Early biomarkers associated with prenatal alcohol exposure and neurodevelopmental outcomes

Prenatal alcohol exposure (PAE) is a major early-life stressor associated with long-lasting neurodevelopmental and neurocognitive alterations. Increasing evidence from human studies indicates that PAE leaves persistent molecular signatures that can be detected in the placenta and in clinically accessible biological fluids. This Mini Review summarizes recent advances in the identification of epigenetic, immune, endocrine, and RNA-based biomarkers measured in placental tissue, umbilical cord blood, and peripheral fluids, and their associations with neurodevelopmental outcomes. We highlight convergent findings across heterogeneous study designs, discuss current methodological challenges and research gaps, and consider future directions toward integrative and longitudinal biomarker approaches. Together, the reviewed evidence supports the potential of placental and circulating biomarkers to improve early risk stratification and to advance understanding of neurodevelopmental alterations following PAE.