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Topic Editor: Mary J. O'Connor, PhD, University of California at Los Angeles, USA
Topic funded by: Margaret & Wallace McCain Family Foundation
The severity of the adverse effects of PAE varies across children, and depends on a number of factors, including the extent of the PAE (amount, timing, incidence) and genetic predispositions. However, even a small amount of alcohol consumed during pregnancy can have lasting effects on offspring. As little as one alcoholic beverage per week in the first three months of pregnancy has been associated with psychiatric problems at age 4 and 8 in young girls, even after controlling for a variety of confounding factors.
Early childhood
Alcohol consumption during pregnancy has been associated with a wide range of negative outcomes throughout development. Infants and toddlers who have been exposed to alcohol in utero display dysfunctions in sleep, regulation, orientation, and habituation. They tend to be more irritable than unexposed children. Heavy alcohol consumption is also associated with more negative emotionality in infants, which in turn, can diminish the level of responsiveness, support and stimulation provided by the mother, and can ultimately exacerbate the negative impact of PAE on development. After controlling for age, ethnicity, and family income, prenatally alcohol-exposed children are much more likely to be classified with an insecure attachment or symptoms of depression than unexposed children.
Childhood
Disturbances in infancy often persist in childhood, where alcohol-exposed children show increased reactivity, irritability and activity level, and struggle with deficits in attention. Difficulties experienced by prenatally alcohol-exposed children are also noted in the neurobehavioural domain, and include impairments in intellectual, language, memory, visual-spatial problem-solving, and executive functioning. Children with FASDs are also more likely than unexposed children to be diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) and to display behaviour problems and poor adaptive skills even after controlling for intellectual functioning.
Adolescence and Adulthood
PAE continues to have an impact on adolescent and adult offspring. One of the most documented effects is the high incidence of mental health problems, such as mood and personality disorders in this population. Problem behaviours and delinquency are also more common among adolescents and adults with FASDs than among non-exposed individuals. These individuals engage in more illegal acts, antisocial conduct, inappropriate sexual behaviours, and are more frequently incarcerated. They are also more likely to experience socioemotional, occupational, and substance-related problems.
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