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Dose and Timing of Prenatal Alcohol Exposure and Maternal Nutritional Supplements: Developmental Effects on 6-Month-Old Infants

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Abstract

Objectives

Fetal alcohol spectrum disorders are more common in disadvantaged populations. Environmental factors, like suboptimal nutrition, may potentiate the developmental effects of prenatal alcohol exposure. To evaluate the impact of micronutrients, including choline, on reduction of effects of exposure, we examined timing and dose of alcohol and effects of nutritional supplementation at two OMNI-Net sites in Western Ukraine that included high and low risk individuals.

Methods

Alcohol-using and nondrinking women were randomized to one of three multivitamin/mineral supplement groups: none, multivitamins/minerals (MVM), and multivitamin/minerals plus choline. Children (N = 367) were tested at 6 months with the Bayley Scales of Infant Development (2nd ED) yielding standard scores for Mental Development Index (MDI), Psychomotor Development Index (PDI) and Behavior.

Results

Generalized linear modeling was used: (1) for factorial analysis of effects of alcohol group, multivitamin/minerals, and choline supplementation; and (2) to examine the relationship between amount and timing of alcohol (ounces of absolute alcohol/day [ozAA/day] peri-conception and on average in the second trimester) and MVM supplementation on developmental outcomes while controlling sex, social class, and smoking. MDI was significantly impacted by peri-conceptual alcohol dose (\(\upchi_{(1)}^{2} = 8.54\), p < .001) with more alcohol associated with lower scores and males more negatively affected than females (\(\upchi_{(3)}^{2} = 11.04\), p < .002). Micronutrient supplementation had a protective effect; those receiving supplements performed better (\(\upchi_{(1)}^{2} = 8.03\), p < .005). The PDI motor scores did not differ by group but were affected by peri-conceptual alcohol dose (\(\upchi_{(1)}^{2} = 4.17\), p < .04).

Conclusions for Practice

Multivitamin/mineral supplementation can reduce the negative impact of alcohol use during pregnancy on specific developmental outcomes.

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Acknowledgments

All or part of this work was done in conjunction with the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), which is funded by grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA). Additional information about CIFASD can be found at http://cifasd.org/. Research described in this manuscript was supported by Contract #U01AA014835 funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) and the NIH Office of Dietary Supplements (ODS). We wish to acknowledge the contribution of: OMNI-Net, Ukraine, Participating families and staff in Rivne and Khmelnytsky, Ukraine.

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Authors and Affiliations

  1. Departments of Psychiatry and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA

    Claire D. Coles & Julie A. Kable

  2. Department of Nutrition, University of California-Davis, Davis, CA, USA

    Carl L. Keen

  3. Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA

    Kenneth Lyons Jones, Wladimir Wertelecki & Christina D. Chambers

  4. University of South Alabama, Mobile, AL, USA

    Wladimir Wertelecki

  5. OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Rivne Province, Ukraine

    Wladimir Wertelecki & Irina V. Granovska

  6. OMNI-Net for Children International Charitable Fund, Khmelnytsky Perinatal Center, Khmelnytsky, Khmelnytsky Province, Ukraine

    Wladimir Wertelecki & Alla O. Pashtepa

  7. Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, Room 212, Atlanta, GA, 30329, USA

    Claire D. Coles

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  1. Claire D. Coles
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  2. Julie A. Kable
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Correspondence to Claire D. Coles.

Additional information

Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD, http://cifasd.org/).

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Coles, C.D., Kable, J.A., Keen, C.L. et al. Dose and Timing of Prenatal Alcohol Exposure and Maternal Nutritional Supplements: Developmental Effects on 6-Month-Old Infants. Matern Child Health J 19, 2605–2614 (2015). https://doi.org/10.1007/s10995-015-1779-x

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  • DOI: https://doi.org/10.1007/s10995-015-1779-x

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