmental psychopathology. In: Cicchetti D, Cohen DJ, eds. Developmental Psychopathology: Theory and Methods. New York:Wiley; 1995.
47. Coles CD, Platzman KA, Lynch ME, Freides D. Auditory and visual sustained attention in adolescents prenatally exposed to alcohol. Alcohol Clin Exp Res 2002;26(2):263–271.
48. Conry J. Neuropsychological deficits in fetal alcohol syndrome and fetal alcohol effects. Alcohol Clin Exp Res 1990;14(5):650-655.
49. Kodituwakku PW. Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Neurosci Biobehav Rev 2007;31(2):192-201.
50. Mattson SN, Riley EP. A review of the neurobehavioral deficits in children with Fetal Alcohol Syndrome or prenatal exposure to alcohol. Alcohol Clin Exp Res 1998;22(2): 279-294.
51. Rasmussen C. Executive functioning and working memory in fetal alcohol spectrum disorder. Alcohol Clin Exp Res 2005;29(8)1359–1367.
52. Jacobson SW, Jacobson JL. Low-moderate prenatal alcohol exposure and the risk to child behavioural development: a prospective cohort study. Commentary. BJOG 2010;117(9):1151-1152.
2. Jones IU, Smith DW, Ulleland CN, Streissguth AP. Pattern of malformation in offspring of chronic alcoholic mothers. Lancet 1973;1(7815):1267- 1271.
3. Lemoine P, Harouseau H, Borteryu JT, Menuet JC. Les enfants des parents alcooliques. Anomalies observées à propos de 127 cas. Ouest Médical.1968;21:476-482.
4. Clarren SK, Smith DW. The fetal alcohol syndrome. N Engl J Med 1978;298(19):1063-1067.
5. Jacobson JL, Jacobson SW. Effects of prenatal alcohol exposure on child development. Alcohol Res Health 2002;26(4):282-286.
6. Majewski F. Alcohol embryopathy: experience in 200 patients. Dev Brain Dysfunc 1993;6:248– 265.
7. Mattson SN, Riley EP, Gramling L, Delis DC, Jones KL. Neuropsychological comparison of alcohol-exposed children with or without physical features of Fetal Alcohol Syndrome. Neuropsychology 1998;12(1):146-153.
8. Steinhausen H-C, Spohr H-L. Long-term outcome of children with Fetal Alcohol Syndrome: Psychopathology, behavior, and intelligence. Alcohol Clin Exp Res 1998;22(2):334-338.
9. Streissguth AP, La Due RA. Fetal alcohol. Teratogenic causes of developmental disabilities. Monogr Am Assoc Ment Defic 1987;(8):1-32.
10. Roebuck TM, Mattson SN, Riley EP. A review of the neuroanatomical findings in children with Fetal Alcohol Syndrome or prenatal exposure to alcohol. Alcohol Clin Exp Res. 1998;22(2):339- 344.
11. Sood B, Delaney-Black V, Covington C, Nordstrom-Klee B, Ager J, Templin T, et al. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. dose-response effect. Pediatrics 2001; 108(2):e34.
12. Olson HC, Streissguth AP, Sampson PD, Barr HM, Bookstein FL, Thiede K. Association of prenatal alcohol exposure with behavioral and learning problems in early adolesence. J Am Acad Child Adolesc Psychiatry 1997;36(9):1187–1194.
13. Sayal K, Heron J, Golding J. Prenatal alcohol exposure and gender differences in childhood mental health problems: a longitudinal population based study. Pediatrics 2007;119(2):e426–434.
14. Brown RT, Coles CD, Smith IE, Platzman KA, Silverstein J, Erickson S, et al. Effects of prenatal alcohol exposure at school age, II: attention and behavior. Neurotoxicol Teratol 1991;13(4):369- 376.
15. Burden MJ, Jacobson SW, Sokol RJ, Jacobson JL. Effects of prenatal alcohol exposure on attention and working memory at 7.5 years of age. Alcohol Clin Exp Res 2005;29(3):443–452.
16. Kelly Y, Sacker A, Gray R, Kelly J, Wolke D, Quigley MA. Light drinking in pregnancy, a risk for behavioural problems and cognitive deficits at 3 years of age? Int J Epidemiol 2009;38(1):129– 140.
17. Robinson M, Oddy WH, McLean NJ, Jacoby P, Pennell CE, De Klerk NH, et al. Low-moderate prenatal alcohol exposure and risk to child behavioural development: a prospective cohort study. BJOG 2010;117(9):1139–1152.
18. Rodriguez A, Olsen J, Kotimaa AJ, Kaakinen M, Moilanen I, Henriksen TB, et al. Is prenatal alcohol exposure related to inattention and hyperactivity symptoms in children? Disentangling the effects of social adversity. J Child Psychol Psychiatry 2009;50(9):1073-1083.
19. Sayal K. Alcohol consumption in pregnancy as a risk factor of later mental health problems. Evid Based Ment Health 2007;10(4):98-100.
20. National Health and Medical Research Council. Australian guidelines to reduce health risks from drinking alcohol. 2009, February. Available from: http://www.nhmrc.gov.au/_files_nhmrc/file/publi cations/synopses/ds10-alcohol.pdf
21. Finer LB, Henshaw SK. Disparities in rates of unintended pregnancy in the United States, 1994 and 2001. Perspect Sex Reprod Health 2006;38(2):90-96.
22. Klein JD, American Academy of Pediatrics Committee on Adolecsence. Adolescent pregnancy: Current trends and issues. Pediatrics 2005;116(1): 281-286.
23. Health Canada. The Canadian Alcohol and Drug Use Monitoring Survey (CADUMS): Summary of the results for 2009. 2010, June. Available from: http://www.hc-sc.gc.ca/hc-ps/drugsdrogues/
stat/_2009/tables-tableaux-eng.php#t6
24. Tsai J, Floyd RL, Green PP, Boyle CA. Patterns and average volume of alcohol use among women of childbearing age. Matern Child Health J 2007;11(5):437-445.
25. Kodituwakku PW, Ceccanti M. Are children born to light drinkers not at high risk of developing clinically relevant cognitive–behavioural problems? A response to Kelly et al. Int J Epidemiol 2010;39 (2):635-637.
26. Sayal K. Commentary: Light drinking in pregnancy: can a glass or two hurt? Int J Epidemiol. 2009;8(1):40-42.
27. Light drinking might not be risky during pregnancy: Report. Maclean’s 2010. (Accessed October 17, 2010) Available from http://www2.macleans.ca/2010/10/06/light-drinkingmight- not-be-risky-during-pregnancy-report/
28. Todorow M, Sakaguchi S, Koren G. Child behaviour following low to moderate maternal drinking in pregnancy. BJOG 2010;117(12): 1563-1564.
29. Achenbach TM, Edelbrock CS. Manual for the Child Behavior Checklist and Revised Child Behavior Profile. Burlington VT: University of Vermont; 1983.
30. Bingol N, Schusterb C, Fuchsc M, Iosubc S, Turnerd G, Stonec RK, Gromisch DS. The influence of socioeconomic factors on the occurrence of Fetal Alcohol Syndrome. Ad Alcohol Subst Abuse 1987;6(4):105-118.
31. Stranges S, Notaro J, Freudenheim JL, Calogero RM, Muti P, Farinaro E, et al. Alcohol drinking pattern and subjective health in a populationbased study. Addiction 2006;101(9):1265-1276.
32. Power C, Rodgers B, Hope S. U-shaped relation for alcohol consumption and health in early adulthood and implications for mortality. Lancet 1998; 352(9131):877.
33. Rodgers B, Parslow R, Degenhardt L. Affective disorders, anxiety disorders and psychological distress in non-drinkers. J Affect Disord 2007;99(1- 3):165-172.
34. Degenhardt L, Hall W, Lynskey M. Alcohol, cannabis and tobacco use among Australians: A comparison of their associations with other drug use and use disorders, affective and anxiety disorders and psychosis. Addiction 2001;96(11):1603–1614.
35. Rodgers B, Korten AE, Jorm AF, Jacomb PA, Christensen H, Henderson S. Non-linear relationships in associations of depression and anxiety with alcohol use. Psychol Med. 2000;30(2):421–432.
36. Skogen JC, Harvey SB, Henderson M, Stordal E, Mykletun A. Anxiety and depression among abstainers and low-level alcohol consumers. The Nord-Trøndelag Health Study. Addiction 2009;104 (9):1519–1529.
37. Staroselsky A, Fantus E, Sussman R, Sandor P, Koren G, Nulman I. Both parental psychopathology and prenatal maternal alcohol dependency can predict the behavioural phenotype in children. Paediatr Drugs 2009;11(1):22-25.
38. Cummings EM, Davies PT. Maternal depression and child development. J Child Psychol Psychiatry 1994;35(1):73–112.
39. Downey G, Coyne JC. Children of depressed parents: an integrative review. Psychol Bull 1990;108(1):50-76.
40. Orvaschel H, Welsh-Allis G, Ye WJ. Psychopathology in children of parents with recurrent depression. J Abnorm Child Psychol 1988;16(1):17-28.
41. Weissman MM, Prusoff BA, Gammon GD, Merikangas KR, Leckman JF, Kidd KK. Psychopathology in the children (ages 6-18) of depressed and normal parents. J Am Acad Child Psychiatry 1984; 23(1)78-84.
42. Beck CT. Maternal depression and child behaviour problems: A meta-analysis. J Adv Nurs 1999;29(3):623–629.
43. Kyskan CE, Moore TE. Global perspectives on fetal alcohol syndrome: assessing practices, policies and campaigns in four English-speaking countries. Can Psychol 2005;46(3):153-165.
44. National Health and Medical Research Council. Australian alcohol guidelines: Health risks and benefits. 2001, October. Available from: http://www.health.gov.au/nhmrc/publications/pdf /ds9.pdf
45. Najman JM, Williams GM, Nikles J, Spence S, Bor W, O'Callaghan M, et al. Mothers' mental illness and child behavior problems: Cause-effect association or observation bias? J Am Acad Child Adolesc Psychiatry 2000;39(5):592-602.
46. Cicchetti D, Cohen DJ. Perspectives on developmental psychopathology. In: Cicchetti D, Cohen DJ, eds. Developmental Psychopathology: Theory and Methods. New York:Wiley; 1995.
47. Coles CD, Platzman KA, Lynch ME, Freides D. Auditory and visual sustained attention in adolescents prenatally exposed to alcohol. Alcohol Clin Exp Res 2002;26(2):263–271.
48. Conry J. Neuropsychological deficits in fetal alcohol syndrome and fetal alcohol effects. Alcohol Clin Exp Res 1990;14(5):650-655.
49. Kodituwakku PW. Defining the behavioral phenotype in children with fetal alcohol spectrum disorders: A review. Neurosci Biobehav Rev 2007;31(2):192-201.
50. Mattson SN, Riley EP. A review of the neurobehavioral deficits in children with Fetal Alcohol Syndrome or prenatal exposure to alcohol. Alcohol Clin Exp Res 1998;22(2): 279-294.
51. Rasmussen C. Executive functioning and working memory in fetal alcohol spectrum disorder. Alcohol Clin Exp Res 2005;29(8)1359–1367.
52. Jacobson SW, Jacobson JL. Low-moderate prenatal alcohol exposure and the risk to child behavioural development: a prospective cohort study. Commentary. BJOG 2010;117(9):1151-1152.