February 16, 2023

expert reaction to study on association between alcohol consumption before and during pregnancy and children’s face shapes

A study, published in Human Reproduction, has investigated a possible association between alcohol consumption before and during pregnancy and children’s face shapes.

Prof Matt Sydes, Professor of Clinical Trials & Methodology, UCL, said:

“There does not appear to be sufficient information in the paper to explain to the lay reader what the physiological implications of differences in facial morphology are outside of FASD. Such an outcome for a study needs to be clear and well justified. Although the study was approved by the ethics committee it would be good to see how ethnicity categories were selected and whether they are a good fit and if we are talking about morphological changes that would be seen as important across people of each of these cultural backgrounds within The Netherlands and more widely.

“A key limitation is likely recall bias in reporting the levels of alcohol consumption or even deliberate misreporting. Self-reported alcohol consumption is perhaps a little unreliable, and this maybe more pronounced in a group that’s repeatedly told not to drink.

“The sample size for 13 year olds was smaller than for 9 year olds. If this was not the same group of people 4 years apart, it would be difficult to argue that any effect had been “attenuated”; it may be just the group was different or the latter was too small for an effect to be detected. Or is it some 13 years olds have started the teenage growth spurt so changes are happening physiologically anyway. And all in the context of whatever an important difference is, which wasn’t clear.

“Randomising mothers to drink or not would be unethical, of course, so it will not be possible to run a randomised controlled trial. In terms of outcomes, could they have followed and measure children prospectively and, moreover, could they have linked to school records to look at attainment? Would that have been a better measure than facial shape?”

‘Association between prenatal alcohol exposure and children’s facial shape: a prospective population-based cohort study’ by X. Liu et al. was published in Human Reproduction at 00:05 UK time Thursday 16^th February.

DOI: https://doi.org/10.1093/humrep/dead006

Declared interests

Prof Matt Sydes: “No financial or scientific conflicts to declare.”