Prenatal alcohol exposure and offspring liver dysfunction: a systematic review and meta-analysis

Limited studies have reported the effect of prenatal alcohol exposure (PAE) on fetal liver development or liver dysfunction. The current review was conducted to systematically review published studies of PAE and liver dysfunction. Pub Med, Embase and Web of Science database were searched using terms of prenatal alcohol exposure and liver or fetal alcohol spectrum disease and liver. The pooled effect size of alcohol exposure was assessed by Hedges's g and 95 % confidence interval (CI) using fixed model or random model depending on the heterogeneity determined by Q test and I (2) statistic. A total of 23 studies were included. The results indicated that gestation alcohol exposure resulted in significant reduction of fetal body weight (Hedges's g = -6.854 +/- A 1.149, 95 % CI -9.106 to -4.602, P < 0.001), but not fetal liver weight reduction (Hedges's g = -0.076 +/- A 0.878, 95 % CI -1.799 to 1.647, P = 0.931). PAE resulted in significant decline in protein synthesis or enzyme activity of offspring fetal liver including glutathione and 25(OH)(2)D (Hedges's g = -1.149 +/- A 0.108, 95 % CI -1.361 to -0.938, P < 0.001), as well as significant increase in proteins including oxidants and collagen (Hedges's g = 1.330 +/- A 0.146, 95 % CI 1.044-1.616, P < 0.001). These results suggested that PAE affects fetal body weight but not liver weight, and that PAE may result in offspring fetal liver dysfunction.