Metabolic Brain Disease

, Volume 31, Issue 1, pp 81–91 | Cite as

Alcohol exposure in utero is associated with decreased gray matter volume in neonates

  • Kirsten A. DonaldEmail author
  • J. P. Fouche
  • Annerine Roos
  • Nastassja Koen
  • Fleur M. Howells
  • Edward P. Riley
  • Roger P. Woods
  • Heather J. Zar
  • Katherine L. Narr
  • Dan J. Stein
Original Article


Neuroimaging studies have indicated that prenatal alcohol exposure is associated with alterations in the structure of specific brain regions. However, the temporal specificity of such changes and their behavioral consequences are less known. Here we explore the brain structure of infants with in utero exposure to alcohol shortly after birth. T2 structural MRI images were acquired from 28 alcohol-exposed infants and 45 demographically matched healthy controls at 2–4 weeks of age on a 3T Siemens Allegra system as part of large birth cohort study, the Drakenstein Child Health Study (DCHS). Neonatal neurobehavior was assessed at this visit; early developmental outcome assessed on the Bayley Scales of Infant Development III at 6 months of age. Volumes of gray matter regions were estimated based on the segmentations of the University of North Carolina neonatal atlas. Significantly decreased total gray matter volume was demonstrated for the alcohol-exposed cohort compared to healthy control infants (p < 0.001). Subcortical gray matter regions that were significantly different between groups after correcting for overall gray matter volume included left hippocampus, bilateral amygdala and left thalamus (p < 0.01). These findings persisted even when correcting for infant age, gender, ethnicity and maternal smoking status. Both early neurobehavioral and developmental adverse outcomes at 6 months across multiple domains were significantly associated with regional volumes primarily in the temporal and frontal lobes in infants with prenatal alcohol exposure. Alcohol exposure during the prenatal period has potentially enduring neurobiological consequences for exposed children. These findings suggest the effects of prenatal alcohol exposure on brain growth is present very early in the first year of life, a period during which the most rapid growth and maturation occurs.


Alcohol FASD MRI Infant Neuroimaging Dubowitz 



We thank the study staff and the staff at Paarl Hospital, Mbekweni and TC Newman clinics for their support of the study. We thank the families and children who participated in this study. Funding: the study was funded by the Bill and Melinda Gates Foundation [OPP 1017641] and an ABMRF young-investigator grant, National Research Foundation, and Medical Research Council. KD was also supported by a South African Medical Association and a Harry Crossley Foundation clinical researcher grant. DJS and HJZ are supported by the Medical Research Council of South Africa.

Compliance with ethical standards

Conflicts of interest

The authors report no conflict of interest with respect to this work.

Supplementary material

11011_2015_9771_MOESM1_ESM.docx (73 kb)
Supplementary Table 1 (DOCX 73 kb)
11011_2015_9771_MOESM2_ESM.docx (19 kb)
Supplementary Table 2 (DOCX 18 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Kirsten A. Donald
    • 1
    • 2
    Email author
  • J. P. Fouche
    • 3
    • 4
    • 5
  • Annerine Roos
    • 6
    • 7
  • Nastassja Koen
    • 5
  • Fleur M. Howells
    • 5
  • Edward P. Riley
    • 8
  • Roger P. Woods
    • 9
  • Heather J. Zar
    • 2
    • 9
  • Katherine L. Narr
    • 2
    • 10
  • Dan J. Stein
    • 11
  1. 1.Division of Developmental Paediatrics, Department of Paediatrics and Child HealthRed Cross War Memorial Children’s HospitalCape TownSouth Africa
  2. 2.University of Cape Town, South AfricaCape TownSouth Africa
  3. 3.Department of Human BiologyUniversity of Cape TownCape TownSouth Africa
  4. 4.Department of PsychiatryStellenbosch UniversityCape TownSouth Africa
  5. 5.Department of Psychiatry and Mental HealthUniversity of Cape TownCape TownSouth Africa
  6. 6.MRC Unit on Anxiety & Stress DisordersUniversity of Cape TownCape TownSouth Africa
  7. 7.Stellenbosch UniversityCape TownSouth Africa
  8. 8.Department of PsychologySan Diego State UniversitySan DiegoUSA
  9. 9.Department of NeurologyUniversity of CaliforniaLos AngelesUSA
  10. 10.Department of Paediatrics and Child Health and MRC Unit on Child & Adolescent HealthRed Cross War Memorial Children’s HospitalCape TownSouth Africa
  11. 11.Department of Psychiatry and Mental Health and MRC Unit on Anxiety & Stress DisordersUniversity of Cape TownCape TownSouth Africa

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