Adverse health outcomes associated with fetal alcohol exposure: A systematic review focused on immune-related outcomes.

Prenatal alcohol exposure (PAE) has well-known teratogenic effects on the developing fetus, potentially resulting in neurologic impairments. However, there is increasing interest regarding other potential adverse health outcomes related to prenatal alcohol exposure. The objective of this study was to undertake a systematic review to identify all the available clinical and preclinical literature investigating immune-related outcomes in offspring with PAE. A systematic review searching four electronic databases (PubMed, CINAHL, Web of Science, and Embase) was conducted. Potential articles were screened against strict inclusion/exclusion criteria. This review specifically focused on evaluating studies related to immune-related outcomes following PAE. Twelve clinical studies were included in the current review. Six included allergy outcomes, four included infection outcomes, and two studies included both. Thirty-nine preclinical studies were identified examining a wide range of immune outcomes. The current review provides some preliminary clinical evidence that PAE can influence immune function, including atopic allergy and infection outcomes. However, there was variability in results across studies, particularly in the atopy area. Preclinical studies demonstrated some changes in lymphocytes and cytokines in offspring following PAE. More research investigating the effects of PAE on immune responses is warranted.