FASD: Association found between poor academic achievement and maternal drinking

Education records from the WA Literacy and Numeracy Assessment statewide testing program were compared with maternal alcohol consumption data. Credit: iStock

Researchers from WA and the UK have linked heavy drinking and binge drinking, even occasionally during pregnancy, to children's academic achievement in reading, writing and spelling; and this impact is related to the trimester in which the exposure occurred.

These results lend further support to other international studies which have found prenatal alcohol exposure increases the risk of a range of neurodevelopmental disorders, including Fetal Alcohol Spectrum Disorder (FASD).

Lead author Colleen O'Leary, from Curtin's Centre for Population Health Research, says this study is a first.

"This is the first population-based study that utilises linked cohort and state-wide education test data to examine the effect of prenatal alcohol exposure on educational achievement," Dr O'Leary says.

The cohort of 4056 children aged 8-9 years-old were from the Randomly Ascertained Sample of Children born in Australia's Largest State study; a 10 per cent random sample of infants born in WA between 1995 and 1997.

FASD Indications

Information about maternal alcohol consumption was catergorised into dosage and pattern; low (1-2 standard drinks on occasion, less than 7 per week), moderate (3-4 standard drinks on occasion, 7 per week), binge drinking (more than 50g per occasion), and heavy drinking (more than 7 standard drinks per week).

They then matched this data with education records from the WA Literacy and Numeracy Assessment statewide testing program, and also examined absenteeism at these tests.

Resulting learning problems varied depending on the dose, timing, and drinking pattern of the prenatal alcohol exposure.

"Children exposed to heavy prenatal alcohol exposure during the first trimester were over twice as likely as comparison children to not achieve the reading benchmark," Dr O'Leary says.

"Prenatal exposure to occasional binge drinking in late pregnancy [second and/or third trimester] increased the risk of not achieving the benchmark for writing.

"Children of mothers binge drinking occasionally or drinking heavily at any stage during pregnancy were more likely to have been absent for the spelling test."

Dr O'Leary says results are particularly pertinent given the high rate of pregnancies reported to be unplanned – around 50 per cent – and thus associated risk of unintentional prenatal alcohol exposure.

While low or moderate levels of prenatal alcohol exposure was not associated with academic underachievement, Dr O'Leary stresses that other studies have demonstrated adverse offspring effects, even at very low doses.

As such, "we cannot conclusively state that any amount of alcohol is 'safe'."

She recommends exploring the impact of whether supportive family and school systems can improve academic achievement of children exposed prenatally to alcohol.

More information: www.ncbi.nlm.nih.gov/pubmed/23837182

Fetal Alcohol Spectrum Disorders (FASD) - South Africa study

Two recently published studies report prevalence data about fetal alcohol spectrum disorders (FASD) in South Africa and find that negative consequences of prenatal exposure to alcohol may be lessened if a child is provided with adequate nutrition and appropriate cognitive and behavioral stimulation in his or her first seven years of life.

Dr. Philip A. May

Dr. Philip A. May, faculty member at the University of North Carolina's Nutrition Research Institute (NRI), research professor of nutrition at the Gillings School of Global Public Health and Principal Investigator at the University of New Mexico's Center on Alcoholism, Substance Abuse, and Addictions (CASAA), is lead author of both papers.

At the NRI, May is conducting a comprehensive study of South African mothers and their children who are affected by FASD.

The work is funded through a $5.3 million grant from the National Institutes of Health's National Institute on Alcohol Abuse and Alcoholism.

The study, titled "Approaching the Prevalence of the Full Spectrum of Fetal Alcohol Spectrum Disorders in a South African Population-Based Study," appeared in the May issue of Alcoholism: Clinical and Experimental Research.

"This is the first population-based study of the prevalence of FASD to diagnose a significant number of alcohol-related disabilities, which are at the mild end of the continuum," Dr. May said of the study.

Employing newly refined diagnostic criteria, the researchers were able to better indicate the scope of the problem.

"There is evidence of advances in diagnosis of the milder effects of alcohol exposure in the prenatal period," Dr. May said. "The rate of FASD is greater than we ever thought in human populations."

In "Maternal Factors Predicting Cognitive and Behavioral Characteristics of Children with Fetal Alcohol Spectrum Disorders," which appeared in the Journal of Developmental and Behavioral Pediatrics in June, May and his colleagues found evidence that good health and nutrition of the pregnant mother provides her child with an advantage for cognitive and behavioral development by age seven.

"In the first seven years of life environmental advantages of cognitive and behavioral stimulation and adequate nutrition can, in many cases, serve to minimize any negative consequences of prenatal alcohol exposure on the children's social, behavioral, and intellectual functioning," May said.

The NIAAA grant is funding a study for children as young as 12 months to improve their development with nutritional supplements and a regimen of cognitive and behavioral interventions.

"There is hope that a good postnatal environment in the early years of life can mitigate some, if not most, of the damage that occurs from alcohol exposure in the prenatal period," May said.

Conclusions
High rates of specific diagnoses within FASD were well documented in this new cohort of children. FASD persists in this community. The data reflect an increased ability to provide accurate and discriminating diagnoses throughout the continuum of FASD.

More information: Approaching the Prevalence of the Full Spectrum of Fetal Alcohol Spectrum Disorders in a South African Population-Based Study