4.4 Article

An investigation of the link between prenatal alcohol exposure and sleep problems across childhood

Journal

DRUG AND ALCOHOL DEPENDENCE
Volume 218, Issue -, Pages -

Publisher

ELSEVIER IRELAND LTD
DOI: 10.1016/j.drugalcdep.2020.108412

Keywords

Prenatal alcohol exposure (PAE); Alcohol; Fetal alcohol spectrum disorder (FASD); Sleep; Pregnancy; Child development

Funding

  1. joint Griffith UniversityDepartment of Health, Australia, Postgraduate Research Scholarship (2019-2021)
  2. Drug and Alcohol Program: Fetal Alcohol Spectrum Disorder (FASD) Diagnostic Services and Models of Care Grant Opportunity - Commonwealth Government, Australia [H1617G038]

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The study revealed that heavy prenatal alcohol exposure is associated with increased number of sleep problems and higher probability of persistent sleep issues in children. Moderate or low exposure showed no negative association with sleep problems. Other factors such as parenting, family, economic status, and child health also significantly impacted child sleep.
Objective: To investigate the association between dose and frequency of prenatal alcohol exposure (PAE) and sleep problems in children, after controlling for established risk factors for sleep problems. Methods: Data from the birth cohort of the Longitudinal Study of Australian Children (LSAC) was used. Mothers of 3447 children provided information on alcohol consumption during pregnancy, children's sleep problems from 2- to 9-years, and potential confounders associated with sleep problems. Children were classified into PAE groups based on distinct patterns of maternal drinking during pregnancy: abstinent, occasional, low, moderate, and heavy. The effect of PAE on the number and persistence of sleep problems across childhood (2-9 years) was examined. Results: After controlling for multiple covariates that impact sleep, children with heavy PAE had 1.13 more sleep problems across childhood (2-9 years) relative to children whose mothers were abstainers, in particular 0.37 more at 2- to 3-years (0.504, 95 % CI 0.053, 0.956), and 0.34 more at 6- to 7-years (0.847, 95 % CI 0.299, 1.396). Compared to children of abstainers, heavy PAE increases the probability of having persistent sleep problems from 2- to 9-years by 22.57 %. No negative associations between moderate or low PAE and sleep were observed. Parenting, family, economic, and child health factors also significantly affected child sleep. Conclusion: Heavy PAE was associated with significantly more sleep problems across childhood and a higher probability of reporting persistent sleep problems, relative to children with no PAE. Implications for the understanding and management of sleep in young children with PAE and FASD are discussed.

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