Original Article

Effects of Heavy Prenatal Alcohol Exposure and Iron Deficiency Anemia on Child Growth and Body Composition through Age 9 Years

  1. R. Colin Carter1,*,
  2. Joseph L. Jacobson2,3,4,
  3. Christopher D. Molteno3,
  4. Hongyu Jiang5,
  5. Ernesta M. Meintjes4,
  6. Sandra W. Jacobson2,3,4,†,
  7. Christopher Duggan5,†

Article first published online: 15 AUG 2012

DOI: 10.1111/j.1530-0277.2012.01810.x

Issue

Alcoholism: Clinical and Experimental Research

Alcoholism: Clinical and Experimental Research

Volume 36, Issue 11, pages 1973–1982, November 2012

Additional Information

How to Cite

Colin Carter, R., Jacobson, J. L., Molteno, C. D., Jiang, H., Meintjes, E. M., Jacobson, S. W. and Duggan, C. (2012), Effects of Heavy Prenatal Alcohol Exposure and Iron Deficiency Anemia on Child Growth and Body Composition through Age 9 Years. Alcoholism: Clinical and Experimental Research, 36: 1973–1982. doi: 10.1111/j.1530-0277.2012.01810.x

Author Information

  1. 1

    Division of Emergency Medicine, Children's Hospital Boston, Boston, Massachusetts

  2. 2

    Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan

  3. 3

    Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa

  4. 4

    Department of Human Biology, University of Cape Town, Cape Town, South Africa

  5. 5

    Division of Gastroenterology and Nutrition, Children's Hospital Boston, Boston, Massachusetts

  1. †

    Drs Christopher Duggan and Sandra W. Jacobson shared equally in the responsibilities of senior author of this study.

*Reprint requests: R. Colin Carter, MD, Division of Emergency Medicine, Children's Hospital Boston, 300 Longwood Avenue, Boston, MA 02115; Tel.: 617-355-6624; Fax: 617-730-0335; E-mail: RobertColin.Carter@childrens.harvard.edu

  1. †

    Drs Christopher Duggan and Sandra W. Jacobson shared equally in the responsibilities of senior author of this study.

  2. Portions of this research were presented at the 2002 and 2010 meetings of the Research Society on Alcoholism and the 2010 Pediatric Academic Society meetings.

Publication History

  1. Issue published online: 29 OCT 2012
  2. Article first published online: 15 AUG 2012
  3. Manuscript Accepted: 13 FEB 2012
  4. Manuscript Received: 6 SEP 2011

Funded by

  • NIAAA. Grant Number: R01 AA09524
  • NIH Office of Research on Minority Health
  • Foundation for Alcohol Related Research. Grant Number: U01 AA014790
  • NIAAA Collaborative Initiative on Fetal Alcohol Spectrum Disorder. Grant Numbers: R01 AA016781, U24 AA014815, U01 AA014809, KL2 RR025757
  • Harvard Catalyst Clinical and Translational Science Program. Grant Number: K23 AA020516

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Keywords:

  • Fetal Alcohol Syndrome;
  • Intrauterine Growth Retardation;
  • Postnatal Growth;
  • Body Composition;
  • Bioelectric Impedance Analysis;
  • Prenatal Alcohol Exposure;
  • Iron Deficiency;
  • Food Security

Background

Prenatal alcohol exposure has been associated with pre- and postnatal growth restriction, but little is known about the natural history of this restriction throughout childhood or the effects of prenatal alcohol on body composition. The objective of this study was to examine the effects of heavy prenatal alcohol exposure on longitudinal growth and body composition.

Methods

Eighty-five heavy drinking pregnant women (≥2 drinks/d or ≥4 drinks/occasion) and 63 abstaining and light-drinking controls (<1 drink/d, no binging) were recruited at initiation of prenatal care in an urban obstetrical clinic in Cape Town, South Africa and prospectively interviewed during pregnancy about alcohol, smoking, drug use, and demographics. Among their children, length/height, weight, and head circumference were measured at 6.5 and 12 months and at 5 and 9 years. Percent body fat (BF) was estimated at age 9 years using bioelectric impedance analysis.

Results

In multiple regression models with repeated measures (adjusted for confounders), heavy alcohol exposure was associated with reductions in weight (0.6 SD), length/height (0.5 SD), and head circumference (0.9 cm) from 6.5 months to 9 years that were largely determined at birth. These effects were exacerbated by iron deficiency in infancy but were not modified by iron deficiency or measures of food security at 5 years. An alcohol-related postnatal delay in weight gain was seen at 12 months. Effects on head circumference were greater at age 9 than at other age points. Although heavy alcohol exposure was not associated with changes in body composition, children with fetal alcohol syndrome (FAS) and partial fetal alcohol syndrome (PFAS) had lower percent BF than heavy exposed nonsyndromal and control children.

Conclusions

Heavy prenatal alcohol exposure is related to prenatal growth restriction that persists through age 9 years and an additional delay in weight gain during infancy. FAS and PFAS diagnoses are associated with leaner body composition in later childhood.

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