Prenatal Alcohol Exposure Linked to Gender-Specific Adversities – Neuroscience News

Summary: A new study identified sex-specific differences in neurodevelopment and health-related disorders in children who were exposed to alcohol while in the womb. Prenatal alcohol exposure increased female children’s risk of developing depression and anxiety, while in males, prenatal alcohol exposure increased the risk of ADHD, conduct disorders, and oppositional defiance disorder.

Source: Research Society on Alcoholism

In a recent analysis, researchers found sex differences in the health and neurodevelopmental outcomes of people exposed to alcohol before birth.

Male participants in the study, published in Alcohol: Clinical and Experimental Research, experienced greater neurodevelopmental impairment, while female participants had higher rates of endocrine problems.

The types of environmental adversity they experienced also differed by sex: female participants had higher rates of trauma and victimization, while male participants had higher rates of problems with school and the criminal justice system.

The findings from the study can help service providers and policymakers tailor interventions for people with prenatal alcohol exposure.

Researchers examined more than 2500 records of people with confirmed prenatal alcohol exposure collected in Canada’s National Fetal Alcohol Spectrum Disorder (FASD) Database. Participants were aged one to 61 with a mean age of 15; 58 percent were male.

Male and female participants were equally likely to be diagnosed with FASD. Overall, male study participants had higher rates of neurodevelopmental impairment, including motor, memory, attention, executive function, and adaptive function challenges.

Male participants were more likely to have ADHD, conduct disorder, and oppositional defiant disorder, while female participants had higher rates of anxiety and depression. Similar patterns are seen in the general population, but the rates are much higher for people with prenatal alcohol exposure than those without.

This shows a sad little girl Male participants were more likely to have ADHD, conduct disorder, and oppositional defiant disorder, while female participants had higher rates of anxiety and depression. Image is in the public domain

The study’s findings showed the significant adversity people with prenatal exposure to alcohol experience throughout their lives. Thirty percent of female and 20 percent of male study participants experienced physical and/or sexual abuse. In school, 18 percent of male students were expelled or suspended compared to nine percent of female students.

Male participants also had more difficulties than female participants with criminal offending and incarceration. The authors suggest that these problems in school and the justice system may be related to challenges with adaptive and executive functioning and difficulties with disruptive behaviors.

Notably, the researchers found no differences by sex in clinical presentation or experiences among preschool-aged children in the study and suggest that gendered expectations and responses of institutions—schools, legal and health-related—with which people come into contact may play a role in the differences found at later ages.

The study highlights opportunities for targeted intervention to support success in school, prevention of legal involvement, recognition of subtler gendered presentations of FASD, and trauma-informed care for this population with complex needs and strengths.

Future research on the interactions between sex and gender and other factors that influence the experiences of people with FASD, such as parenting, employment, cultural identity, and interpersonal relationships, can provide greater insight.

At least four to five percent of the population is estimated to be affected by fetal alcohol spectrum disorder, a neurodevelopmental disability caused by exposure to alcohol in utero.


Sex-related differences among individuals assessed for fetal alcohol spectrum disorder in Canada


Consideration of sex- and gender-related factors is critical for understanding and supporting health and wellbeing. Although both sex and gender influence people with developmental disabilities, there is relatively little research on these factors and their influences among individuals with fetal alcohol spectrum disorder (FASD), a complex neurodevelopmental disability impacting an estimated 4%–5% of the population. Understanding sex- and gender-related differences in FASD is needed to facilitate evidence-informed assessment, treatment planning, and advocacy. To begin unpacking these factors, we investigated sex-based differences in clinical presentation and experiences among individuals assessed for FASD across the lifespan.


We analyzed 2574 clinical records from 29 FASD diagnostic centers in Canada. Participants ranged in age from 1 to 61 years (mean 15.2 years), and more than half (58.3%) were male at birth. Study variables included participant demographics, physical indicators of prenatal alcohol exposure (PAE), neurodevelopmental impairment, FASD diagnosis, co-occurring physical and mental health diagnoses, and environmental adversity.


There were no significant differences between males and females with respect to FASD diagnostic outcome or physical indicators of PAE. However, males experienced significantly more neurodevelopmental impairment. Females experienced higher rates of endocrine problems, anxiety, and depressive/mood disorders, whereas males had higher rates of attention deficit-hyperactivity disorder, conduct disorder, and oppositional defiant disorder. Adversity also differed by sex, with females experiencing higher rates of trauma and legal problems with victimization/custody, and males having more difficulties with school and offending/incarceration. Sex-based differences were most apparent in adolescents (13–17 years) and adults (≥25 years).


Individuals with PAE/FASD experience notable sex-related differences in clinical presentation and experiences across the lifespan. Findings from this study should help to guide researchers, service providers, and policy makers to improve FASD screening, diagnosis, and intervention and better address the needs of individuals with PAE/FASD of all genders.


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