title: Early fetal binge alcohol exposure predicts high behavioral symptom scores in 5.5-year-old children.
abstract: BACKGROUND
  Fetal binge alcohol exposure has been associated with neurobehavioral and cognitive symptoms. This study explored whether binge drinking mainly before recognition of pregnancy predicted high symptom scores on the Strengths and Difficulties Questionnaire (SDQ) in 5.5-year-old children.
  
  
  METHODS
  In a population-based, longitudinal study representative of pregnant women in Oslo, Norway, questionnaires were answered at 17 and 30 weeks of pregnancy, 6 months after term, and at child age 5.5 years (n = 1,116, constituting 66% of the original cohort). Logistic regression analyses identified factors predicting high SDQ scores, and multiple regression analyses identified direct effects on the SDQ Total.
  
  
  RESULTS
  Binge exposure (≥5 standard units per occasion [SUpo]) during pregnancy week 0 to 6, that is, 0 to 4 weeks after conception, predicted scores in the Abnormal and Borderline range on the SDQ in 5.5-year-olds, after adjusting for other confounding variables. Very early binge exposure less often than once a week predicted high symptom scores on the SDQ Total (p = 0.05) and Hyperactivity/Inattention (significant), while exposure at least once a week demonstrated a 3- to 5-fold significant increase in high symptom scores on Total, Emotional, and Conduct problems. Reporting ≥8 SUpo had stronger predictive power than reporting 5 to 7 SUpo. The results were not explained by participants reporting major lifetime depression. Other predictive factors, although weaker, were maternal symptoms of depression and anxiety during the child's infancy. High education (mother and father), high income (maternal partner), higher child birth weight, and child female sex reduced the likelihood of high SDQ symptom scores. Path analysis demonstrated early binge exposure to have a direct effect on the SDQ Total score.
  
  
  CONCLUSIONS
  Binge drinking up to 4 weeks after conception had a strong and direct predictive effect on SDQ symptom scores in 5.5-year-olds. These results strongly support the advice to avoid binge drinking when planning pregnancy.
authors.affiliation: Division of Mental Health and Addiction, Institute of Clinical Medicine University of Oslo, Oslo, Norway; Child and Adolescent Mental Health Research Unit, Oslo University Hospital, Oslo, Norway.
authors.forename: Astrid
authors.initials: A
authors.lastname: Alvik
authors.forename: Odd O
authors.initials: OO
authors.lastname: Aalen
authors.forename: Rolf
authors.initials: R
authors.lastname: Lindemann
mesh_terms: D000328:Adult; D001526:Behavioral Symptoms / Q000453:epidemiology / Q000209:etiology*; D063425:Binge Drinking; D002648:Child; D002675:Child, Preschool; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009664:Norway / Q000453:epidemiology; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D011297:Prenatal Exposure Delayed Effects / Q000453:epidemiology / Q000523:psychology*
keywords: Binge; Child Development; Fetal Alcohol Spectrum Disorder; Mental Health; Prenatal Alcohol Exposure