27 January 2016 In Social and Cultural Aspects

AIMS: In the United Kingdom, alcohol warning labels are the subject of a voluntary agreement between industry and government. In 2011, as part of the Public Health Responsibility Deal in England, the industry pledged to ensure that 80% of products would have clear, legible health warning labelling, although an analysis commissioned by Portman found that only 57.1% met best practice. We assessed what proportion of alcohol products now contain the required health warning information, and its clarity and placement.

DESIGN: Survey of alcohol labelling data.

SETTING: United Kingdom.

PARTICIPANTS: Analysis of the United Kingdom's 100 top-selling alcohol brands (n = 156 individual products).

MEASUREMENTS: We assessed the product labels in relation to the presence of five labelling elements: information on alcohol units, government consumption guidelines, pregnancy warnings, reference to the Drinkaware website and a responsibility statement. We also assessed the size, colour and placement of text, and the size and colouring of the pregnancy warning logo.

FINDINGS: The first three (required) elements were present on 77.6% of products examined. The mean font size of the Chief Medical Officer's (CMO) unit guidelines (usually on the back of the product) was 8.17-point. The mean size of pregnancy logos was 5.95 mm. The pregnancy logo was on average smaller on wine containers.

CONCLUSIONS: The UK Public Health Responsibility Deal alcohol labelling pledge has not been fully met. Labelling information frequently falls short of best practice, with font and logos smaller than would be accepted on other products with health effects.

26 November 2015 In Pregnant Women

BACKGROUND: Heavy alcohol use during pregnancy can cause considerable developmental problems for children, but effects of light-moderate drinking are uncertain. This study examined possible effects of moderate drinking in pregnancy on children's conduct problems using a Mendelian randomisation design to improve causal inference.

METHODS: A prospective cohort study (ALSPAC) followed children from their mother's pregnancy to age 13 years. Analyses were based on 3,544 children whose mothers self-reported either not drinking alcohol during pregnancy or drinking up to six units per week without binge drinking. Children's conduct problem trajectories were classified as low risk, childhood-limited, adolescence-onset or early-onset-persistent, using six repeated measures of the Strengths and Difficulties Questionnaire between ages 4-13 years. Variants of alcohol-metabolising genes in children were used to create an instrumental variable for Mendelian randomisation analysis.

RESULTS: Children's genotype scores were associated with early-onset-persistent conduct problems (OR = 1.29, 95% CI = 1.04-1.60, p = .020) if mothers drank moderately in pregnancy, but not if mothers abstained from drinking (OR = 0.94, CI = 0.72-1.25, p = .688). Children's genotype scores did not predict childhood-limited or adolescence-onset conduct problems.

CONCLUSIONS: This quasi-experimental study suggests that moderate alcohol drinking in pregnancy contributes to increased risk for children's early-onset-persistent conduct problems, but not childhood-limited or adolescence-onset conduct problems.

26 November 2015 In Pregnant Women

OBJECTIVES: Despite potential health risks for women and children, one in five women report alcohol use during pregnancy and a significant proportion of those who quit during pregnancy return to drinking post-delivery. This study seeks to understand the longitudinal patterns of alcohol consumption before, during pregnancy and post-delivery, and the role of maternal characteristics for purposes of informing prevention design.

METHODS: General growth mixture models were used to describe the average developmental patterns of maternal weekly drinking quantity at six time points, from preconception through child entering kindergarten, as well as heterogeneity in these patterns among 9100 mothers from the Early Childhood Longitudinal Study representing the 2001 US national birth cohort.

RESULTS: Four distinct classes of mothers were defined by their longitudinal alcohol consumption patterns: Low Probability Drinkers (50.3 %), Escalating Risk Drinkers (12.0 %), Escalating Low Risk Drinkers (27.4 %), and Early Parenting Quitters (10.2 %). Heterogeneous covariate associations were observed. For example, mothers who gave birth after age 36 were twice as likely to be Escalating Risk Drinkers and Escalating Low Risk Drinkers (vs Low Probability Drinkers), but not more likely to be Early Parenting Quitters, when compared to mothers who gave birth between the ages of 26 and 35.

CONCLUSIONS: for practice There is significant heterogeneity in maternal longitudinal alcohol use patterns during the perinatal period. Baseline maternal characteristics and behavior associated with these heterogeneous patterns provide valuable tools to identify potential risky drinkers during this critical time period and may be synthesized to tailor pre- and postnatal clinical counseling protocols.

16 October 2015 In Pregnant Women

BACKGROUND: Deficits in information processing may be a core deficit after fetal alcohol exposure. This study was designed to investigate the possible effects of weekly low to moderate maternal alcohol consumption and binge drinking episodes in early pregnancy on choice reaction time (CRT) and information processing time (IPT) in young children.

METHOD: Participants were sampled based on maternal alcohol consumption during pregnancy. At the age of 60-64 months, 1,333 children were administered a modified version of the Sternberg paradigm to assess CRT and IPT. In addition, a test of general intelligence (WPPSI-R) was administered.

RESULTS: Adjusted for a wide range of potential confounders, this study showed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT. There was, however, an indication of slower CRT associated with binge drinking episodes in gestational weeks 1-4.

CONCLUSION: This study observed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT as assessed by the Sternberg paradigm. However, there were some indications of CRT being associated with binge drinking during very early pregnancy. Further large-scale studies are needed to investigate effects of different patterns of maternal alcohol consumption on basic cognitive processes in offspring.

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