New Zealand guidelines for alcohol use in pregnancy advise that there is no known safe level of alcohol consumption during pregnancy. Prenatal alcohol exposure (PAE) may cause major congenital abnormalities or functional defects, including changes to brain development associated with cognitive and behavioural changes. The impact of PAE is subject to individual factors, such as diet, genetics, maternal stress, tobacco smoking, use of other substances, and postnatal environment. Where PAE impacts multiple neurodevelopmental domains, individuals may be diagnosed with Fetal Alcohol Spectrum Disorder (FASD), a lifelong disability estimated to affect 1-3% of New Zealanders.

We will use data from the Growing Up in New Zealand (GUiNZ) prospective cohort study to understand the impact of PAE on affect regulation and cognitive development, and examine how the environment can moderate or exacerbate the effects of PAE up to early school-age. The objective of the proposed study is to examine the relationship between PAE and neurocognitive development in children by:

• conducting a systematic review of the association between PAE and childhood development outcomes related to FASD, including language, cognitive and executive function, and behaviour.

• conducting longitudinal data analyses to explore the relationship between PAE and neurocognitive development outcomes at 8-years using data from the Growing Up in New Zealand (GUiNZ) prospective cohort study.

• identifying children impacted by PAE across multiple domains and therefore at risk of FASD.