The AQUA study involved almost 1600 Victorian women who provided information during pregnancy about alcohol consumption, diet, supplements and lifestyle. Samples were collected from placentas, cord blood and cheek swabs to test for genetic markers and over 500 babies had 3D photos of their faces at age 1 to look for signs of prenatal alcohol exposure. At ages 1 and 2, children received developmental assessments and mothers reported on development. Researchers are examining outcomes like facial shape and child development and how genes and metabolism may impact alcohol's effects. The study found over half took supplements before pregnancy and most took them during pregnancy. However, 70% of women did not meet recommended iron intake by the third trimester despite many increasing intake. Researchers will further

1. AQUA Study Updates
Almost 1600 Victorian women participated in AQUA from early in their pregnancy, many of whom drank varying levels of alcohol before they realised
they were pregnant. Participants provided detailed information at three stages of pregnancy on demographics, obstetric history and pregnancy
complications, diet, use of folate, health and lifestyle, and family/personal drinking history.
Samples from placenta, cord blood and cheek brush swabs were collected to test for genetic
and other markers thought to be important indicators of an alcohol effect. Over 500 babies
had a 3D photo taken of their face at 12 months looking for potential early subtle signs of
alcohol effects. Then, at two years of age, mothers again brought their children to the Royal
Children’s Hospital for a comprehensive developmental assessment, done by a trained
psychologist. At both time points, all AQUA mothers also reported on their baby’s
development and aspects of family environment.
Participants chose up to five types of alcoholic drink from a list of pictures of different
drink sizes and types and nominated how often they would usually drink these.
Researchers then converted the choices into number of standard drinks consumed per
week.
One of the outcomes researchers are looking at in this study is facial shape. This is because the face of a child can look quite different after heavy
alcohol exposure in the womb. While this doesn’t happen all the time, doctors can use the characteristics of this facial shape, to help diagnose
whether the child has Fetal Alcohol Syndrome or Fetal Alcohol Spectrum Disorder. In these situations doctors look for changes in facial shape
around the eyes, nose and mouth.
Child development is the main study outcome of AQUA. To date, we have information on the children when they were one and two years old.
95% of women in the study gave us a sample of their cheek cells to study genes associated with how alcohol is metabolised. When the women in
AQUA filled in their first questionnaire, we also asked if they generally felt the effects of alcohol slowly, normally or quickly. We are interested to
see if this information could be related to alcohol metabolism. It may be that in mothers who metabolise alcohol quickly, the baby is exposed to
lower levels or for a shorter period of time.
Good nutrition during pregnancy is important for the development of a healthy baby. The need for certain nutrients, such as iron, iodine and folate
is increased at this time, and many women take extra vitamin supplements.
We asked all participants about their diet with a Food Frequency Questionnaire and also if they were taking any vitamin supplements, such as
folate, and when they started taking these. We will take this information into account when we look at any possible effects of drinking alcohol on
the baby’s development.
What have we found?
Over half of women were taking supplements before pregnancy and almost all women took some when they were pregnant (91%). Mostly these
were multivitamins, but many women also took Vitamin D and/or iron later in pregnancy. Women who planned their pregnancy were more likely
to take pregnancy-specific multivitamins or folate preparations in the 3 months before they became pregnant. We also took into account any
vitamins and minerals from the women’s diet as well as any supplements taken. Here, we found that even though many women increased their
iron intake over the course of their pregnancy, 70% of pregnant women did not reach the recommended dietary intake for this nutrient by the third
trimester.
Alcohol consumption in pregnancy !
3D photography of the children’s faces !
Child development !
Laboratory studies of samples collected !
Mothers’ diet and dietary supplements "

2. What will we do next?
We have published these findings in a public health nutrition journal because it is
important for midwives and doctors to know whether pregnant women consume
enough micronutrients for their health and wellbeing, as well as that of their baby. We
will further look into the diet of pregnant women and compare this to the Australian
Dietary Guidelines recommendations to better understand what women in Australia
eat. This will give us important information to take into account when looking at
possible negative effects of pregnancy alcohol consumption on the child (as some
nutrients and diet types may lessen any harm). It will also help target healthy-eating
programs to positively change food choices.
If you have any questions about your participation or any aspects of the study, please contact us at aquastudy@mcri.edu.au or 03 8341 6370.
If you are a study participant and have changed your contact details, or changed address, then please let us know by email or phone at:
aquastudy@mcri.edu.au or 03 83416370.
How can I get more information? !
Help us keep in touch !
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5. Contact the AQUA team
(https://www.mcri.edu.au/research/projects/aqua-project/contact-
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7. NEW: AQUA at 6
(https://www.mcri.edu.au/aquastudy/aqua-6)