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Is the association between maternal alcohol consumption in pregnancy and pre-school child behavioural and emotional
Ingunn Olea Lund1, Espen Moen Eilertsen1, Line C Gjerde1,2
1The Norwegian Institute of Public health, Oslo, Norway.
Insights
Maternal hazardous drinking in early pregnancy is linked to increased emotional reactivity and somatic complaints in 3-year-olds. However, these effects diminish by age 5, with children showing less aggression. This study explores causal links between prenatal alcohol exposure and child behavior.
Area of Science:
- Perinatal mental health and child development.
- Reproductive toxicology and developmental outcomes.
- Behavioral science and epidemiology.
Background:
- Maternal hazardous alcohol consumption during pregnancy is associated with adverse child outcomes.
- Establishing a causal link requires controlling for confounding factors like genetics and environment.
- The first trimester is a critical period for fetal development, making maternal drinking during this time a key concern.
Purpose of the Study:
- To estimate the causal effect of maternal hazardous drinking in the first trimester on offspring emotional and behavioral problems.
- To investigate these effects across preschool age (1.5, 3, and 5 years).
- To control for measured confounding, familial risk factors, and non-shared environmental factors.
Main Methods:
- A prospective cohort study involving 14,639 mothers and 25,744 offspring siblings from the Norwegian Mother and Child Cohort Study.
- Data collected via self-report on alcohol consumption and child emotional/behavioral problems at multiple time points.
- Longitudinal latent growth curve models were used, with hazardous drinking prior to pregnancy serving as an instrumental variable to address causality.
Main Results:
- Associations between maternal hazardous drinking and child problems were significantly reduced after adjusting for familial and environmental factors.
- At age 3, children exposed to maternal hazardous drinking showed increased emotional reactivity (β=2.33) and somatic complaints (β=1.93).
- By age 5, these specific effects were no longer significant, but exposed children exhibited reduced aggression (β=-2.27) compared to unexposed siblings.
Conclusions:
- Maternal hazardous drinking in early pregnancy is associated with specific emotional and behavioral issues in early childhood.
- These effects appear transient, with some outcomes changing by age 5.
- The findings suggest a complex interplay of prenatal exposure and other factors influencing child development.
Background And Aims:
Hazardous drinking (i.e. alcohol consumption that places drinkers at risk for adverse health outcomes) during pregnancy is associated with adverse child outcomes. To address whether the associations are causal, we aimed to estimate the effect of maternal hazardous drinking during the first trimester on offspring emotional and behavioural problems throughout the pre-school age. We adjusted for: (1) measured confounding (e.g. smoking), (2) familial risk factors by sibling control design and (3) non-shared environmental risk factors by using hazardous drinking the 3 months before pregnancy as an instrumental variable.
Design:
Prospective cohort study. Participants were recruited between 1999 and 2009 at ultrasound examination offered to all pregnant women in Norway. Data were collected during the 17th and the 30th weeks of gestation, and when the children were aged 1.5, 3 and 5 years.
Setting:
Norway, 1999-2015.
Participants:
The sample consisted of 14 639 mothers with 25 744 offspring siblings from the Norwegian Mother and Child Cohort Study.
Measurements:
Respondents self-reported on: alcohol consumption, children's emotional problems (i.e. emotional reactive, anxiety/depression, somatic complaints) and children's behavioural problems (i.e. attention and aggressive behaviour) throughout pre-school age. We used longitudinal latent growth curve models to estimate the effect of maternal drinking during the first trimester on offspring emotional and behavioural problems.
Findings:
Most associations were strongly reduced after controlling for both familial and measured environmental risk factors. After adjustment, exposed children were more emotionally reactive [β = 2.33; 95% confidence interval (CI) = 0.13-4.53] and had more somatic complaints (β = 1.93; 95% CI = 0.09-3.77) at age 3, but not at age 5. Exposed children were less aggressive than unexposed siblings at age 5 (β = -2.27; 95% CI = -4.02 to -0.52).
Conclusions:
Children exposed to their mothers' hazardous drinking during the first trimester appear to be more emotionally reactive and have more somatic complaints at age 3, but not at age 5, and are less aggressive at age 5 compared with unexposed siblings.
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