Prenatal alcohol exposure (PAE) is a leading cause of neurodevelopmental disabilities and can result in a wide range of lifelong challenges for children, including difficulties with learning, behavior, and physical health. While much of the research has focused on alcohol’s direct effects on the developing fetus, this article highlights additional pathways through which alcohol can disrupt fetal development. These include alcohol’s impact on the placenta, maternal metabolism, paternal factors, inflammation, and the maternal microbiome. Understanding these broader, non-fetal mechanisms offers important insights into the complex ways alcohol affects development and may inform more effective prevention and intervention strategies.
