{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:26:04Z","timestamp":1791228364850,"version":"4.1.0"},"reference-count":36,"publisher":"American Academy of Pediatrics (AAP)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,2,1]]},"abstract":"<jats:sec><jats:title>BACKGROUND:<\/jats:title><jats:p>Previous studies have had inconsistent findings regarding the quantity and frequency of prenatal alcohol exposure (PAE) that lead to deficits in growth and neurodevelopment. This may be due to imprecise methods of exposure classification. Our objective in this study was to employ longitudinal trajectory modeling of maternal drinking patterns associated with infant growth or neurodevelopmental deficits to a homogenous sample of mothers and infants.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>From a sample of 471 pregnant women prospectively enrolled in a longitudinal study in the Ukraine, we performed a longitudinal cluster analysis of drinking patterns across gestation. We employed multivariable regression analyses to determine if each trajectory group was associated with infant weight, length, or head circumference at birth or psychomotor or mental deficits in infancy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>We identified 5 distinct PAE trajectory groups: minimal or no PAE throughout gestation, low-to-moderate PAE with discontinuation early in gestation, low-to-moderate PAE sustained across gestation, moderate-to-high PAE with reduction early in gestation, and high PAE sustained across gestation. The highest-trajectory group was associated with deficits in infant weight and length at birth and deficits in psychomotor and mental performance at 6 to 12 months of age. Although confidence intervals overlapped, low-to-moderate sustained use was more strongly associated with most negative infant outcomes than moderate-to-high PAE with early reduction.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>With these findings, we confirm that high, sustained PAE confers the highest risk for adverse infant outcomes but demonstrate that even low-to-moderate PAE continued across gestation is associated with certain deficits. This approach may be used to help clinicians identify high-risk infants for targeted early intervention.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2018-2399","type":"journal-article","created":{"date-parts":[[2019,1,4]],"date-time":"2019-01-04T13:45:24Z","timestamp":1546609524000},"source":"Crossref","is-referenced-by-count":47,"title":["Patterns of Prenatal Alcohol Use That Predict Infant Growth and Development"],"prefix":"10.1542","volume":"143","author":[{"given":"Gretchen","family":"Bandoli","sequence":"first","affiliation":[{"name":"Departments of Pediatrics and"},{"name":"Family Medicine and Public Health, University of California, San Diego, La Jolla, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire D.","family":"Coles","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Pediatrics, School of Medicine, Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Kable","sequence":"additional","affiliation":[{"name":"Departments of Psychiatry and Pediatrics, School of Medicine, Emory University, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wladimir","family":"Wertelecki","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"},{"name":"Omni-Net for Children International Charitable Fund and Rivne Regional Medical Diagnostic Center, Rivne, Ukraine;"},{"name":"Omni-Net for Children International Charitable Fund and Khmelnytsky Perinatal Center, Khmelnytskyi, Ukraine;"},{"name":"Department of Medical Genetics, University of South Alabama, Mobile, Alabama; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lyubov","family":"Yevtushok","sequence":"additional","affiliation":[{"name":"Omni-Net for Children International Charitable Fund and Rivne Regional Medical Diagnostic Center, Rivne, Ukraine;"},{"name":"Lviv National Medical University, Lviv, Ukraine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalya","family":"Zymak-Zakutnya","sequence":"additional","affiliation":[{"name":"Omni-Net for Children International Charitable Fund and Rivne Regional Medical Diagnostic Center, Rivne, Ukraine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Wells","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina V.","family":"Granovska","sequence":"additional","affiliation":[{"name":"Omni-Net for Children International Charitable Fund and Rivne Regional Medical Diagnostic Center, Rivne, Ukraine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alla O.","family":"Pashtepa","sequence":"additional","affiliation":[{"name":"Omni-Net for Children International Charitable Fund and Khmelnytsky Perinatal Center, Khmelnytskyi, Ukraine;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina D.","family":"Chambers","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and"},{"name":"Family Medicine and Public Health, University of California, San Diego, La Jolla, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the CIFASD","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"issue":"37","key":"2021121013285378600_B1","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.15585\/mmwr.mm6437a3","article-title":"Alcohol use and binge drinking among women of childbearing age - United States, 2011-2013.","volume":"64","author":"Tan","year":"2015","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"1","key":"2021121013285378600_B2","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1111\/acer.12214","article-title":"The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: a meta-analysis.","volume":"38","author":"Flak","year":"2014","journal-title":"Alcohol Clin Exp Res"},{"issue":"2","key":"2021121013285378600_B3","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1007\/s11065-011-9166-x","article-title":"Fetal alcohol spectrum disorders: an overview.","volume":"21","author":"Riley","year":"2011","journal-title":"Neuropsychol Rev"},{"issue":"5","key":"2021121013285378600_B4","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1001\/jama.2017.21896","article-title":"Prevalence of fetal alcohol spectrum disorders in 4 US communities.","volume":"319","author":"May","year":"2018","journal-title":"JAMA"},{"issue":"2","key":"2021121013285378600_B5","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1007\/s11065-011-9169-7","article-title":"Biobehavioral markers of adverse effect in fetal alcohol spectrum disorders.","volume":"21","author":"Jacobson","year":"2011","journal-title":"Neuropsychol Rev"},{"key":"2021121013285378600_B6","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1016\/B978-0-444-62619-6.00025-2","article-title":"Neurobehavioral, neurologic, and neuroimaging characteristics of fetal alcohol spectrum disorders.","volume":"125","author":"Glass","year":"2014","journal-title":"Handb Clin Neurol"},{"key":"2021121013285378600_B7","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.bbr.2013.10.040","article-title":"Deficits in response inhibition correlate with oculomotor control in children with fetal alcohol spectrum disorder and prenatal alcohol exposure.","volume":"259","author":"Paolozza","year":"2014","journal-title":"Behav Brain Res"},{"issue":"5","key":"2021121013285378600_B8","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2009-0712","article-title":"Prenatal alcohol exposure and neurodevelopmental disorders in children adopted from eastern Europe.","volume":"125","author":"Landgren","year":"2010","journal-title":"Pediatrics"},{"issue":"2","key":"2021121013285378600_B9","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1016\/j.drugalcdep.2013.07.013","article-title":"Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): quantity, frequency, and timing of drinking.","volume":"133","author":"May","year":"2013","journal-title":"Drug Alcohol Depend"},{"issue":"1","key":"2021121013285378600_B10","first-page":"15","article-title":"Maternal risk factors for fetal alcohol spectrum disorders: not as simple as it might seem.","volume":"34","author":"May","year":"2011","journal-title":"Alcohol Res Health"},{"issue":"8","key":"2021121013285378600_B11","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1002\/bdra.23034","article-title":"Safety concerns regarding binge drinking in pregnancy: a review.","volume":"94","author":"Conover","year":"2012","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"issue":"12","key":"2021121013285378600_B12","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1136\/jech.2006.054213","article-title":"Systematic review of the fetal effects of prenatal binge-drinking.","volume":"61","author":"Henderson","year":"2007","journal-title":"J Epidemiol Community Health"},{"issue":"3","key":"2021121013285378600_B13","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1111\/j.1600-0412.2010.01039.x","article-title":"Prenatal alcohol exposure - a systematic review of the effects on child motor function.","volume":"90","author":"Bay","year":"2011","journal-title":"Acta Obstet Gynecol Scand"},{"issue":"3","key":"2021121013285378600_B14","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1111\/j.1471-0528.2006.01163.x","article-title":"Systematic review of effects of low-moderate prenatal alcohol exposure on pregnancy outcome [published correction appears in BJOG. 2007;114(7):914\u2013915].","volume":"114","author":"Henderson","year":"2007","journal-title":"BJOG"},{"issue":"10","key":"2021121013285378600_B15","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1111\/j.1471-0528.2012.03393.x","article-title":"The effect of different alcohol drinking patterns in early to mid pregnancy on the child\u2019s intelligence, attention, and executive function.","volume":"119","author":"Kesmodel","year":"2012","journal-title":"BJOG"},{"key":"2021121013285378600_B16","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1186\/1471-2458-14-1048","article-title":"Women\u2019s perceptions of information about alcohol use during pregnancy: a qualitative study.","volume":"14","author":"Anderson","year":"2014","journal-title":"BMC Public Health"},{"issue":"6","key":"2021121013285378600_B17","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1111\/1471-0528.13078","article-title":"Prenatal exposure to alcohol and the developing fetus: methodological issues.","volume":"122","author":"Niclasen","year":"2015","journal-title":"BJOG"},{"issue":"10","key":"2021121013285378600_B18","doi-asserted-by":"crossref","first-page":"1201","DOI":"10.1111\/j.1471-0528.2012.03397.x","article-title":"The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on executive function in 5-year-old children [published correction appears in BJOG. 2012;119(13):1683; BJOG. 2013;120(10):1302].","volume":"119","author":"Skogerb\u00f8","year":"2012","journal-title":"BJOG"},{"issue":"4","key":"2021121013285378600_B19","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1007\/s00404-013-3056-9","article-title":"Determinants of alcohol cessation, reduction and no reduction during pregnancy.","volume":"289","author":"Kitsantas","year":"2014","journal-title":"Arch Gynecol Obstet"},{"key":"2021121013285378600_B20","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.alcohol.2017.03.001","article-title":"Drinking and smoking patterns during pregnancy: development of group-based trajectories in the Safe Passage Study.","volume":"62","author":"Dukes","year":"2017","journal-title":"Alcohol"},{"issue":"2","key":"2021121013285378600_B21","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1111\/j.1465-3362.2009.00136.x","article-title":"What women in France say about alcohol abstinence during pregnancy.","volume":"29","author":"Toutain","year":"2010","journal-title":"Drug Alcohol Rev"},{"issue":"6","key":"2021121013285378600_B22","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1111\/dar.12428","article-title":"Life course outcomes for women with different alcohol consumption trajectories: a population-based longitudinal study.","volume":"35","author":"Tran","year":"2016","journal-title":"Drug Alcohol Rev"},{"issue":"2","key":"2021121013285378600_B23","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1111\/ajo.12294","article-title":"Predictors of maternal drinking trajectories before and after pregnancy: evidence from a longitudinal study.","volume":"55","author":"Tran","year":"2015","journal-title":"Aust N Z J Obstet Gynaecol"},{"issue":"4","key":"2021121013285378600_B24","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.1111\/acer.12318","article-title":"Prevalence and predictors of maternal alcohol consumption in 2 regions of Ukraine.","volume":"38","author":"Chambers","year":"2014","journal-title":"Alcohol Clin Exp Res"},{"issue":"12","key":"2021121013285378600_B25","doi-asserted-by":"crossref","first-page":"2605","DOI":"10.1007\/s10995-015-1779-x","article-title":"Dose and timing of prenatal alcohol exposure and maternal nutritional supplements: developmental effects on 6-month-old infants.","volume":"19","author":"Coles","year":"2015","journal-title":"Matern Child Health J"},{"key":"2021121013285378600_B26","first-page":"477","volume-title":"Handbook of Psychiatric Measures","author":"Sobell","year":"2000"},{"issue":"2","key":"2021121013285378600_B27","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s00180-009-0178-4","article-title":"KmL: K-means for longitudinal data.","volume":"25","author":"Genolini","year":"2010","journal-title":"Comput Stat"},{"key":"2021121013285378600_B28","unstructured":"Genolini\u2008C, Falissard\u2008B. Package 'kml'. Available at: https:\/\/cran.r-project.org\/web\/packages\/kml\/kml.pdf. Accessed December 6, 2018"},{"issue":"6","key":"2021121013285378600_B29","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.amepre.2009.01.038","article-title":"Geographic patterns of frequent mental distress: U.S. adults, 1993-2001 and 2003-2006.","volume":"36","author":"Moriarty","year":"2009","journal-title":"Am J Prev Med"},{"key":"2021121013285378600_B30","volume-title":"Bayley Scales of Infant Development Manual","author":"Bayley","year":"1993","edition":"2nd ed"},{"issue":"23","key":"2021121013285378600_B31","first-page":"21","article-title":"Four factor index of social status.","volume":"8","author":"Hollingshead","year":"2011","journal-title":"J Sociol (Melb)"},{"key":"2021121013285378600_B32","doi-asserted-by":"crossref","first-page":"i189","DOI":"10.1136\/bmj.i189","article-title":"Inverse probability weighting.","volume":"352","author":"Mansournia","year":"2016","journal-title":"BMJ"},{"issue":"10","key":"2021121013285378600_B33","doi-asserted-by":"crossref","first-page":"1584","DOI":"10.1111\/j.1530-0277.2002.tb02459.x","article-title":"Prenatal alcohol exposure predicts continued deficits in offspring size at 14 years of age.","volume":"26","author":"Day","year":"2002","journal-title":"Alcohol Clin Exp Res"},{"issue":"5","key":"2021121013285378600_B34","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1111\/j.1530-0277.1985.tb05582.x","article-title":"Neonatal neurobehavioral characteristics as correlates of maternal alcohol use during gestation.","volume":"9","author":"Coles","year":"1985","journal-title":"Alcohol Clin Exp Res"},{"issue":"5","key":"2021121013285378600_B35","first-page":"539","article-title":"Patterns of alcohol consumption and fetal development.","volume":"61","author":"Rosett","year":"1983","journal-title":"Obstet Gynecol"},{"issue":"7","key":"2021121013285378600_B36","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1177\/0962280216673085","article-title":"Group-based multi-trajectory modeling.","volume":"27","author":"Nagin","year":"2018","journal-title":"Stat Methods Med Res"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-2399\/1076475\/peds_20182399.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/doi\/10.1542\/peds.2018-2399\/1076475\/peds_20182399.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,13]],"date-time":"2024-07-13T20:21:00Z","timestamp":1720902060000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/143\/2\/e20182399\/37355\/Patterns-of-Prenatal-Alcohol-Use-That-Predict"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2,1]]},"references-count":36,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,1]]},"published-print":{"date-parts":[[2019,2,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2018-2399","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,2,1]]},"article-number":"e20182399"}}