Which statement is true regarding maternal alcohol use during pregnancy?

• A. Prenatal alcohol exposure is the leading known cause of intellectual delay.
• B. Prenatal alcohol exposure definitively increases risk for preterm birth.
• C. Prenatal alcohol exposure is not known to affect the structure or integrity of the fetal lungs.
• D. Prenatal alcohol exposure reduces risk of neural tube defects.

Answer: (A)

Alcohol acts as a teratogen during pregnancy, with brain development being especially vulnerable to disruption. Prenatal alcohol exposure can lead to fetal alcohol spectrum disorders, which include cognitive and behavioral problems and, in many cases, intellectual disability. This intellectual impairment is a prominent and lasting outcome, making it the leading known preventable cause of intellectual disability.

Statements about preterm birth are less definitive because the evidence linking alcohol to preterm delivery varies with the amount and timing of exposure. It isn’t as consistently established as the neurodevelopmental impact. Saying there is no effect on the fetal lungs isn’t accurate enough, since the main concerns with alcohol exposure focus on brain development and growth, even though multiple organ systems can be affected. And there is no protective effect against neural tube defects; alcohol exposure does not reduce risk and can contribute to CNS anomalies.