Zaso, M.J., Youngentob, S.L. and Park, A. (2021), Characterizing the role of early alcohol re‐exposure in associations of prenatal alcohol exposure with adolescent alcohol outcomes. Alcoholism: Clinical and Experimental Research. Accepted Author Manuscript. https://doi.org/10.1111/acer.14632
Prenatal alcohol exposure has been linked to a host of negative outcomes, although it remains largely unknown whether prenatal exposure leads to earlier age of alcohol use initiation and/or exacerbates early alcohol initiation. The current study examined whether adolescents exposed to heavy drinking during gestation began drinking earlier than their non‐exposed peers and whether earlier age of alcohol re‐exposure in adolescence exacerbated associations with alcohol outcomes.
Adolescents (17 years of age; 57% female; 96% White) from a longitudinal, population‐based cohort study, the Avon Longitudinal Study of Parents and Children (ALSPAC), reported on their age at first whole drink and alcohol behaviors. Adolescents’ mothers also reported on their own heavy drinking during pregnancy (i.e., any consumption of 4+ U.K. units in a drinking day at either 18‐ or 32‐weeks gestation).
Survival analyses indicated that prenatal heavy drinking exposure was not associated with earlier initiation of alcohol use after controlling for potential demographic and parental mental health and substance use confounds. Generalized negative binomial models demonstrated that prenatal heavy drinking exposure moderated associations of alcohol initiation age with alcohol quantity and heavy drinking frequency (but not alcohol frequency or Alcohol Use Disorders Identification Test score), after controlling for the same demographic and parental confounds. Specifically, earlier alcohol initiation was associated with more adverse alcohol outcomes regardless of prenatal exposure. However, the protective associations of delayed alcohol initiation diminished among adolescents exposed to prenatal heavy drinking.
This study provides evidence for interplay between prenatal and postnatal alcohol exposures. Importantly, even when adolescent re‐exposure was delayed, prenatally exposed adolescents appeared to be less protected by such later alcohol initiation.
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