Addictions, Drug & Alcohol Institute

New from ADAI/FADU: Prenatal Alcohol Exposure and Mental Health at Midlife


The effects of prenatal alcohol exposure (PAE) have been studied a lot, with a particular focus on physical birth defects and neurocognitive development.

Much less studied has been an association between PAE and mental health disorders, especially for adults with both PAE and fetal alcohol spectrum disorders (FASD).

Though some research has found a connection between PAE and mental health problems, people with PAE often experience a range of social and environmental stressors that could also be connected. Understanding these factors could help improve prevention efforts for prenatal alcohol use and care for those impacted by it.

In this study, ADAI/Fetal Alcohol & Drug Unit (FADU) researchers Therese Grant, PhD, and Susan Stoner, PhD, along with authors from Emory University School of Medicine, compared the self-reported midlife mental health status of people who were exposed to alcohol prenatally (both with and without FASD) with that of unexposed individuals.

They found that people with PAE (regardless of FASD status) reported higher levels of current depressive symptoms and a higher prevalence of depression, anxiety, bipolar disorder, and/or attention deficit/hyperactivity disorder. PAE was also associated with greater environmental stressors, like adverse childhood events and lower socioeconomic status, and these stressors did appear to impact the connection between PAE and mood disorders and anxiety.

These outcomes suggest that instead of a direct connection between prenatal alcohol exposure and mental health problems, the connection is more indirect, involving multiple “hits” on a vulnerable person.

That means that targeting prevention efforts at reducing or eliminating environmental stressors early in development could help mitigate lifelong consequences of PAE on mental health. Earlier identification of PAE and its effects on people could also help improve mental health outcomes for those affected.

Citation: Coles CD, et al. Prenatal alcohol exposure and mental health at midlife: A preliminary report on two longitudinal cohorts. Alcoholism: Clinical & Experimental Research 2022 (in press). Doi: 10.1111/acer.14761

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