title: Dose and Timing of Prenatal Alcohol Exposure and Maternal Nutritional Supplements: Developmental Effects on 6-Month-Old Infants.
abstract: OBJECTIVE
  Fetal alcohol spectrum disorders are more common in disadvantaged populations. Environmental factors, like suboptimal nutrition, may potentiate the developmental effects of prenatal alcohol exposure. To evaluate the impact of micronutrients, including choline, on reduction of effects of exposure, we examined timing and dose of alcohol and effects of nutritional supplementation at two OMNI-Net sites in Western Ukraine that included high and low risk individuals.
  
  
  METHODS
  Alcohol-using and nondrinking women were randomized to one of three multivitamin/mineral supplement groups: none, multivitamins/minerals (MVM), and multivitamin/minerals plus choline. Children (N = 367) were tested at 6 months with the Bayley Scales of Infant Development (2nd ED) yielding standard scores for Mental Development Index (MDI), Psychomotor Development Index (PDI) and Behavior.
  
  
  RESULTS
  Generalized linear modeling was used: (1) for factorial analysis of effects of alcohol group, multivitamin/minerals, and choline supplementation; and (2) to examine the relationship between amount and timing of alcohol (ounces of absolute alcohol/day [ozAA/day] peri-conception and on average in the second trimester) and MVM supplementation on developmental outcomes while controlling sex, social class, and smoking. MDI was significantly impacted by peri-conceptual alcohol dose (X2(1), p < .001) with more alcohol associated with lower scores and males more negatively affected than females (X2(1), p < .002). Micronutrient supplementation had a protective effect; those receiving supplements performed better ([Formula: see text], p < .005). The PDI motor scores did not differ by group but were affected by peri-conceptual alcohol dose (X2(1), p < .04).
  
  
  CONCLUSIONS
  Multivitamin/mineral supplementation can reduce the negative impact of alcohol use during pregnancy on specific developmental outcomes.
authors.affiliation: Departments of Psychiatry and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA. ccoles@emory.edu.|Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, 12 Executive Park Drive, Room 212, Atlanta, GA, 30329, USA. ccoles@emory.edu.
authors.forename: Claire D
authors.identifier: http://orcid.org/0000-0003-3399-6644
authors.initials: CD
authors.lastname: Coles
authors.affiliation: Departments of Psychiatry and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Kable
authors.affiliation: Department of Nutrition, University of California-Davis, Davis, CA, USA.
authors.forename: Carl L
authors.initials: CL
authors.lastname: Keen
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Kenneth Lyons
authors.initials: KL
authors.lastname: Jones
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA.|University of South Alabama, Mobile, AL, USA.|OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Rivne Province, Ukraine.|OMNI-Net for Children International Charitable Fund, Khmelnytsky Perinatal Center, Khmelnytsky, Khmelnytsky Province, Ukraine.
authors.forename: Wladimir
authors.initials: W
authors.lastname: Wertelecki
authors.affiliation: OMNI-Net for Children International Charitable Fund, Rivne Regional Medical Diagnostic Center, Rivne, Rivne Province, Ukraine.
authors.forename: Irina V
authors.initials: IV
authors.lastname: Granovska
authors.affiliation: OMNI-Net for Children International Charitable Fund, Khmelnytsky Perinatal Center, Khmelnytsky, Khmelnytsky Province, Ukraine.
authors.forename: Alla O
authors.initials: AO
authors.lastname: Pashtepa
authors.affiliation: Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Christina D
authors.initials: CD
authors.lastname: Chambers
mesh_terms: D002657:Child Development / Q000187:drug effects*; D019587:Dietary Supplements / Q000706:statistics & numerical data*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders; D006801:Humans; D007223:Infant; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D011597:Psychomotor Performance / Q000187:drug effects
keywords: Choline; Fetal alcohol spectrum disorders; Infant development; Multivitamin supplement; Prenatal alcohol exposure