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Prenatal alcohol exposure affects renal function in overweight schoolchildren: birth cohort analysis

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Abstract

Background

Prenatal ethanol exposure has been shown to reduce nephron endowment in animal models, but the effect of alcohol during human pregnancy on postnatal kidney function has not been explored. We aim to investigate the potential association of maternal alcohol consumption during pregnancy with the offspring renal function, considering potential confounding by intrauterine growth and children’s current nutritional status.

Methods

Prospective longitudinal study in a random sample of 1093 children from a population-based birth cohort. Anthropometrics and estimated glomerular filtration rate (eGFR) were assessed at 7 years of age. Multiple linear regression models were fitted, adjusting for child’s gender, age, birthweight, and maternal age, education, prepregnancy nutritional status, and smoking.

Results

Thirteen percent of mothers consumed alcohol during pregnancy. At 7 years of age, eGFR was significantly lower in children with prenatal alcohol exposure (134 ± 17 vs.138 ± 16 mL/min/1.73m2, p = 0.014). The effect was dose dependent and only present in overweight and obese children, among whom adjusted eGFR was −6.6(−12.0 to −1.1)mL/min/1.73m2 and −11.1(−21.3 to −1.2)mL/min/1.73m2 in those exposed to ≤ 40 g and to > 40 g of alcohol per week, respectively, compared to no consumption (ptrend = 0.002).

Conclusions

Prenatal alcohol exposure has a dose-dependent adverse effect on renal function at school age in overweight and obese children.

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Acknowledgments

The authors gratefully acknowledge the families enrolled in Generation XXI for their kindness, all members of the research team for their enthusiasm and perseverance, and the participating hospitals and their staff for their help and support.

Liane Correia-Costa and Franz Schaefer contributed equally to this work.

Funding

This work was supported by FEDER funds from Programa Operacional Factores de Competitividade—COMPETE [grant number FCOMP-01-0124-FEDER-028751—and national funds from the Portuguese Foundation for Science and Technology, Lisbon, Portugal [grant number PTDC/DTP-PIC/0239/2012, SFRH/SINTD/95898/2013 to Liane Correia-Costa]. Generation XXI was funded by Programa Operacional de Saúde—Saúde XXI, Quadro Comunitário de Apoio III—by Administração Regional de Saúde Norte (Regional Department of Ministry of Health) [grant number 15-01-01-FDR-00197] and by Foundation Calouste Gulbenkian. Franz Schaefer was supported by the ERA-EDTA Research Programme and the KfH Foundation for Preventive Medicine.

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    Authors and Affiliations

    1. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal

      Liane Correia-Costa, Alberto Caldas Afonso, Sofia Correia, João Tiago Guimarães, Henrique Barros & Ana Azevedo

    2. Department of Pediatric Nephrology, Centro Materno-Infantil do Norte, Centro Hospitalar Universitário do Porto, Porto, Portugal

      Liane Correia-Costa & Alberto Caldas Afonso

    3. Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Porto, Portugal

      Liane Correia-Costa & Alberto Caldas Afonso

    4. Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Heidelberg, Germany

      Franz Schaefer

    5. Public Health and Forensic Sciences and Medical Education Department, Faculty of Medicine, University of Porto, Porto, Portugal

      Sofia Correia, Henrique Barros & Ana Azevedo

    6. Department of Clinical Pathology, Centro Hospitalar São João & Department of Biochemistry, Faculty of Medicine, University of Porto, Porto, Portugal

      João Tiago Guimarães

    7. Division of Pediatric Nutrition, Integrated Pediatric Hospital, Centro Hospitalar Universitário São João, Porto, Portugal

      António Guerra

    8. Department of Gynecology-Obstetrics and Pediatrics, Faculty of Medicine, University of Porto, Porto, Portugal

      António Guerra

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    1. Liane Correia-Costa
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    Contributions

    Liane Correia-Costa and Franz Schaefer conceptualized and designed the study, analyzed the data and drafted the initial manuscript, and approved the final manuscript as submitted. Alberto Caldas Afonso, Sofia Correia, and António Guerra conceptualized and designed the study, participated in the initial analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. João Tiago Guimarães was responsible for all laboratory measurements and critically reviewed the manuscript and approved the final manuscript as submitted. Henrique Barros and Ana Azevedo conceptualized and designed the study, supervised data collection, participated in and supervised data analyses, reviewed and revised the manuscript, and approved the final manuscript as submitted. All authors approved the final manuscript as submitted and agree to be accountable for all aspects of the work.

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    Correspondence to Liane Correia-Costa.

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    Correia-Costa, L., Schaefer, F., Afonso, A.C. et al. Prenatal alcohol exposure affects renal function in overweight schoolchildren: birth cohort analysis. Pediatr Nephrol 35, 695–702 (2020). https://doi.org/10.1007/s00467-019-04429-x

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