Attention problems are thought to be a hallmark feature of prenatal alcohol exposure (PAE). Despite decades of research however, these findings have never been pooled to assess the association between PAE and the different domains of attention functioning. This systematic review and meta-analysis aimed to examine the relationships between low-moderate, binge and heavy PAE with domains of attention functioning (encode, focus, shift, sustain and behavioural) in children. Thirteen studies compared children with PAE to abstinent controls. A significant adverse effect of any PAE on shifting attention (Cohen’s d = -0.61), and a trend towards an adverse effect of heavy PAE on encoding attention (Cohen’s d = -0.79) were identified. Compared to controls, there were trends showing that low-moderate PAE (odds ratio = 1.21) was associated with greater odds of behavioural attention problems. Remaining analyses were limited by insufficient studies or were non-significant. In summary, a vulnerability of higher-level attention skills to PAE was found. Urgent investigation into the effects of low to moderate PAE is needed given the prevalence of this drinking pattern, trends towards behavioural attention problems, the lack of comprehensive and high-quality research and the known impacts of attention difficulties on academic and social development in children.

注意力问题被认为是产前酒精暴露 (PAE) 的一个标志性特征。然而，尽管进行了数十年的研究，但这些发现从未被汇总用于评估 PAE 与不同注意力功能领域之间的关联。本系统评价和荟萃分析旨在检查儿童低中度、暴食和重度 PAE 与注意力功能领域（编码、聚焦、转移、维持和行为）之间的关系。13 项研究将患有 PAE 的儿童与禁欲的对照儿童进行了比较。任何 PAE 对转移注意力的显着不利影响（Cohen 的d  = -0.61），以及重 PAE 对编码注意力的不利影响的趋势（Cohen 的d = -0.79) 被识别。与对照组相比，有趋势表明低中度 PAE（比值比 = 1.21）与行为注意力问题的几率更大有关。其余分析因研究不足或不显着而受到限制。总之，发现了更高级别注意力技能对 PAE 的脆弱性。鉴于这种饮酒模式的普遍性、行为注意力问题的趋势、缺乏全面和高质量的研究以及注意力困难对儿童学业和社会发展的已知影响，需要对低至中度 PAE 的影响进行紧急调查。