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Description
Despite the well-documented teratogenic effects of prenatal alcohol exposure on executive functioning, the interaction of various risk factors on these effects has not been well studied. The current study aimed to address this issue by (1) developing a risk score model incorporating various risk factors known to exist among children with prenatal alcohol exposure in a development cohort and then validating this model in an independent validation cohort; (2) determining whether the risk score relates to performance on executive function measures. Subjects (N=661) aged 10-16 comprised two different samples: a development cohort (DC) and a validation cohort (VC). Within the DC, there were two groups of subjects:subjects with histories of heavy prenatal alcohol exposure (AE-DC, N=125) and a non-exposed comparison group (CON-DC, N=281). The VC also included exposed (AE-VC, N=74) and control (CON-VC, N=181) groups. In both cohorts, the non-exposed comparison groups consisted of non-exposed subjects with and without other behavioral conditions or concerns. Caregivers completed a questionnaire that provided developmental and familial history for each subject and the C-DISC-4.0. Measures were analyzed in the DC and validated in the VC using regression techniques to identify potential postnatal risk factors for prenatal alcohol exposure. In the VC, The BRIEF Parent Form, BRIEF Teacher Form, BRIEF Self-Rated Form, and performance on the D-KEFS were used in four different hierarchical regression analyses to determine if the relationship between risk score and executive function varied by group. A risk score model including postnatal risk factors was developed to accurately identify children with prenatal alcohol exposure. The subjects were divided into 3 subgroups based on their risk score (low-risk, intermediate-risk, high-risk) indicating the likelihood of prenatal alcohol exposure based on the risk factors. Higher risk scores related to poorer performance in executive function measures. If exposure is unknown, the risk scores derived from the current study could help identify children who are at a high-risk of being alcohol-exposed and therefore, referred for further evaluation and interventions. The current study provides a new approach in examining postnatal risk factors in this population, as well as how postnatal risk factors can impact areas of cognition.
