This is a summary of the recent article Prenatal alcohol exposure and developmental programming of mental illness that is featured in CanFASD’s Top FASD Articles of 2020. For a complete understanding of the subject matter, we encourage you to read the full paper, available open access.

Background

In the 1980s, researcher David Barker and his team set the stage for the Developmental Origins of Health and Disease (DOHaD) hypothesis, which suggests that changes to maternal physiology, placental function, and changes to the nutrients and hormones a fetus is exposed to will impact the offspring’s long-term health and wellbeing. Research published recently also suggests that various prenatal factors are associated with the development of mental illness.

There have been numerous research studies examining the impacts of high-dose alcohol consumption during pregnancy on postnatal development. However, there are not many studies on low and early dose effects of prenatal alcohol exposure on the offspring’s mental health. The researchers in this study conducted a review of the literature on prenatal alcohol exposure and mental illness to better understand the intersection of this impact.

Results

Mental Health Outcomes with Prenatal Alcohol Exposure (PAE)

• 70%-90% of adults with FASD also have psychiatric conditions like depression, anxiety, and/or mood disorders
• Clinical studies have shown an association between prenatal exposure to low* doses of alcohol or early PAE and mental health outcomes
• Researchers have shown increased behavioural problems, attention disorders, internalizing and externalizing symptoms, altered social behaviour and sleeping patterns, social difficulties, and anxiety and depression with prenatal exposure to both low and high doses of alcohol

Animal Models of PAE and Mental Illness

• In animal studies, offspring that experienced both low and high doses of alcohol prenatally showed increased depressive and anxiety-like symptoms
• Low dose alcohol exposure during pregnancy also resulted in offspring with altered social behaviour in several studies

Pathways Underlying Mental Health Outcomes

• Previous studies of behavioural changes after PAE often associated PAE with changes to neurological structures and pathways
• An emerging hypothesis as to the mechanism behind the development of mental illnesses suggests that PAE impacts the epigenetic process, which results in altered gene expression during development
• Alcohol exposure during pregnancy can co-occur with other prenatal influences, such as maternal mental illness, obesity, smoking, maternal stress, and prenatal exposure to other substances
  • Some have hypothesized that it is the combination of these factors that can increase or extend the severity of outcomes

Implications

PAE can have adverse outcomes on the mental health and wellbeing of offspring. Numerous studies have identified a wide range of impairments associated with PAE, including neurodevelopmental, physiological, emotional, behavioural, cognitive, social, and psychiatric difficulties. It is important to understand the impact of PAE within the context of the Developmental Origins of Health and Disease (DOHaD) hypothesis, regardless of the dose and timing of exposure. The greater the understanding of the impact, the more support for individuals experiencing mental health challenges.

Journal: Journal of Developmental Origins of Health and Disease

Authors: Danielle J. Burgess and Karen M. Moritz

Date: January 2020

Read the full article (available open access)

*Some clinical studies do not provide an adequate definition for how they characterize low-, moderate- and high- doses of alcohol, which can make comparisons across studies challenging