Alcohol Policy, Social Context, and Infant Health: The Impact of Minimum Legal Drinking Age

Objective: The minimum legal drinking age (MLDA) was increased in the U.S. in the late 1980s in an effort to reduce intoxication-associated injuries, especially those related to motor vehicle accidents. This paper explores distal (secondary) effects of changing MLDA on indices of infant health, and whether changes in drinking behaviors or birth composition contributed to these effects. Methods: State- and year-fixed-effects models are used to analyze the relationship between MLDA, drinking behaviors, and birth outcomes. We studied the effects of different MLDA (age 18, 19, 20, or 21 years) when potential mothers were 14 years old by merging two population-based datasets, the Natality Detailed Files and the Behavioral Risk Factor Surveillance System between 1985 and 2002. Results: A MLDA of 18 years old (when potential mothers were 14 years old) increased the prevalence of low birth weight, low Apgar scores, and premature births. Effects were stronger among children born to black women compared with white women. Moreover, a younger MLDA was associated with an increasing proportion of very young and high school dropouts for black women. Furthermore, older MLDA laws at age 14 years decreased the prevalence of binge drinking among black women. Conclusions: Increasing the MLDA had longer term, distal impacts beyond the initially intended outcomes, specifically on birth outcomes (particularly among infants born to black women) as well as school drop-outs and binge drinking patterns among black young females. The older MLDA, intended initially to reduce problematic drinking behaviors, appeared to alter broader social contexts that influenced young women during their early childbearing years

Preterm birth and small for gestational age in relation to alcohol consumption during pregnancy: stronger associations among vulnerable women? Results from two large Western-European studies

Pfinder M, Kunst AE, Feldmann R, van Eijsden M, Vrijkotte TGM. Preterm birth and small for gestational age in relation to alcohol consumption during pregnancy: stronger associations among vulnerable women? Results from two large Western-European studies. BMC Pregnancy and Childbirth. 2013;13(1): 49.BACKGROUND: Inconsistent data on the association between prenatal alcohol exposure and a range of pregnancy outcomes, such as preterm birth (PTB) and small for gestational age (SGA) raise new questions. This study aimed to assess whether the association between low-moderate prenatal alcohol exposure and PTB and SGA differs according to maternal education, maternal mental distress or maternal smoking. METHODS: The Amsterdam Born Children and their Development (ABCD) Study (N=5,238) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) (N=16,301) are both large studies. Women provide information on alcohol intake in early pregnancy, 3 months postpartum and up to 17 years retrospectively. Multivariate logistic regression analyses and stratified regression analyses were performed to examine the association between prenatal alcohol exposure and PTB and SGA, respectively. RESULTS: No association was found between any level of prenatal alcohol exposure (non-daily, daily, non-abstaining) and SGA. The offspring of daily drinkers and non-abstainers had a lower risk of PTB [ABCD: odds ratio (OR) 0.31, 95% confidence interval (CI) 0.13, 0.77; KiGGS: OR 0.75, 95% CI 0.57, 0.99]. Interactions with maternal education, maternal distress or maternal smoking were not significant. CONCLUSIONS: Although these results should be interpreted with caution, both studies showed no adverse effects of low-moderate prenatal alcohol exposure on PTB and SGA, not even in the offspring of women who were disadvantaged in terms of low education, high levels of distress, or smoking during pregnancy

Breastfeeding and cognitive development in the first 2 years of life

The relationship between breastfeeding and cognitive development in the first 2 years of life was examined in a cohort of children being followed in a study of risk factors in development. A significant difference between bottlefed children, children breastfed [less-than-or-equals, slant]4 months and those breastfed >4 months was found on the Mental Development Index of the Bayley Scales at ages 1 and 2 years, favoring the breastfed children. At age 6 months, the direction of the relationship was the same but did not reach significance. Supplementary regression analyses examining the strength of the relationship between duration of breastfeeding and cognitive development similarly showed a small but significant relationship between duration of breastfeeding and scores on the Bayley at 1 and 2 years. Alternative explanations for the results are discussed.breastfeeding cognitive development early childhood

Breastfeeding and long-chain polyunsaturated fatty acid intake in the first 4 post-natal months and infant cognitive development: an observational study

The aim of this study was to examine infant feeding and the long-chain polyunsaturated fatty acid (LCPUFA) concentration of breast milk and formulas in relation to infant development. The prospective Pregnancy, Infection and Nutrition Study (n = 358) collected data on breastfeeding, breast milk samples and the formulas fed through 4 months post-partum. At 12 months of age, infants’ development was assessed (Mullen Scales of Early Learning). Linear regression was used to examine development in relation to breastfeeding, breast milk docosahexaenoic acid (DHA) and arachidonic acid (AA) concentration, and DHA and AA concentration from the combination of breast milk and formula. The median breast milk DHA concentration was 0.20% of total fatty acids [interquartile range (IQR) = 0.14, 0.34]; median AA concentration was 0.52% (IQR = 0.44, 0.63). Upon adjustment for preterm birth, sex, smoking, race and ethnicity and education, breastfeeding exclusivity was unrelated to development. Among infants exclusively breastfed, breast milk LCPUFA concentration was not associated with development (Mullen composite, DHA: adjusted β = −1.3, 95% confidence interval: −10.3, 7.7). Variables combining DHA and AA concentrations from breast milk and formula, weighted by their contribution to diet, were unassociated with development. We found no evidence of enhanced infant development related to the LCPUFA content of breast milk or formula consumed during the first four post-natal months