Adolescents' use of alcohol, tobacco and illicit drugs in relation to prenatal alcohol exposure: modifications by gender and ethnicity.
OBJECTIVE
The study aimed to investigate (a) the association between low to moderate prenatal alcohol exposure (PAE) and the use of alcohol, tobacco and illicit drugs in adolescence and (b) whether the associations are modified by gender and ethnicity.


METHODS
The subjects of the study were 5922 children and adolescents, aged from 11 to 17 years, enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents (the KiGGS study). Information on PAE is based on parental self-report questionnaires. Use of alcohol, tobacco and illicit drugs was assessed through self-report questionnaires for adolescents.


RESULTS
Low to moderate PAE was associated with an increased risk of drinking alcohol (adjusted odds ratio (OR) 1.73, 95% confidence interval (CI) 1.34, 2.18) and also of illicit drug use (adjusted OR 1.62, 95% CI 1.23, 2.14). The associations between PAE and the use of alcohol, tobacco and illicit drugs differed according to gender and ethnicity. Gender-stratified analyses resulted in adverse effects of PAE on drinking alcohol, smoking and illicit drug use in females; however, in German males, the associations disappeared. Stronger associations between PAE and the outcome measures were found in non-Germans.


CONCLUSIONS
Our findings indicate that low to moderate levels of maternal alcohol intake during pregnancy are a risk factor for use of alcohol, tobacco and illicit drugs by the offspring, with stronger associations in females and non-Germans.
Corresponding author: Bielefeld Graduate School in History and Sociology, University of Bielefeld, PO Box 10 01 31, 33501 Bielefeld, Germany. manuela.pfinder@uni-bielefeld.de.
Manuela
M
Pfinder
Stefan
S
Liebig
Reinhold
R
Feldmann
D000293:Adolescent; D000428:Alcohol Drinking / Q000453:epidemiology / Q000208:ethnology; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012307:Risk Factors; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000208:ethnology*; D011795:Surveys and Questionnaires; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000208:ethnology
D013287:Illicit Drugs