Prenatal alcohol exposure tied to subtle but persistent changes in facial structure in children: JAMA

A recent study found that even low to moderate prenatal alcohol exposure can lead to subtle but persistent changes in facial structure in children up to the age of 6 to 8 years. The findings published in the Journal of American Medical Association, highlighted the need for further research into the long-term effects of prenatal alcohol exposure, even at levels previously considered low risk.

This research followed a total of 549 children of European descent, assessing their facial structures using advanced three-dimensional craniofacial imaging. These children, born to mothers recruited during the first trimester of pregnancy from public maternity clinics, were studied at 2 different time points: once at 12 months old (421 children) and again at ages 6 to 8 (363 children). Nearly, 235 children had imaging data available from both time points.

The study analyzed children exposed to low to moderate levels of alcohol during pregnancy and compared them to a control group of children with no prenatal alcohol exposure. The goal was to determine whether facial differences observed in infancy persisted into childhood and whether they resembled those seen in children diagnosed with fetal alcohol spectrum disorder (FASD).

This study found a consistent association between prenatal alcohol exposure and specific changes in facial shape, particularly in the eyes and nose. These changes were noted regardless of whether the exposure occurred only in the first trimester or throughout the entire pregnancy.

The study found a significant association between alcohol exposure and differences in the shape of the eyes. Statistical analysis revealed a Spearman correlation of 0.19 (95% confidence interval: 0.10-0.29, P < .001) in children aged 6 to 8 which indicated a moderate but measurable change. Similar changes were observed in the nasal region, with a Spearman correlation of 0.19 (95% CI: 0.09-0.27, P < .001) in children at the second time point.

Also, these facial differences did not match the well-known diagnostic facial features of FASD, like a smooth philtrum (the groove between the nose and upper lip), a thin upper lip, and small eye openings. But, the findings suggest a distinct but subtle effect of prenatal alcohol exposure on facial development.

Overall, the study provides strong data that even low to moderate alcohol consumption during pregnancy can have measurable effects on a child’s facial development, which persist into later childhood. While these facial changes are not as pronounced as those seen in FASD, they suggest that prenatal alcohol exposure influences craniofacial development in ways that warrant further investigation.

Source:

Muggli, E., Matthews, H., Suttie, M., Halliday, J., Penington, A., Elliott, E. J., Thompson, D., Spittle, A., Hearps, S., Anderson, P. J., & Claes, P. (2025). Low to moderate prenatal alcohol exposure and facial shape of children at age 6 to 8 years. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2024.6151