0145-600819912307- 1238$03.0(1/0 zyxwvutsrqpon AI.COHOI ISM: CI.INI(.AL AN11 EXPI-RIMENTAI. RESEARCH Vol. 23, No. z 7 July 1999 Prenatal Alcohol Use Among Teenagers: Effects on Neonatal Outcomes Marie D. Cornelius, Lidush Goldshmidt, Paul M. Taylor, and Nancy L. Day Background: This longitudinal study examines the effects of alcohol use during pregnancy on the growth and gestational age at birth of 413 offspring of adolescents. Methods: Data were collected during 1990 to 1994. The adolescents were from a prenatal clinic in Pittsburgh, PA. They were interviewed at mid-pregnancy and at delivery to obtain information on alcohol and other substance use before and during pregnancy. Infants werc examined 24 to 36 hr after birth. Results: The average maternal age was 16.3 (12-18) years; 68% were African American. Prenatal exposure to alcohol during the second trimester was significantly related to decreases in head circumfer- ence, birthweight, and chest circumference. There was also a significant relationship between alcohol exposure in each trimester and lower Apgar scores. All of the analyses controlled for other prenatal substance use and covariates of drinking during pregnancy. Conclusion: Prenatal alcohol exposure is associated with decreases in fetal growth and in APGAR scores in the offspring of adolescents. Key Words: Alcohol, Pregnancy, Growth, Adolescent. LCOHOL IS TERATOGENIC to the human fetus A (Abel, 1984; Jones and Smith, 1973; Lemoine et al., 1968). Prenatal alcohol exposure has been shown to cause morphological and neurobehavioral abnormalities, as well as reduced growth in the offspring (Abel, 1984; Coles et al., 1985; Day et al., 1989; Fried and O’Connell, 1987; Jacobson et al., 1996; Smith et al., 1986; Streissguth et al., 1983; Streissguth et al., 1981). In our Maternal Health Practices and Child Development Study (MHPCD) of adult mothers, drinking in early pregnancy was significantly associated with having a low birthweight neonate (<2500 gm) (Day et al., 1989). In a reanalysis of the birth data, first- and third- trimester alcohol exposures were significantly associated with a reduction in head circumference in neonates (Day et al., 1999). Irrespective of alcohol and other substance exposure, offspring of adolescents are at increased risk for intrauter- ine growth retardation (IUGR), prematurity, morbidity, zyxwvu From the Departments of Psychiatry and Epidemiology, University of Pittsburgh School of Medicine (M. D.C.), Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center (L. zyxwvutsrqp G.), Department of Pedi- atrics, University of Pittsburgh School of Medicine (P.M.T.), and the Depart- ments of Psychiutry, Epidemiology, and Pediatrics, University of Pittsburgh School of Medicine (N.L.D.) Received for publication December 21, 1998; accepted April 27, 1999. This work wus done at the University of Pittsburgh School of Medicine, Western Psychiatric Institute and Clinic, and the Magee- Womens Hospital. Support was zyxwvutsrqpon f.om the National Institute of Alcoholism and Alcohol Abuse #08284 (MC), and from the National Institute of DrugAbuse #09275 (MC). Reprint requests: Mane D. Cornelius, Ph.D., Associate Professor of Psy- chiatry and Epidemiology, Program in Epidemiology, 3811 O’Hara Street, Pittsburgh, PA 15213; Fax: 412-681-1261; E-mail: mdcl@pitt.edu Copyright zyxwvutsrqp 0 1999 by the Research Society on Alcoholism. 1238 and neonatal and infant mortality (Babsin and Clark, 1983; Hechtman, 1989; Scholl et al., 1987; Winick, 1989; Zuck- erman et al., 1984). In a large epidemiological study of more than 134,000 adolescents and adults, younger age (adolescence) was significantly associated with an increase in adverse pregnancy outcomes independent of confound- ing sociodemographic factors (Fraser et al., 1995). In an- other study that examined the incidence of congenital mal- formations in the offspring of more than one million women, it was reported that women in the extremes of the childbearing age distribution (under 20 years, over 40 years) had a significantly increased risk of congenital mal- formations (Croen and Shaw, 1995). Previous research on the effects of prenatal alcohol ex- posure has focused exclusively on populations of adults and their offspring, despite the fact that adolescent drinking is prevalent (Johnston et al., 1994). However, compared with adult pregnant women, pregnant adolescents tend to drink at lower average levels and more sporadically (Cornelius et al., 1994). A recent study reported that older maternal age was a risk factor for alcohol-related birth defects even after controlling for heavier drinking in women over 30 years (Jacobson et al., 1996). The current article considers the other end of the maternal age spectrum and focuses on the dual risks of young maternal age and prenatal alcohol exposure in the offspring of pregnant adolescents. The purpose of the current study was to examine the effects of prenatal drinking on the growth, gestational age, and morphology of the offspring of pregnant teenagers. We hypothesized that the offspring of adolescents would be adversely affected by prenatal exposure to alcohol. Alcohol Clin zyxw Fxp Res, Vol23, No 7, 1999: pp 1238-1244