Abstract
There is evidence for social inequalities in the health status of children with prenatal alcohol exposure (PAE). This study aimed to describe social inequalities in low birth weight (LBW) in children/adolescents with PAE and to examine the contribution of anthropometric and health-related behavioral factors to the explanation of social inequalities. A total of 2,159 participants with parental self-reported moderate to regular PAE (enrolled in the cross-sectional German Health Interview and Examination Survey for Children and Adolescents) were examined. At similar levels of PAE, the risk of LBW was significantly increased in subjects with a low socioeconomic status (SES) (adjusted odds ratio (OR) 2.78, 95% confidence interval (CI) 1.59, 4.86) and middle SES (adjusted OR 2.04, 95% CI 1.28, 3.24). Maternal height, maternal body mass index (BMI) and smoking during pregnancy mediated the association. The mediating effect of maternal height was 12.5% to 33.7%. Maternal BMI explained 7.9% of the socioeconomic difference in LBW between the high and low SES groups in children with PAE. The mediating effect of smoking during pregnancy was 17.3% to 31.5%. Maternal height, maternal BMI and smoking during pregnancy together explained 24.4% to 60.1% of the socioeconomic differences in LBW in children with PAE. A large proportion of the socioeconomic differences in LBW in children with PAE can be attributed to anthropometric and health-related behavioral factors.
Highlights
It is known that maternal alcohol intake during pregnancy is associated with a broad range of irreversible disorders and serious impairments in the offspring since Lemoine et al [1] reported on the adverse effects of prenatal alcohol exposure (PAE); these effects are covered by the umbrella term “fetal alcohol spectrum disorders” (FASD)
Of the 2,159 participants whose mothers consumed alcohol during pregnancy, 17.1% are from the low social class, 44.5% have a social middle-class background, and 38.4% are from the highest social class
This study has shown that low birth weight (LBW) in children with PAE is subject to social inequalities
Summary
It is known that maternal alcohol intake during pregnancy is associated with a broad range of irreversible disorders and serious impairments in the offspring since Lemoine et al [1] reported on the adverse effects of prenatal alcohol exposure (PAE); these effects are covered by the umbrella term “fetal alcohol spectrum disorders” (FASD). Alcohol intake during pregnancy was reported to be most prevalent in women with a high socioeconomic status (SES) [11,12,13,14,15,16,17], the adverse effects of PAE appeared mostly in the offspring with a low socioeconomic background [18,19,20,21,22,23,24,25].
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