BACKGROUND: Prenatal exposures can contribute to long term impacts on health and disease. We sought to characterise bone and body composition in children and adolescents diagnosed with, or at risk of, fetal alcohol spectrum disorder (FASD) compared to typically developing children.
METHODS: Bone and body composition were determined through use of dual X-ray absorptiometry, and height and weight collected through use of a stadiometer and digital scale respectively. FASD diagnosis was confirmed by a clinical assessment team, including a psychologist, paediatrician, and occupational therapist.
RESULTS: Children with FASD or at risk of FASD (aged 4-10, n=13) tended to be shorter than age matched controls (n=34) (p=0.05), although there were no statistically significant differences in other general clinical or densitometric measures. By adolescence (aged ≥11) those with FASD (n=10) remained shorter (p<0.05) and recorded lower areal bone mineral density (p=0.06) than their typically developing peers (n=26). Multiple regression analysis accounting for age and sex demonstrated a diagnosis of FASD or ‘at risk of FASD’ was a significant predictor of reduced bone area (p<0.05) and a trending predictor of reduced lean tissue mass (p=0.097) in the 4-10 age group. From 11 years of age, reductions in bone mineral content (p<0.05), and lean tissue mass (p<0.05), as well as a greater percentage fat mass (p<0.05) were observed in the FASD group.
DISCUSSION: Adolescents who were diagnosed with FASD had greater odds of impairments to bone and body composition. The results suggest that alcohol-induced changes to the regulation of lean tissue mass and bone and fat deposition worsen in the second decade of life, coinciding with body composition changes that occur around puberty. The exacerbation of metabolic outcomes at adolescence highlights the importance of early screening and diagnosis of FASD to allow for interventions in order to optimise bone and body composition.