Role of Caregiver-Reported Outcomes in Identification of Children with Prenatal Alcohol Exposure during the First Year of Life

INTRODUCTION: Earlier identification of children with prenatal alcohol exposure (PAE) remains a challenge. The objective of this study was to identify neurobehavioral (NB) outcomes associated with PAE in infants. METHODS: This manuscript evaluates NB outcomes at 6.33±1.12 months of age in 93 infants (39 PAE and 54 No-PAE) recruited prospectively into the ENRICH cohort. PAE was assessed by prospective repeated TLFB interviews and a panel of ethanol biomarkers. NB outcomes were evaluated by the Bayley Scales of Infant Development (BSID-III), Parenting Stress Index (PSI), Infant Behavior Questionnaire (IBQ-R), and Infant Sensory Profile (ISP). RESULTS: Mean maternal age at enrollment was 28.18 ±5.75, and 64.52 % were Hispanic/Latina. Across three TLFB calendars, absolute alcohol per day in the PAE group was 0.44±0.72, corresponding to low-moderate alcohol consumption. While no association was observed between PAE and BSID-III (p’s>0.05), PAE was associated with higher scores on the PSI difficult child scale (β̂ =13.9; p=0.015), total stress (β̂ =13.9; p=0.010), and IBQ negative affect (β̂ =8.60; p=0.008) measures after adjustment for covariates. CONCLUSIONS: Caregiver-reported assessments may provide a currently unrecognized opportunity to identify behavioral deficits, point to early interventions, and should be included in clinical assessments of infants at-risk for FASD.