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Cohort study
The risk of low-to-moderate prenatal alcohol exposure on child academic underachievement and behaviour may be difficult to measure and should not be underestimated
  1. Sandra W Jacobson1,2,
  2. Joseph L Jacobson1,2
  1. 1Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan, USA;
  2. 2Departments of Human Biology and of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
  1. Correspondence to: Professor Sandra W Jacobson, Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, 3091 Chrysler Drive, Suite 2-C, Detroit, MI 48201, USA; sandra.jacobson{at}wayne.edu

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Context

Two large population-based studies have recently reported no adverse effects of prenatal alcohol exposure at low-to-moderate levels on child academic underachievement and behaviour. However, these negative findings are inconsistent with research from prior longitudinal cohort studies that have detected effects of moderate alcohol exposure on growth, cognition and behaviour,1 ,2 using prospective ascertainment of maternal alcohol use3 and consideration of appropriate effect modifiers,46 while controlling for potential confounders, including smoking and drug use, sociodemographic factors and maternal IQ. A careful review of these two recent studies illustrates the methodological challenges associated with detection of the effects of low-to-moderate levels of prenatal alcohol consumption.

Methods

Skogerbø and colleagues administered the Strengths and Difficulties Questionnaire (SDQ), a brief behavioural screening instrument, to parents and kindergarten teachers of 5-year-old children from the large prospective Danish National Birth Cohort. O'Leary and colleagues linked data from their randomly selected, non-indigenous birth cohort to the children's …

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