Who is most affected by prenatal alcohol exposure: Boys or girls?

Philip A May1, Barbara Tabachnick2, Julie M Hasken3

  • 1The University of North Carolina at Chapel Hill, Nutrition Research Institute, United States; Stellenbosch University, Faculty of Medicine and Health Sciences, South Africa; The University of New Mexico, Center on Alcoholism, Substance Abuse and Addictions, United States.

Insights

Prenatal alcohol exposure impacts boys and girls differently. While both sexes show similar developmental issues, males have lower survival rates, and females experience more physical abnormalities and cognitive deficits, increasing their risk for fetal alcohol spectrum disorders (FASD).

Area of Science:

  • Neuroscience
  • Developmental Biology
  • Public Health

Background:

  • Prenatal alcohol exposure is a leading preventable cause of birth defects and neurodevelopmental abnormalities.
  • Fetal alcohol spectrum disorders (FASD) encompass a range of physical, cognitive, and behavioral impairments.
  • Understanding sex-specific outcomes is crucial for targeted interventions and support.

Purpose of the Study:

  • To investigate sex-specific differences in physical and neurobehavioral outcomes associated with prenatal alcohol exposure.
  • To compare outcomes between boys and girls diagnosed with fetal alcohol spectrum disorders (FASD) and controls.

Main Methods:

  • A case-control study comparing boys and girls with FASD and randomly selected controls.
  • Assessment of physical and neurobehavioral traits at age seven.
  • Statistical analyses including sequential regression to identify predictors of dysmorphology and FASD diagnosis.

Main Results:

  • Sex ratios suggest reduced viability and survival for males exposed prenatally to alcohol compared to females by age seven.
  • While most physical and neurobehavioral traits were similarly affected, girls exhibited more dysmorphology and poorer non-verbal IQ scores than boys.
  • Logistic regression indicated significantly worse overall outcomes for girls, with a higher probability of FASD diagnosis (Nagelkerke R²=0.54 for girls vs. 0.42 for boys).

Conclusions:

  • Prenatal alcohol exposure leads to largely similar physical and neurocognitive impairments in both sexes.
  • Males appear to have lower viability and survival rates, while females exhibit more severe dysmorphology and neurocognitive deficits, resulting in a higher likelihood of FASD diagnosis.
Abstract

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