University of Salford Directorate of Allied and Public Health, University of Salford, Salford, UK.
Psychology Department Bradford University, Bradford, UK.
J Dev Orig Health Dis. 2024 Nov 29;15:e29. doi: 10.1017/S2040174424000369.
Prenatal alcohol exposure (PAE) is associated with cognitive, behavioural, and developmental impairments throughout the lifespan of affected individuals, but there is limited evidence on how early this impact can be identified through routinely collected childhood data. This paper explores the relationship between PAE and the Early Years Foundation Stage Profile (EYFSP), a statutory teacher-based summative assessment of early development in relation to learning goals. This analysis uses the Born in Bradford dataset, a UK based cohort ( = 13,959; full dataset), which collected self-reported PAE from 11,905 mothers, with 19.8% reporting drinking alcohol at some point during pregnancy. Coarsened exact matching was conducted to examine relationships between patterns of PAE and children achieving a 'Good Level of Development' on the EYFSP, a binary variable assessed at 4-5 years of age, controlling for known confounders, including deprivation, mother's education, exposure to other teratogenic substances, and child's age at assessment. Additionally, we examined EYFSP sub-scores to identify specific developmental deficits associated with PAE.The key finding is a statistically significant association between PAE at a level of consuming 5 or more units of alcohol (equivalent to 50 ml or 40 g of pure alcohol) at least once per week from the 4 month of pregnancy onwards and lower EYFSP scores when accounting for established confounding variables. These findings highlight that the detrimental impact of alcohol during pregnancy can be identified using statutory educational assessments. This has implications internationally for prevention work, policy, and commissioning of support services for people impacted by PAE.
产前酒精暴露（PAE）与受影响个体一生中的认知、行为和发育障碍有关，但关于如何通过常规收集的儿童数据尽早识别这种影响的证据有限。本文探讨了 PAE 与早期基础阶段概况（EYFSP）之间的关系，EYFSP 是一种基于教师的法定总结性评估，用于评估与学习目标相关的早期发展。本分析使用了英国的出生在布拉德福德数据集（= 13959；完整数据集），该数据集从 11905 位母亲那里收集了自我报告的 PAE 数据，其中 19.8%的母亲在怀孕期间曾有过饮酒行为。为了研究 PAE 模式与儿童在 EYFSP 上达到“良好发展水平”之间的关系，我们进行了粗糙精确匹配，该关系是一个二项变量，在 4-5 岁时进行评估，控制了已知的混杂因素，包括贫困、母亲的教育程度、接触其他致畸物质以及儿童评估时的年龄。此外，我们还检查了 EYFSP 的子评分，以确定与 PAE 相关的特定发育缺陷。主要发现是，在怀孕期间每周至少饮用 5 个或更多单位的酒精（相当于 50 毫升或 40 克纯酒精）的 PAE 水平与 EYFSP 评分较低之间存在统计学上的显著关联，在考虑了既定的混杂变量后更是如此。这些发现强调了使用法定教育评估可以识别怀孕期间酒精的有害影响。这对国际上的预防工作、政策以及为受 PAE 影响的人提供支持服务的委托具有影响。
