title: Alcohol exposure in utero is associated with decreased gray matter volume in neonates.
abstract: Neuroimaging studies have indicated that prenatal alcohol exposure is associated with alterations in the structure of specific brain regions. However, the temporal specificity of such changes and their behavioral consequences are less known. Here we explore the brain structure of infants with in utero exposure to alcohol shortly after birth. T2 structural MRI images were acquired from 28 alcohol-exposed infants and 45 demographically matched healthy controls at 2-4 weeks of age on a 3T Siemens Allegra system as part of large birth cohort study, the Drakenstein Child Health Study (DCHS). Neonatal neurobehavior was assessed at this visit; early developmental outcome assessed on the Bayley Scales of Infant Development III at 6 months of age. Volumes of gray matter regions were estimated based on the segmentations of the University of North Carolina neonatal atlas. Significantly decreased total gray matter volume was demonstrated for the alcohol-exposed cohort compared to healthy control infants (p < 0.001). Subcortical gray matter regions that were significantly different between groups after correcting for overall gray matter volume included left hippocampus, bilateral amygdala and left thalamus (p < 0.01). These findings persisted even when correcting for infant age, gender, ethnicity and maternal smoking status. Both early neurobehavioral and developmental adverse outcomes at 6 months across multiple domains were significantly associated with regional volumes primarily in the temporal and frontal lobes in infants with prenatal alcohol exposure. Alcohol exposure during the prenatal period has potentially enduring neurobiological consequences for exposed children. These findings suggest the effects of prenatal alcohol exposure on brain growth is present very early in the first year of life, a period during which the most rapid growth and maturation occurs.
authors.affiliation: Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Klipfontein Road/Private Bag, Rondebosch, 7700/7701, Cape Town, South Africa. kirsty.donald@uct.ac.za.|University of Cape Town, South Africa, Cape Town, South Africa. kirsty.donald@uct.ac.za.
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Donald
authors.affiliation: Department of Human Biology, University of Cape Town, Cape Town, South Africa.|Department of Psychiatry, Stellenbosch University, Cape Town, South Africa.|Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: J P
authors.initials: JP
authors.lastname: Fouche
authors.affiliation: MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa.|Stellenbosch University, Cape Town, South Africa.
authors.forename: Annerine
authors.initials: A
authors.lastname: Roos
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Nastassja
authors.initials: N
authors.lastname: Koen
authors.affiliation: Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
authors.forename: Fleur M
authors.initials: FM
authors.lastname: Howells
authors.affiliation: Department of Psychology, San Diego State University, San Diego, CA, USA.
authors.forename: Edward P
authors.initials: EP
authors.lastname: Riley
authors.affiliation: Department of Neurology, University of California, Los Angeles, CA, USA.
authors.forename: Roger P
authors.initials: RP
authors.lastname: Woods
authors.affiliation: University of Cape Town, South Africa, Cape Town, South Africa.|Department of Neurology, University of California, Los Angeles, CA, USA.
authors.forename: Heather J
authors.initials: HJ
authors.lastname: Zar
authors.affiliation: University of Cape Town, South Africa, Cape Town, South Africa.|Department of Paediatrics and Child Health and MRC Unit on Child & Adolescent Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Narr
authors.affiliation: Department of Psychiatry and Mental Health and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D002492:Central Nervous System Depressants / Q000009:adverse effects*; D002657:Child Development / Q000187:drug effects; D015331:Cohort Studies; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D005333:Fetus / Q000187:drug effects*; D066128:Gray Matter / Q000187:drug effects* / Q000254:growth & development / Q000473:pathology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects; D012727:Sex Characteristics; D012907:Smoking / Q000009:adverse effects; D012959:Socioeconomic Factors; D013019:South Africa
chemical_list: D002492:Central Nervous System Depressants; D000431:Ethanol
keywords: Alcohol; Dubowitz; FASD; Infant; MRI; Neuroimaging