Prenatal alcohol exposure and offspring cognition and school performance: a 'Mendelian randomization' natural experiment.

Luisa Zuccolo, Sarah J Lewis, George Davey Smith, Kapil Sayal, Elizabeth S Draper, Robert Fraser, Margaret Barrow, Rosa Alati, Sue Ring, Jean Golding, Jon Heron, Ron Gray, John A A Macleod

Research output: Contribution to journalArticle (Academic Journal)

52 Citations (Scopus)

Abstract

BACKGROUND: There is substantial debate as to whether moderate alcohol use during pregnancy could have subtle but important effects on offspring, by impairing later cognitive function and thus school performance. The authors aimed to investigate the unconfounded effect of moderately increased prenatal alcohol exposure on cognitive/educational performance.

METHODS: We used mother-offspring pairs participating in the Avon Longitudinal Study of Parents and Children (ALSPAC) and performed both conventional observational analyses and Mendelian randomization using an ADH1B variant (rs1229984) associated with reduced alcohol consumption. Women of White European origin with genotype and self-reported prenatal alcohol consumption, whose offspring's IQ score had been assessed in clinic (N=4061 pairs) or Key Stage 2 (KS2) academic achievement score was available through linkage to the National Pupil Database (N=6268), contributed to the analyses.

RESULTS: Women reporting moderate drinking before and during early pregnancy were relatively affluent compared with women reporting lighter drinking, and their children had higher KS2 and IQ scores. In contrast, children whose mothers' genotype predisposes to lower consumption or abstinence during early pregnancy had higher KS2 scores (mean difference +1.7, 95% confidence interval +0.4, +3.0) than children of mothers whose genotype predisposed to heavier drinking, after adjustment for population stratification.

CONCLUSIONS: Better offspring cognitive/educational outcomes observed in association with prenatal alcohol exposure presumably reflected residual confounding by factors associated with social position and maternal education. The unconfounded Mendelian randomization estimates suggest a small but potentially important detrimental effect of small increases in prenatal alcohol exposure, at least on educational outcomes.

Translated title of the contributionDoes maternal alcohol consumption in pregnancy influence offspring school performance? A“Mendelian randomization” natural experiment
Original languageEnglish
Pages (from-to)1358-1370
Number of pages13
JournalInternational Journal of Epidemiology
Volume42
Issue number5
Early online date24 Sep 2013
DOIs
Publication statusPublished - Oct 2013

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