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Heavy Prenatal Alcohol Exposure and Risk of Morbidities Not Previously Identified: A Danish Nationwide Cohort Study from 1996 to 2018

19 Pages Posted: 26 May 2022

See all articles by Marcella Broccia

Marcella Broccia

Aalborg University Hospital - Department of Obstetrics and Gynaecology

Anders MSc Munch

University of Copenhagen - Department of Biostatistics

Bo Mølholm

Nordsjaellands Hospital - Department of Paediatrics and Adolescent Medicine

Kathrine Kold Sørensen

Nordsjællands Hospital - Department of Cardiology

Thomas Larsen

Lillebaelt Hospital

Katrine Strandberg-Larsen

University of Copenhagen - Section of Epidemiology

Thomas Gerds

University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health; Danish Heart Foundation

Christian Torp-Pedersen

Aalborg University, Faculty of Medicine, Aalborg University Hospital & Clinical Institute, Department of Cardiology; Nordsjællands Hospital - Department of Cardiology

Ulrik Schiøler Kesmodel

Aalborg University Hospital - Department of Obstetrics and Gynaecology

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Abstract

Background: Alcohol consumption during pregnancy can harm the fetus and cause fetal alcohol spectrum disorders (FASD), but the effect on other morbidities is less clear. A systematic review and meta-analysis suggested 428 comorbidities related to FASD of which we demonstrated 29 conditions with a standardized risk difference ≥ 0·5%. In the current study, we investigated all hospital diagnoses in Denmark apart from the 428 comorbidities in children with prenatal heavy alcohol exposure compared with unexposed.  

Methods: This Danish cohort study used nationwide registries from Jan 1, 1996 to Dec 31, 2018, following all singletons from birth until 18 years. Crude and standardized risk differences of hospital diagnoses were calculated. Heavy alcohol consumption was defined by alcohol-attributable diagnoses given to either the mother to be or the newborn and/or redeemed prescriptions for drugs to treat maternal alcohol dependence one year prior to or during pregnancy. 

Findings: In total, 1,188,503 children were included, of which 4,799 (0·4%) were alcohol-exposed. We found 719 conditions with an incidence of ≥ 0·1% among the alcohol-exposed children; 32 conditions had a standardized excess risk difference ≥ 1·0%, and 143 conditions had a crude absolute risk ratio ≥ 2·5. Conditions at risk were related to brain function, low birth weight, injuries, observation for unspecific diseases, substance- and alcohol-related conditions, and childhood adversities. 

Interpretation: In addition to the 428 previously suggested FASD-related comorbidities, we found 719 conditions with an incidence of ≥ 0·1% among children with prenatal heavy alcohol exposure of which 32 had a standardized risk difference ≥ 1·0% and 143 conditions had a crude absolute risk ratio ≥ 2·5. 

Funding: This study was supported from external sources by The Obel Family Foundation, The Health Foundation, TrygFonden, Aase and Ejnar Danielsens Foundation, The North Denmark Region Health Science and Research Foundation, Holms Memorial Foundation, Dagmar Marshalls Foundation, A.P. Møller og Hustru Chastine Mc-Kinney Møllers Foundation, Kong Christian den Tiendes Fond, Torben and Alice Frimodts Foundation, Tømrermester Axel Kastrup-Nielsen & hustru Eva Kastrup-Nielsens Memorial Foundation and Grosserer A.V Lykfeldts og Hustrus foundation.

The funding had no role in the scientific work.

Christian Torp-Pedersen reports grants for studies from Bayer and Novo Nordisk unrelated to the current study.

Declaration of Interest: All contributing authors have no conflict of interest. CTP reports grants for studies from Bayer and Novo Nordisk unrelated to the current study.

Ethical Approval: Register-based studies do not require patient consent or ethics approval in Denmark, and all data were anonymized and only available through Statistics Denmark. Approval to use data sources for research purposes from the data responsible institute in the Capital Region of Denmark was granted in accordance with the General Data Protection Regulation. Approval number: P-2019-280.

Keywords: Fetal alcohol syndrome: Fetal alcohol spectrum disorders: Comorbidities: Epidemiolog*: Prevalence: Binge drinking: Alcohol drinking.

Suggested Citation

Broccia, Marcella and Munch, Anders MSc and Mølholm, Bo and Sørensen, Kathrine Kold and Larsen, Thomas and Strandberg-Larsen, Katrine and Gerds, Thomas and Torp-Pedersen, Christian and Kesmodel, Ulrik Schiøler, Heavy Prenatal Alcohol Exposure and Risk of Morbidities Not Previously Identified: A Danish Nationwide Cohort Study from 1996 to 2018. Available at SSRN: https://ssrn.com/abstract=4117357 or http://dx.doi.org/10.2139/ssrn.4117357

Marcella Broccia (Contact Author)

Aalborg University Hospital - Department of Obstetrics and Gynaecology ( email )

Denmark

Anders MSc Munch

University of Copenhagen - Department of Biostatistics ( email )

Bo Mølholm

Nordsjaellands Hospital - Department of Paediatrics and Adolescent Medicine ( email )

Kathrine Kold Sørensen

Nordsjællands Hospital - Department of Cardiology ( email )

Thomas Larsen

Lillebaelt Hospital ( email )

Katrine Strandberg-Larsen

University of Copenhagen - Section of Epidemiology ( email )

Thomas Gerds

University of Copenhagen, Faculty of Health and Medical Sciences, Department of Public Health ( email )

Danish Heart Foundation ( email )

Vognmagergade 7
Copenhagen K, 1120
Denmark

Christian Torp-Pedersen

Aalborg University, Faculty of Medicine, Aalborg University Hospital & Clinical Institute, Department of Cardiology ( email )

Nordsjællands Hospital - Department of Cardiology ( email )

Denmark

Ulrik Schiøler Kesmodel

Aalborg University Hospital - Department of Obstetrics and Gynaecology ( email )

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