Prenatal alcohol exposure and traumatic childhood experiences: A systematic review

- Reviewed impacts of Prenatal Alcohol Exposure and trauma (e.g. abuse and neglect).
- There are high levels of comorbidity but a lack of studies that address both exposures.
- Dual exposure was associated with increased cognitive and behavioural impairment.
- The spectrum of effects and diagnostic criteria of PAE were not fully accounted for.
- Longitudinal studies on PAE and trauma needed to strengthen evidence of causality.

Prenatal alcohol exposure (PAE) and traumatic childhood experiences (trauma) such as abuse or neglect can each cause central nervous system neurobiological changes or structural damage which can manifest as cognitive and behavioural dysfunction. In cases where both exposures have occurred, the risk of neurodevelopmental impairment may be greater, but this interaction has not been well studied. Here we present a systematic review that identified five primary research studies which investigated either the impact of trauma in children with PAE, or of PAE in children with trauma. Due to the heterogeneity of studies, narrative analysis was applied. Children in these cohorts with both exposures were more likely to show deficits in language, attention, memory and intelligence, and exhibit more severe behavioural problems than children with one exposure in absence of the other. However, the current literature is scarce and methodologically flawed. Further studies are required that: assess dual exposure in other neurodevelopmental domains; feature developmentally impaired yet non-exposed controls; and account for the wide spectrum of effects and different diagnostic criteria associated with PAE.