Exploring the Influence of Maternal Behavioural Activation and Inhibition on Predicting Fetal Alcohol Exposure

Background: Prenatal alcohol exposure (PAE) can cause adverse physical and neurocognitive fetal development. Numerous underlying mechanisms of PAE-risk have been hypothesized; however, these have predominantly focused on health-, interpersonal-, and social-related factors. Evidence suggests that stable personality traits, such as behavioral activation (BA) and behavioral inhibition (BI) may contribute toward risk of alcohol misuse. We posit that BA and BI may therefore increase risk of PAE. The potential of BA and BI to underpin both pre- and during-pregnancy alcohol use was thus explored in a sample of UK-based pregnant and recently-pregnant mothers. Methods: Participants (n = 1371) completed an anonymous online questionnaire, containing the Behavioral Inhibition System/Behavioral Activation System scale; ("BIS/BAS") and the Alcohol Use Disorders Identification Test - Consumption ("AUDIT-C"); completed twice to reflect both pre- and during-pregnancy alcohol use. Results: In the initial regression model, the BIS/BAS subfactor "Fun Seeking" remained significant in predicting pre-pregnancy alcohol use (β = 0.119, p < 0.001) after correcting for other PAE-risk factors (maternal age, pregnancy intention, educational attainment, and mental wellbeing status). In the second regression model, "Fun Seeking" also emerged as a significant predictor (β = 0.120, p < 0.001) of alcohol use during pregnancy, even after correcting for pre-pregnancy alcohol use and participant demographics (β = 0.088, p = 0.005). Conclusions: Fun seeking played a small yet significant role in PAE-risk. It therefore appears that targeting malleable personality traits during PAE-prevention interventions, alongside aggravating health, personal, and interpersonal factors, may minimize the risk of alcohol-exposed pregnancies.