Published online January 26, 2009
PEDIATRICS Vol. 123 No. 2 February 2009, pp. 547-554 (doi:10.1542/peds.2008-0459)
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ARTICLE

Prenatal Alcohol Exposure and Language Delay in 2-Year-Old Children: The Importance of Dose and Timing on Risk

Colleen O'Leary, BSc, MPHa,b, Stephen R. Zubrick, MSc, MA, PhDa,c, Catherine L. Taylor, BAppSc, PGradDipHlthSc, PhD, FSPAa,c, Glenys Dixon, BA, BPsych, MPsycha,b and Carol Bower, MBBS, MSc, PhD, FAFPHM, DLSHTMa,b

a Division of Population Sciences, Telethon Institute for Child Health Research
b Centre for Child Health Research, University of Western Australia, Perth, WA, Australia
c Curtin University Centre for Developmental Health, Perth, WA, Australia

OBJECTIVE. The aim of this study was to investigate the association of dose and timing of prenatal alcohol exposure with early language acquisition.

METHODS. We examined language delay in a randomly selected, population-based sample of Western Australian children born in 1995–1996 whose mothers had agreed to participate in a longitudinal study on health-related behaviors and who had completed the 2-year questionnaire (N = 1739). Information on alcohol consumption was collected at 3 months after birth for four periods; the three months pre-pregnancy and for each trimester separately. Prenatal alcohol exposure was grouped into none, low, moderate-heavy and binge (>5) based on the total quantity consumed per week, quantity consumed per occasion, and frequency of consumption. The communication scale from the Ages & Stages Questionnaire was used to evaluate language delay. Logistic regression analysis was used to generate odds ratios and 95% confidence intervals, adjusted for confounding factors.

RESULTS. There was no association between low levels of alcohol consumption and language delay at any time period, although there was a nonsignificant 30% increase in risk when moderate-to-heavy levels of alcohol were consumed in the third trimester. Children exposed to a binge pattern of maternal alcohol consumption in the second trimester had nonsignificant, three-fold increased odds of language delay, with a similar estimate following third trimester alcohol exposure after controlling for covariates.

CONCLUSIONS. This study did not detect an association between low levels of prenatal alcohol exposure and language delay when compared with women who abstained from alcohol during pregnancy. A nonsignificant threefold increase in the likelihood of language delay was seen in children whose mothers binged during late pregnancy. However, the small numbers of women with a binge-drinking pattern in late pregnancy limited the power of this study; studies analyzing larger numbers of children exposed to binge drinking in late pregnancy are needed.

Key Words: prenatal alcohol exposure • fetal alcohol spectrum disorders • language development disorders • child development • longitudinal study • prospective study • RASCALS study

Abbreviations: FAS—fetal alcohol syndrome • MAST—Michigan Alcohol Screening Test • AA—absolute alcohol • DASS—Depression Anxiety Stress Scale • OR—odds ratio • CI—confidence interval

Accepted May 23, 2008.


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