Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Aug;138(2):e20160775.
doi: 10.1542/peds.2016-0775. Epub 2016 Jul 8.

Fetal Alcohol Growth Restriction and Cognitive Impairment

R Colin Carter  1 , Joseph L Jacobson  2 , Christopher D Molteno  3 , Neil C Dodge  4 , Ernesta M Meintjes  5 , Sandra W Jacobson  2
Affiliations

Fetal Alcohol Growth Restriction and Cognitive Impairment

R Colin Carter et al. Pediatrics. 2016 Aug.

Abstract

Background: Although both fetal and long-term growth restriction are well documented in fetal alcohol spectrum disorders, effects on pattern of growth trajectory have not been characterized. Furthermore, the degree to which growth trajectories are related to fetal alcohol-related neurocognitive deficits is unknown.

Methods: Ninety-three heavy drinking pregnant women and 64 controls were recruited at initiation of prenatal care in Cape Town, South Africa. Small for gestational age (SGA) was defined as birth weight <10th percentile. Length/height, weight, and head circumference were measured at 6.5 and 12 months and 5, 9, and 13 years. Four growth trajectories were identified: SGA with long-term postnatal growth restriction (length/height-for-age <10th percentile through 13 years); SGA with catch-up growth; no SGA or postnatal growth restriction; and late-onset postnatal stunting. IQ was assessed at 5 and 10 years, and learning, memory, and executive function at 10 years.

Results: Children born SGA with postnatal growth restriction were most heavily exposed. Exposure was intermediate for those born SGA with catch-up growth and lowest for those without prenatal or postnatal growth restriction. Effects on neurocognition were strongest in children with both prenatal and long-term growth restriction, more moderate in those with fetal growth restriction and postnatal catch-up, and weakest in those without growth restriction.

Conclusions: These findings validate the use of growth restriction in the diagnosis of fetal alcohol spectrum disorders and identify growth trajectory as a biomarker of which heavily exposed children are at greatest risk for cognitive developmental deficits.

PubMed Disclaimer

Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Growth trajectories across levels of alcohol exposure. Excludes children with late-onset postnatal stunting.
See this image and copyright information in PMC

References

    1. May PA, Gossage JP, Kalberg WO, et al. . Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev. 2009;15(3):176–192 - PubMed
    1. May PA, Blankenship J, Marais A-S, et al. . Approaching the prevalence of the full spectrum of fetal alcohol spectrum disorders in a South African population-based study. Alcohol Clin Exp Res. 2013;37(5):818–830 - PMC - PubMed
    1. Lupton C, Burd L, Harwood R. Cost of fetal alcohol spectrum disorders. Am J Med Genet C Semin Med Genet. 2004;127C(1):42–50 - PubMed
    1. Greene T, Ernhart CB, Sokol RJ, et al. . Prenatal alcohol exposure and preschool physical growth: a longitudinal analysis. Alcohol Clin Exp Res. 1991;15(6):905–913 - PubMed
    1. Streissguth AP, Martin DC, Martin JC, Barr HM. The Seattle longitudinal prospective study on alcohol and pregnancy. Neurobehav Toxicol Teratol. 1981;3(2):223–233 - PubMed

Publication types