Effects of heavy, moderate, and rare alcohol consumption on fetal development were analyzed in a prospective study of 469 mother-infant pairs. Differential effects of heavy drinking in early and late gestation were evaluated by separate analysis of neonates born to women who reduced consumption before the third trimester. Using chi 2 analysis, multiple regression, and matched sets, statistically significant associations (P less than .01) were observed between sustained heavy drinking and both intrauterine growth retardation and congenital anomalies. These associations were independent of eight other risk factors. No differences were observed between offspring of rare and moderate drinkers. Infants born to women who reduced heavy drinking did not differ in growth from offspring of rare and moderate drinkers but demonstrated a higher frequency of abnormalities. Sustained heavy drinking represents a major risk; reduction in midpregnancy can benefit the newborn. Identification and therapy of heavy drinking are important components of prenatal care.

It has been widely reported that adolescent mothers are more likely to experience poor pregnancy outcome, especially low-birth-weight and/or premature infants. Recent data suggest that this poor outcome may be attributed to confounding health and social characteristics of adolescent mothers. A study of maternal health and neonatal development at Boston City Hospital provided an opportunity to assess whether adolescent mothers deliver infants with poorer outcomes at birth than nonadolescents independent of numerous social and health differences between adolescent and nonadolescent mothers. A total of 275 infants of primiparous adolescents (aged 13 to 18 years) were compared at birth with 423 infants of primiparous nonadolescents. Size at birth, length of gestation, Apgar scores, and birth trauma were examined. The only statistically significant difference between the two groups was that adolescent mothers delivered infants whose mean weight was 94 g less (P less than .03) than infants of nonadolescent mothers. Multiple and logistic regression analyses demonstrated that several health and social factors, but not adolescent status, were independently associated with the measures of adverse infant outcome. A subsequent regression analysis demonstrated similarly that being a younger adolescent (16 years and younger) did not independently predict low birth weight at delivery or other measured adverse neonatal outcomes. These data support the view that health and social factors are more important to poor fetal outcome among primiparous mothers than adolescent status. Some of the health factors are amenable to clinical intervention.

As part of a prospective study investigating maternal characteristics and habits during pregnancy and their impact on fetal development, 1,690 mother/infant pairs were studied. Of the mothers, 375 reported using Bendectin during pregnancy. Multivariate analyses examining birth weight, length, head circumference, gestational age, and congenital malformations as dependent variables demonstrated no associations between Bendectin exposure and adverse fetal outcome.

A study of 1,690 mother/child pairs at Boston City Hospital was conducted to assess the impact of maternal alcohol consumption on fetal development when confounding variables were controlled. Level of maternal drinking prior to pregnancy was associated with shorter duration of gestation. Lower maternal weight change, history of maternal illnesses, cigarette smoking, and marijuana use, however, were more consistently related to adverse fetal growth and development. New findings in this study include a negative association between maternal marijuana use during pregnancy and fetal growth. Also when confounding variables were controlled, women who used marijuana during pregnancy were five times more likely to deliver infants with features considered compatible with the fetal alcohol syndrome.

This paper describes the methods of the Maternal Health and Child Development of Project at the Boston City Hospital which explored the impact of maternal drinking prior to and during pregnancy on fetal development. Between February 1977 and October 1979, of 3222 women who delivered single infants, 1690 were interviewed in hospital after delivery and their babies examined by a pediatrician who was unaware of the interview results. The 1690 mother-infant pairs of whom both interview and exam are available did not systematically differ from the 272 for whom the interview only or 824 for whom the exam only was conducted. Interviews were also collected prenatally in the Boston City Hospital's Women's Clinic, from 470 women whose infants were examined. Maternal and infant characteristics are described. Heavy drinkers were much more likely to smoke cigarettes and to have used psychoactive drugs than lighter drinkers. Heavy drinkers also differed from non-heavy drinkers on several other factors which may influence fetal development.

Assessment of the impact of maternal alcohol consumption and other substance abuse during pregnancy on newborn size was accomplished by a two year study of 1,690 mother-infant pairs. Mothers were interviewed in hospital after delivery. 328 were also interviewed prenatally. Infants were examined at 1-3 days of age by one of 4 M.D.'s for growth, morphologic, and neurologic parameters. The sample was 59% Black, 22% Hispanic, 19% white; young (12% < 18); poor (88% annual income < $6,000) and poorly nourished. Prenatal and hospital interviews yielded similar results. The 1.8% of women who reported heavy drinking (3+ drinks/day) during pregnancy when compared with 64.5% abstainers were more likely to smoke (48% vs. 14%) and use drugs (marijuana 51% vs. 9%, psychoactive drugs 4% vs. 1%) all P ≤ .0001. Stepwise multiple regressions examined the relative impact of interrelated variables including social, demographic, and pregnancy history factors on birth weight, length, head circ. (HC) and gestational age (GA). GA accounted for the largest variance in newborn size (22-29%). An additional 8-13% was explained by maternal age, pre-pregnancy weight, weight change during pregnancy, race, smoking, illness, and marijuana use (each significant P ≤ .05). These results add marijuana as a previously unreported factor affecting fetal growth.