| Summary: | Maternal behaviours during pregnancy may contribute to unhealthy child development. Previous research has linked adverse outcomes to prenatal exposure to heavy alcohol use, to tobacco use, and to socioeconomic background. Health professionals have been responsive because of the preventable nature of these risks. This research examined the impact on children from diverse backgrounds who had been exposed prenatally to varying amounts of alcohol and tobacco, or both. It further assessed the additive effects of these risks. The Vancouver Island Pregnancy Follow-up Study is population-based. It examined the health, academic abilities and behaviours of 8-year old children born over a 1-year period in a pre-defined area of British Columbia (n=3,659). It attempted to find the total randomly selected sample (n=403), with the result that 65.7% families (n=265) participated, 25.8% were not located, 5.5% refused, and 3.0% were not available. The data sources were children, who were tested on their academic abilities using the WRAT-3, and their parents and teachers who were interviewed regarding the child's health, behaviour and school performance. Results with respect to academic abilities showed that only reading scores were associated with prenatal alcohol exposure. Reading and spelling ability scores were associated with the combination of being prenatally exposed to alcohol and having a father with low education. Poorer health ratings were associated with prenatal alcohol exposure, with the combination of pre- and postnatal tobacco exposure, and with lower socioeconomic background. All three independent variables were associated with behaviour scores. Children of heavy drinkers had higher scores on the total behaviour scale and on five subscales. Prenatal tobacco exposure was associated with higher Conduct Disorder scores. The findings are consistent with other longitudinal studies. In the absence of other risk factors, there was little evidence of associations between prenatal exposure to moderate alcohol use or risk level and academic abilities, health ratings, or behavioural problems. It may be productive to take ecological approaches to understanding children's behavioural, academic and health problems in the context of their socioeconomic conditions and their exposure to alcohol prenatally and to tobacco both prenatally and postnatally. === Graduate and Postdoctoral Studies === Graduate
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