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Studies on the Neurodevelopmental Effects of Low-Moderate Alcohol Use During Pregnancy

Developmental Issues Related to Alcohol During Pregnancy

Alcohol use during pregnancy can lead to neurodevelopmental effects that could impact the developing child throughout their life. Data is hard to capture in this field because of evident ethical reasons. This is why it is still “unclear whether a single binge drinking episode in early gestation, during increased teratogenic susceptibility, results in an increased fetal risk or impacts future development.”1

Alcohol consumption during pregnancy is known as a teratogen. A teratogen is defined as anything that causes birth defects or disruption to the developing embryo or fetus upon exposure. Typical teratogens include specific medications, the use of recreational drugs or alcohol, certain infections, and in certain cases, health problems such as uncontrolled diabetes in pregnant individuals.1

Studies Regarding the Effects of Alcohol on a Pregnancy

While they are scarce, there have been studies which have provided substantial information on the topic, such as the research published in the Archives of Women’s Mental Health. One particular study was a prospective observational study, conducted over a decade, examining “51 preschool-aged offspring of nonalcohol-dependent women who engaged in 1 to 5 binge drinking episodes during the first trimester and compared them with 51 children not exposed to any teratogens.” In the conclusion of the study, the data showed behavioral differences between “preschool aged children within 3 of 9 scales, specifically a greater degree of disinhibited behavior but no differences in regards to physical, language, or cognitive outcomes.”2

A larger multinational systematic review involving countries like the United States, England, and Australia found that “the cognitive, mental health, and socioemotional development of 3 to 16 year old children following pregnancies with maternal low-dose alcohol consumption…[showed] subtle long-term cognitive and behavioral effects such as inattention, mental health problems, and difficulties with short-term memory.”2

Another study conducted by Washington state followed the offspring of mothers who engaged in low-moderate maternal alcohol consumption into adulthood (age 18). This study found striking statistics; it was reported that “half of the older children diagnosed with fetal alcohol syndrome disorder (FASD) exhibited normal developmental scores as preschoolers but by age 10 all had severe brain dysfunction.”2

Fetal Alcohol Syndrome (FASD)

The above study is extremely conducive to learning more about FASD and when the developmental disadvantages surface for such offspring. It also demonstrates that the low statistics of preschool aged children with little to no effect from low-moderate prenatal alcohol exposure does not reveal the actual consequences of the alcohol consumption on the child. In fact, “only 10% of children diagnosed with FASD in this study had attention difficulties by age 5 but 60% were affected by age 10 and 100% had severe dysfunction in areas such as language, memory, and activity level.” While studies like these provide some insight into the relationship between alcohol use and pregnancy, it has been difficult throughout the ages to study the impact of low-dose or inconsistent prenatal drinking.2

Side Effects of Drinking Whilst Pregnant

The side effects of maternal alcohol consumption during pregnancy do not reveal themselves until later in the offspring’s development, due to the timeline of when children start demonstrating certain skills. This typically first takes place in structured school settings and with involvement in peer to peer social interactions. Because alcohol-related neurodevelopmental disorders involve intellectual disabilities, there is usually difficulty with behavior inhibition and inability to learn in the same way as peers in the same grade. That being said, starting school is usually what brings attention to these issues. Unfortunately, “school is often challenging and [children with prenatal alcohol consumption exposure] have difficulty with math, memory, attention, judgment, and poor impulse control.”3

Overall, the effects from low-moderate alcohol consumption during pregnancy are not as widely understood as heavy and consistent alcohol use during pregnancy. In studies focused on heavy and consistent alcohol use during pregnancy, the data leads researchers to the same conclusion: there are adverse neurodevelopmental effects in childhood due to maternal drinking during pregnancy.4

There are not just neurodevelopmental defects from prenatal alcohol consumption, as there is also the chance of alcohol-related birth defects that can have structural abnormalities of the heart, kidney, and bones, as well as difficulty hearing. There is a spectrum of effects from fetal alcohol exposure.

Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure (ND-PAE)

Neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE) is used to diagnose children who were exposed prenatally to alcohol but do not satisfy the full criteria of FASD. In fact, ND-PAE is recognized as an official condition in the American Psychiatric Association’s 2013 Diagnostic and Statistical Manual 5, telling us that the effects of low-moderate alcohol use are real and can cause actual medical concerns.4

This particular disorder is diagnosed if the mother of the child consumed “greater than minimal levels of alcohol, > 13 alcohol drinks per month or >2 alcohol drinks in 1 sitting, prenatally. The difficulties associated with ND-PAE are not that dissimilar to FASD, as children diagnosed with ND-PAE have difficulties in 3 areas: (1) thinking and memory; (2) behavior problems; and (3) trouble with day-to-today living.” These skills are clearly critical to thriving in society; having any of these issues can lead to issues in social settings, such as school.5

Symptoms of ND-PAE

A child with ND-PAE could experience the following:6

  • Forgetting material recently learned
  • Severe tantrums
  • Irritable mood
  • Difficulty with transitions
  • Difficulty shifting attention between tasks
  • Difficulty playing amicably with other children

Boardwalk Recovery Center Can Help

At Boardwalk Recovery Center, we recognize the disadvantage that children born to mothers who engage in prenatal alcohol consumption will have as they enter into the world. While we are a men’s facility, we know the reality of a lifestyle where partners abuse alcohol together. That being said, we are devoted to learning as much as we can to protect our clients’ entire family by establishing knowledge, safety, and a better future for all of those involved in the shifting dynamic of an alcoholic family. Our hope is that we can end the addiction and all of the resulting pain for the entire family and its next generation.


  5. Nulman I, Rover J, Kennedy D, et al. Binge alcohol consumption by non-alcohol dependent women during pregnancy affects child behavior, but not general intellectual functioning; a prospective controlled study. Arch Women’s Ment Health. 2004;7:173–181.
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Drinking While Pregnant