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Prenatal alcohol exposure and adverse fetal growth restriction: findings from the Japan Environment and Children’s Study



Japanese studies on the association between maternal alcohol consumption and fetal growth are few. This study assessed the effect of maternal alcohol consumption on fetal growth.


This prospective birth cohort included 95,761 participants enrolled between January 2011 and March 2014 in the Japan Environment and Children’s Study. Adjusted multiple linear and logistic regression models were used to assess the association between prenatal alcohol consumption and infant birth size.


Consumption of a weekly dose of alcohol in the second/third trimester showed a significant negative correlation with standard deviation (SD; Z) scores for body weight, body length, and head circumference at birth, respectively. Consumption of a weekly dose of alcohol during the second/third trimester had a significant positive correlation with incidences of Z-score ≤ −1.5 for birth head circumference. Associations between alcohol consumption in the second/third trimester and Z-score ≤ −1.5 for birth weight or birth length were not significant. Maternal alcohol consumption in the second/third trimester above 5, 20, and 100 g/week affected body weight, body length, and head circumference at birth, respectively.


Low-to-moderate alcohol consumption during pregnancy might affect fetal growth. Public health policies for pregnant women are needed to stop alcohol consumption during pregnancy.


  • This study examined the association between maternal alcohol consumption and fetal growth restriction in 95,761 pregnant Japanese women using the prospective birth cohort.

  • Maternal alcohol consumption in the second/third trimester more than 5, 20, and 100 g/week might affect fetal growth in body weight, body length, and head circumference, respectively.

  • The findings are relevant and important for educating pregnant women on the adverse health effects that prenatal alcohol consumptions have on infants.

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We thank all the individuals who participated in the Japan Environment and Children’s Study. We express our sincere appreciation to the collaborating hospitals and clinics. We also express our gratitude to the members of staff of the Hokkaido, Miyagi, Fukushima, Chiba, Kanagawa, Koshin, Toyama, Aichi, Kyoto, Osaka, Hyogo, Tottori, Kochi, Fukuoka, and Minami-Kyushu and Okinawa Regional Centers, Program Office, and Medical Support Center for the Japan Environment and Children’s Study (Appendix 1). The Japan Environment and Children’s Study is funded by the operating budget of the Ministry of the Environment, Japan. The findings and conclusions of this article are solely the responsibility of the authors and do not represent the official views of the Ministry of the Environment of the Japanese government.

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K.C., S.K., A.A., S.I., H.M., and R.K. conceived and designed the study. K.C., S.K., A.A., C.M., S.I., Y.S., Y.I., K.S., T.B., H.M., and R.K. performed the data collection. K.C., S.K., A.A., S.I., and R.K. performed the statistical analysis and contributed the manuscript preparation and literature search. S.K., A.A., S.I., H.M., and R.K. interpreted the data. S.K., A.A., C.M., S.I., Y.S., Y.I., Y.N., and R.K. contributed the critical revision of the manuscript for important intellectual content. Y.S., Y.I., K.S., and R.K. contributed the funds collection and was supervisor of the study. All authors approved the version of the manuscript to be published.

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Correspondence to Sumitaka Kobayashi.

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Informed consent was obtained from all participants (patients).

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Cho, K., Kobayashi, S., Araki, A. et al. Prenatal alcohol exposure and adverse fetal growth restriction: findings from the Japan Environment and Children’s Study. Pediatr Res 92, 291–298 (2022).

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