Prenatal alcohol exposure and the development of multiple risk behaviours in adolescence: A birth cohort study

Background: The UK has the fourth highest estimated prevalence globally of maternal alcohol consumption during pregnancy (41%). It is therefore important to understand the long-term impacts of prenatal alcohol exposure (PAE) by examining its impact on the development of adolescent multiple risk behaviours (MRBs) which may increase morbidity and premature mortality across the life-course. Methods: Using Avon Longitudinal Study of Parents and Children (ALSPAC) cohort data with multiple imputation (n=6,752), we examined the impacts of infrequent, frequent, and binge PAE groups on the development of seven MRBs at 16 years old, encompassing substance misuse, risky sexual behaviour and antisocial behaviour. Data were analysed using multiple regression, using q-statistics to adjust for multiple comparisons. Results: Adolescents with infrequent and frequent PAE were more likely to develop hazardous alcohol use at 16 years old compared to those without PAE, with the strongest association being for the frequent group (adjusted odds ratio (aOR) 1.45 [1.19-1.76], p