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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Ikeda-Sakai, Y. et al. Inadequate folic acid intake among women taking antiepileptic drugs during pregnancy in Japan: a cross-sectional study. Sci. Rep. 9, 13497 (2019).
Yamamoto, Y. et al. Alcohol consumption and abstention among pregnant Japanese women. J. Epidemiol. 18, 173–182 (2008).
Ministry of Health, Labour and Welfare. Japan 2010 e-health net (in Japanese; cited 2019.10.11); https://www.e-healthnet.mhlw.go.jp/information/alcohol/a-06-002.html.
Ishitsuka, K. et al. Determinants of alcohol consumption in women before and after awareness of conception. Matern. Child Health J. 24, 165–176 (2020).
Pereira, P. P. D. S., Mata, F. A. F. D., Figueiredo, A. C. M. G., Silva, R. B. & Pereira, M. G. Maternal exposure to alcohol and low birthweight: a systematic review and meta-analysis. Rev. Bras. Ginecol. Obstet. 41, 333–347 (2019).
Oster, R. T. & Toth, E. L. Longitudinal rates and risk factors for adverse birth weight among first nations pregnancies in Alberta. J. Obstet. Gynaecol. Can. 38, 29–34 (2016).
Silva, I. D., Quevedo Lde, A., Silva, R. A., Oliveira, S. S. & Pinheiro, R. T. Association between alcohol abuse during pregnancy and birth weight. Rev. Saude Publ. 45, 864–869 (2011).
Witt, W. P. et al. Infant birthweight in the US: the role of preconception stressful life events and substance use. Arch. Womens Ment. Health 19, 529–542 (2016).
Mariscal, M. et al. Pattern of alcohol consumption during pregnancy and risk for low birth weight. Ann. Epidemiol. 16, 432–438 (2006).
Bandoli, G. et al. Patterns of prenatal alcohol use that predict infant growth and development. Pediatrics 143, e20182399 (2019).
Maruoka, K. et al. Risk factors for low birthweight in Japanese infants. Acta Paediatr. 87, 304–309 (1998).
Ogawa, H. et al. Passive smoking by pregnant women and fetal growth. J. Epidemiol. Community Health 45, 164–168 (1991).
Nagata, C., Iwasa, S., Shiraki, M., Sahashi, Y. & Shimizu, H. Association of maternal fat and alcohol intake with maternal and umbilical hormone levels and birth weight. Cancer Sci. 98, 869–873 (2007).
Miyake, Y., Tanaka, K., Okubo, H., Sasaki, S. & Arakawa, M. Alcohol consumption during pregnancy and birth outcomes: the Kyushu Okinawa maternal and child health study. BMC Pregnancy Childbirth 14, 79 (2014).
Tamura, N. et al. Different risk factors for very low birth weight, term-small-for-gestational-age, or preterm birth in Japan. Int. J. Environ. Res. Public Health 15, E369 (2018).
Cederbaum, A. I. Alcohol metabolism. Clin. Liver Dis. 16, 667–685 (2012).
Cooper, D. L., Petherick, E. S. & Wright, J. The association between binge drinking and birth outcomes: results from the born in Bradford cohort study. J. Epidemiol. Community Health 67, 821–828 (2013).
Ikehara, S. et al. Association between maternal alcohol consumption during pregnancy and risk of preterm delivery: the Japan environment and children’s study. BJOG 126, 1448–1454 (2019).
Feldman, H. S. et al. Prenatal alcohol exposure patterns and alcohol-related birth defects and growth deficiencies: a prospective study. Alcohol Clin. Exp. Res. 36, 670–676 (2012).
Auty, R. M. & Branch, R. A. Pharmacokinetics and pharmacodynamics of ethanol, whiskey, and ethanol with n-propyl, n-butyl, and iso-amyl alcohols. Clin. Pharmacol. Ther. 22, 242–249 (1977).
Ohlin, H., Brattström, L., Israelsson, B., Bergqvist, D. & Jerntorp, P. Atherosclerosis and acetaldehyde metabolism in blood. Biochem. Med. Metab. Biol. 46, 317–328 (1991).
Kawamoto, T. et al. Rationale and study design of the Japan environment and children’s study (JECS). BMC Public Health 14, 25 (2014).
Michikawa, T. et al. Baseline profile of participants in the Japan environment and children’s study (JECS). J. Epidemiol. 28, 99–104 (2018).
Yokoyama, Y. et al. Validity of short and long self-administered food frequency questionnaires in ranking dietary intake in middle-aged and elderly Japanese in the Japan public health center-based prospective study for the next generation (JPHC-NEXT) protocol area. J. Epidemiol. 26, 420–432 (2016).
Itabashi, K., Miura, F., Uehara, R. & Nakamura, Y. New Japanese neonatal anthropometric charts for gestational age at birth. Pediatr. Int. 56, 702–708 (2014).
Itabashi, K. et al. Introduction of the new standard for birth size by gestational ages. (in Japanese). J. Jpn Pediatr. Soc. 114, 1271–1293 (2010).
Patra, J. et al. Dose-response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)—a systematic review and meta-analyses. BJOG 118, 1411–1421 (2011).
Strandberg-Larsen, K. et al. Association of light-to-moderate alcohol drinking in pregnancy with preterm birth and birth weight: elucidating bias by pooling data from nine European cohorts. Eur. J. Epidemiol. 32, 751–764 (2017).
Jensen, R. B., Juul, A., Larsen, T., Mortensen, E. L. & Greisen, G. Cognitive ability in adolescents born small for gestational age: associations with fetal growth velocity, head circumference and postnatal growth. Early Hum. Dev. 91, 755–760 (2015).
Sanou, A. S. et al. Maternal alcohol consumption during pregnancy and child’s cognitive performance at 6-8 years of age in rural Burkina Faso: an observational study. PeerJ 5, e3507 (2017).
Chiaffarino, F. et al. Alcohol drinking and risk of small for gestational age birth. Eur. J. Clin. Nutr. 60, 1062–1066 (2006).
Kobayashi, S. et al. Dose-dependent associations between prenatal caffeine consumption and small for gestational age, preterm birth, and reduced birthweight in the Japan environment and children’s study. Paediatr. Perinat. Epidemiol. 33, 185–194 (2019).
Kobayashi, S. et al. Association of blood mercury levels during pregnancy with infant birth size by blood selenium levels in the Japan environment and children’s study: a prospective birth cohort. Environ. Int. 125, 418–429 (2019).
O’Leary, C. M., Nassar, N., Kurinczuk, J. J. & Bower, C. The effect of maternal alcohol consumption on fetal growth and preterm birth. BJOG 116, 390–400 (2009).
Bhatia, S., Drake, D. M., Miller, L. & Wells, P. G. Oxidative stress and DNA damage in the mechanism of fetal alcohol spectrum disorders. Birth Defects Res. 111, 714–748 (2019).
Stockwell, T. et al. Estimating under- and over-reporting of drinking in national surveys of alcohol consumption: identification of consistent biases across four English-speaking countries. Addiction 111, 1203–1213 (2016).
Nam, H. K. & Lee, K. H. Small for gestational age and obesity: epidemiology and general risks. Ann. Pediatr. Endocrinol. Metab. 23, 9–13 (2018).
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.
The authors declare no competing interests.
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 (2021). https://doi.org/10.1038/s41390-021-01595-3