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

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/1.73m(2), 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/1.73m(2) and -11.1(-21.3 to -1.2)mL/min/1.73m(2) in those exposed to <= 40 g and to > 40 g of alcohol per week, respectively, compared to no consumption (p(trend) = 0.002). Conclusions Prenatal alcohol exposure has a dose-dependent adverse effect on renal function at school age in overweight and obese children.