Prenatal Alcohol Exposure and Hypothalamic-Pituitary-Adrenal Axis Activity of the Offspring in Humans: a Systematic Review

Purpose of Review: We aimed to conduct a systematic review of studies exploring the relationship between prenatal alcohol exposure (PAE) and hypothalamic-pituitary-adrenal (HPA) axis functioning in the offspring in humans. Recent Findings: Animal studies have demonstrated that PAE has long-term consequences in HPA axis activity in the offspring. Fewer studies have been conducted in humans. Summary: Our systematic review identified 9 studies including infants/toddlers (n = 6) and children/adolescents (n = 3). Cortisol responses to stress were only studied in infants/toddlers (3 studies: painful stressors; 3 studies: social stressors). In infants/toddlers, PAE seems to be associated with a blunted response to painful stressors whereas an enhanced cortisol response to social stress is observed (only in boys). In children/adolescents, the normal cortisol circadian rhythm is altered in PAE participants with a FASD diagnosis, who show increased evening cortisol levels. These findings support the programming effects of alcohol on the HPA stress system.