Association between Moderate Prenatal Alcohol Exposure and Mathematical Development in Early Childhood Open Access

Abstract

Background: Over half of women of reproductive age report drinking, and 7.6% report drinking during pregnancy. Therefore, it is important to investigate the effects of prenatal alcohol exposure. The aim of this study was to determine the effect of moderate drinking and binge drinking behaviors before and during each trimester of pregnancy on mathematical ability in early childhood.

Methods: Data from this study came from the Fetal Growth and Development Study (FGDS) and the Follow-Up of Development and Growth Experiences Study (FUDGE). FGDS participants were recruited in the neonatal period from infants born between February 1, 1993 and December 31, 1994 at a private and public hospital. The FUDGE was a follow-up of selected infants at around 54 months. The exposures of interest were the average number of drinks per week and binge episodes before pregnancy and in each of the 3 trimesters. Our outcomes of interest were two developmental tests: the Test of Early Mathematical Ability and the Woodcock Johnson Applied Problems subtest. An analysis of variance was run to estimate beta coefficients for each of our main predictors while controlling for confounders.

Results: In the crude analysis, a number of measures of prenatal alcohol exposure were significantly associated with both math ability scores. However, these associations disappeared after controlling for confounders. The single negative association that remained significant was having a binge episode in the second trimester which leads to a 7.4 (95% CI: -14.2, -0.6) point decrease in the Woodcock Johnson score. There were a few positive associations that remained significant which might be due to residual confounding.

Conclusion: The majority of the associations between moderate prenatal alcohol exposure and mathematical development can be explained by confounding.

Table of Contents

Background. 1

Alcohol Use during Pregnancy. 1

Mathematical Development. 2

Biological Reasoning. 2

Association between Mathematical Development and Prenatal Alcohol Exposure. 3

Methods. 6

Study Design. 6

Data Collection. 6

Measures. 7

Statistical Analysis.9

Results. 10

Sample Characteristics. 10

Associations between Prenatal Alcohol Exposure and Mathematical Scores. 11

Discussion. 13

Limitations and Strengths. 14

Future Directions. 15

Public Health Implications.15

References. 17

Tables. 21

Table 1. Associations between Delivery Hospital and Social Class Variables. 21

Table 2. Characteristics of Mothers and Infants by Delivery Hospital and Size for Gestational Age. 22

Table 3. Drinking Habits of Mothers by Infants' Delivery Hospital and Infants' Size for Gestational Age. 24

Table 4. Scores on Mathematical Development Tests by Delivery Hospital and Size for Gestational Age. 26

Table 5. Associations between Mathematical Development Scores and Covariates. 27

Table 6. Estimated Crude and Adjusted Regression Coefficients between Alcohol Usage and Math Development. 29

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Degree	MPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Keyword	mathematics pregnancy alcohol prenatal arithmetic drinking numerical
Committee Chair / Thesis Advisor	Drews-Botsch, Carolyn D, Emory University

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