Causal Inferences Regarding Prenatal Alcohol Exposure and Childhood Externalizing ProblemsArch Gen Psychiatry. 2007;64(11):1296-1304.
Existing research on the neurobehavioral consequences of prenatal alcohol exposure (PAE) has not adequately accounted for genetic and environmental confounds.
To examine the association between PAE and offspring externalizing problems in a large representative sample of families in the United States using measured covariates and a quasi-experimental design to account for unmeasured genetic and environmental confounds.
There was an association between PAE and offspring CPs that was independent of confounded genetic and fixed environmental effects and the measured covariates. The CPs in children of mothers who drank daily during pregnancy were 0.35 SD greater than those in children whose mothers never drank during pregnancy. Although AIPs were associated with PAE when comparing unrelated offspring, children whose mothers drank more frequently during pregnancy did not have more AIPs than siblings who were less exposed to alcohol in utero. Additional subsample analyses suggested that maternal polysubstance use during pregnancy may account for the associations between PAE and AIPs.
These results are consistent with PAE exerting an environmentally mediated causal effect on childhood CPs, but the relation between PAE and AIPs is more likely to be caused by other factors correlated with maternal drinking during pregnancy.
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