# Examining Complex Relationships Between Alcohol Exposure and Miscarriage Risk

> **NIH NIH F30** · VANDERBILT UNIVERSITY · 2020 · $29,974

## Abstract

PROJECT SUMMARY/ABSTRACT
Alcohol consumption during pregnancy persists as a featured topic in public health, yet the impact of early
pregnancy exposure on miscarriage risk remains uncertain. Despite recommendations for women who are
planning a pregnancy or who might become pregnant to abstain from alcohol, over 50% of women report
alcohol exposure at some point in the first trimester regardless of pregnancy intention. The objective of the
proposed work is to examine the relationship between alcohol consumption during pregnancy and miscarriage
risk through three approaches with the central hypothesis that the relationship between alcohol consumption
and risk of miscarriage is dependent on timing of exposure. For my first aim, I will conduct a systematic review
and meta-analysis to synthesize the present understanding of this risk-relationship and to critically evaluate the
design and analytical features of prior studies. After taking account of the current literature's shortcomings,
such as the common practice of modeling alcohol consumption as a static exposure during pregnancy, I will
delineate the relationship between alcohol use and miscarriage risk in the Right from the Start (RFTS) cohort
for my second aim. RFTS is a community-based pregnancy cohort that is nationally recognized for its success
in recruiting women in early pregnancy and collecting detailed information on first trimester exposures,
including pattern of alcohol consumption in early pregnancy. Modeling alcohol use as a time-varying exposure
is a more rigorous and appropriate technique than methods used in prior studies and estimating the risk-
relationship with proportional hazard models will further improve upon past methods by accounting for timing of
cohort entry and exit. For my third aim, I will investigate whether alcohol metabolism modifies the relationship
between exposure and miscarriage risk by determining haplotypes of RFTS participants for the ADH1C gene,
which is related to rate of alcohol clearance. I will then evaluate the interaction between alcohol exposure and
haplotype in relation to miscarriage risk. Together, this work will provide more precise information about how
pattern of alcohol exposure in early pregnancy relates to miscarriage and has the potential to inform more
specific approaches for mitigating risk.

## Key facts

- **NIH application ID:** 9856495
- **Project number:** 5F30HD094345-03
- **Recipient organization:** VANDERBILT UNIVERSITY
- **Principal Investigator:** Alexandra Clare Sundermann
- **Activity code:** F30 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $29,974
- **Award type:** 5
- **Project period:** 2018-02-01 → 2020-05-08

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9856495

## Citation

> US National Institutes of Health, RePORTER application 9856495, Examining Complex Relationships Between Alcohol Exposure and Miscarriage Risk (5F30HD094345-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9856495. Licensed CC0.

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