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John S. Baer, PhD; Paul D. Sampson, PhD; Helen M. Barr, MA, MS; Paul D. Connor, PhD; Ann P. Streissguth, PhD

Arch Gen Psychiatry. 2003;60:377-385.

Background  Prenatal alcohol exposure may be a risk factor for the development of alcohol problems in humans.

Methods  We use data beginning with interviews of women in prenatal care at midpregnancy to predict alcohol use and alcohol-related problems in their offspring now aged 21 years. Maternal drinking during pregnancy was assessed from November 4, 1974, through October 2, 1975, along with measures of maternal smoking, use of caffeine and other drugs, and demographic factors. Family history of alcohol problems was assessed from interviews with parents when offspring were 14 years of age and updated when offspring were 21 years of age. Measures of parental use of alcohol and other drugs and many aspects of the family environment were assessed at 7 different ages, prenatally through 21 years. Young adult offspring (age, 21 years [N = 433]) provided self-reports of drinking quantity and frequency and completed the Alcohol Dependence Scale as a measure of alcohol-related problems and dependence.

Results  Univariate, partial least squares, and regression analyses indicate that prenatal alcohol exposure is significantly associated with alcohol problems at 21 years of age. The relationship persists independent of the effects of family history of alcohol problems, nicotine exposure, other prenatal exposures, and postnatal environmental factors including parental use of other drugs. Prenatal nicotine exposure was not associated with alcohol problems by offspring at 21 years of age.

Conclusions  Prenatal alcohol exposure is a risk factor for the development of drinking problems in humans. Potential mechanisms for the role of fetal exposure and the development of alcohol problems deserve study.

From the Departments of Psychology (Dr Baer) and Statistics (Dr Sampson), University of Washington, Veterans Affairs Puget Sound Health Care System (Dr Baer), and the University of Washington School of Medicine (Ms Barr and Drs Connor and Streissguth), Seattle, Wash.

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