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The cohort is being followed to develop a better understanding of the influence of prenatal alcohol consumption on child development and behaviours. This will provide timely, accurate and reliable data on child outcomes and the design of future studies. It has been reported that Australian women are drinking less before conception [ 22 ] and have an increased use of folic acid [ 23 ], hence, this study will provide a sound basis for determining the association between maternal alcohol consumption patterns and child cognitive development. Follow-up interviews with the cohort will provide data on child outcomes in the first few years of life and the influence of prenatal drinking on child development. Mothers will be contacted to complete follow-up interviews if they live in the community rather than in prison and if they and/or the child have moved from the cohort catchment. These follow-up interviews will allow for a test of the hypothesis that those who are drinking moderately in pregnancy have fewer neurocognitive difficulties compared to those who did not drink during pregnancy. The cohort will continue to accrue until about 5,500 women have been enrolled.

Although only a minority of women binge drink in early pregnancy, the majority of women are consuming alcohol at higher levels than recommended by the Australian guidelines. In addition, binge drinking in pregnancy is associated with multiple pregnancy risk factors, preterm birth, low birth weight, and neonatal abstinence syndrome. Hormones affect the amount of alcohol that is consumed. Alcohol increases prolactin and progesterone secretion, thereby increasing breast milk production [ 30 ]. Progesterone may be responsible for the protective effects of maternal alcohol against pregnancy loss [ 31, 32 ]. Progesterone also represses several cell-signaling pathways that are involved in the responses of the placenta to alcohol exposure [ 33 ]. It is possible that women may consume lower levels of alcohol if they are unaware they are pregnant and therefore their alcohol use may be underestimated. Therefore, they may consume more alcohol than women who are specifically asked about Alcohol Free Download consumption during pregnancy. The low drinking levels recorded in this study (6.7%) may also have been underestimated [ 25 ].

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