Department of Psychology, Syracuse University, Syracuse, NY, USA.
Clinical and Research Institute on Addictions, University at Buffalo-The State University of New York, Buffalo, NY, USA.
Alcohol Clin Exp Res. 2021 Jul;45(7):1436-1447. doi: 10.1111/acer.14632. Epub 2021 Jul 8.
Prenatal alcohol exposure has been linked to a host of negative outcomes, although it is largely unknown whether prenatal exposure leads to an earlier age of initiation of alcohol use or exacerbates early alcohol initiation. The current study examined whether adolescents exposed to heavy drinking during gestation began drinking earlier than their nonexposed peers and whether an earlier age of alcohol reexposure in adolescence exacerbated associations with adverse alcohol outcomes.
Adolescents (17 years of age; 57% female; 96% White) from a longitudinal, population-based cohort study, the Avon Longitudinal Study of Parents and Children, reported on the age they first consumed a whole drink and other alcohol behaviors. Adolescents' mothers also reported on their own heavy drinking during pregnancy (i.e., any consumption of 4+ U.K. units in a drinking day at either 18 or 32 weeks of gestation).
Survival analyses indicated that prenatal heavy drinking exposure was not associated with an earlier initiation of alcohol use after controlling for potential demographic and parental mental health and substance use confounds. Generalized negative binomial models demonstrated that prenatal heavy drinking exposure moderated associations of the age of alcohol initiation with alcohol quantity and heavy drinking frequency (but not alcohol frequency or Alcohol Use Disorders Identification Test score), after controlling for the same demographic and parental confounds. Specifically, earlier alcohol initiation was associated with more adverse alcohol outcomes regardless of prenatal exposure. However, the protective associations of delayed alcohol initiation were lower among adolescents exposed to prenatal heavy drinking.
This study provides evidence for the interplay between prenatal and postnatal alcohol exposures. Importantly, adolescents who were prenatally exposed to heavy drinking appeared to be less protected by later alcohol initiation than those who were not exposed in utero.
产前酒精暴露与许多负面后果有关，尽管尚不清楚产前暴露是否会导致饮酒年龄更早开始，或者是否会加剧早期饮酒的开始。本研究探讨了在怀孕期间大量饮酒的青少年是否比未暴露的同龄人更早开始饮酒，以及青春期酒精再暴露的更早年龄是否会加剧与不良酒精后果的关联。
来自纵向、基于人群的队列研究——雅芳父母与子女纵向研究的青少年（17 岁；57%为女性；96%为白人）报告了他们第一次饮用整杯酒的年龄以及其他饮酒行为。青少年的母亲还报告了她们在怀孕期间的大量饮酒情况（即，在妊娠 18 或 32 周时，任何一天内饮用 4 个或以上英国单位的酒）。
生存分析表明，在控制潜在的人口统计学和父母心理健康以及物质使用混杂因素后，产前大量饮酒暴露与饮酒后开始饮酒的年龄无关。广义负二项模型表明，在控制相同的人口统计学和父母混杂因素后，产前大量饮酒暴露调节了饮酒年龄与酒精量和重度饮酒频率（但不包括饮酒频率或酒精使用障碍识别测试分数）之间的关联。具体来说，无论产前暴露如何，更早的饮酒开始都与更多的不良饮酒后果有关。然而，在产前暴露于大量饮酒的青少年中，延迟饮酒开始的保护关联较低。
本研究为产前和产后酒精暴露之间的相互作用提供了证据。重要的是，与未暴露于子宫内的青少年相比，产前暴露于大量饮酒的青少年似乎不太受晚发性饮酒开始的保护。
