Newswise — Exposure to alcohol in the womb exacerbates children’s vulnerability to social and environmental stressors and to mental health issues in adulthood, according to a new study. Prenatal alcohol exposure (PAE) is known to cause neurocognitive and physical conditions, including facial and growth abnormalities. Previous research has also linked PAE to long-term mental health effects, though these outcomes are not well understood. This is partly because the impact of alcohol exposure before birth is difficult to separate from the effects of other early social and environmental stressors, including adverse childhood experiences, that often accompany PAE. For the new study in Alcoholism: Clinical & Experimental Research, investigators compared mental health conditions among adults who’d been exposed to alcohol before birth with those who weren’t. They also explored the role of early childhood adversity and other social and environmental factors on mental health.
The study involved 283 adults, in Atlanta or Seattle, who had either been diagnosed with a fetal alcohol spectrum disorder (FASD) or exposed to alcohol prenatally (according to their mothers during pregnancy); all had been followed over time. A contrasting group of adults had not experienced alcohol exposure before birth. The participants filled out surveys assessing their health, including certain mental health diagnoses and recent symptoms of anxiety and depression, in addition to adverse childhood experiences and demographic information. They were organized into three groups: adults without PAE; alcohol-exposed people with dysmorphic physical features who met criteria for fetal alcohol syndrome (FAS); and alcohol-exposed adults who were non-dysmorphic. The researchers used statistical analysis to examine associations between PAE, mental health, and other factors known to influence human development.
The alcohol-exposed adults reported fewer years of schooling, lower incomes and social status, and more adverse childhood experiences than the participants without PAE. They were likelier to report diagnoses of depression, bipolar disorder, anxiety disorder, and ADHD, though not psychotic disorders, compared to non-exposed participants. People with PAE also reported more recent symptoms of anxiety or depression. The findings indicate that the relationship between PAE and later mental health problems is indirect and influenced by childhood environmental factors, including adverse experiences and social and economic pressures. For example, alcohol exposure in the womb was associated with lower socioeconomic status, which in turn was linked to a depression diagnosis; PAE was associated with more adverse childhood experiences which in turn was linked to a higher risk of bipolar disorder. People without the physical features of FAS reported more current symptoms of depression than those with dysmorphic features. This is in line with previous data suggesting that the mental health burden falls more heavily on those with less obvious physical and cognitive effects of PAE.
The findings confirm that people with PAE are more likely than others to report symptoms of depression and varying mental health diagnoses well into adulthood. The study captures the effects of multiple hits during early development. Children exposed to alcohol in the womb may be especially vulnerable to additional environmental and social hardships, a combination that raises their long-term risk of mental health conditions. The study underscores the importance of preventing or reducing PAE and early childhood stressors. The researchers recommend that future studies assess the physiological impact of stress on emotional function as well as the possibility of increased vulnerability to stress in people with PAE.
Prenatal alcohol exposure and mental health at midlife: A preliminary report on two longitudinal cohorts. C. Coles, T. Grant, J. Kable, S. Stoner, A. Perez. (p xxx)
ACER-21-5108
Journal Link: Alcoholism: Clinical and Experimental Research
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