Effects of In Utero Alcohol Exposure on Adult Health and Disease (R21 - Clinical Trial Optional) | PA 18 508

Opportunity Information: Apply for PA 18 508

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health (NIH), released this grant opportunity to support early-stage, innovative studies on how alcohol exposure during pregnancy can shape health risks much later in life. The core idea behind the program is the developmental origins of health and disease (DOHaD) framework, which argues that the fetus can make biological "adjustments" in response to harmful conditions in the womb, and that these adjustments may raise the likelihood of chronic disease during childhood, adolescence, or adulthood. In practical terms, the FOA is trying to push the field beyond immediate birth outcomes and childhood neurodevelopment alone, and toward understanding whether prenatal alcohol exposure contributes to long-term cardiometabolic disease, immune dysfunction, endocrine disorders, neurological decline, and other chronic health conditions that may not show up until decades after exposure.

This opportunity is designed specifically for novel, exploratory work under the NIH R21 mechanism, which generally emphasizes new concepts, emerging hypotheses, and proof-of-principle results rather than large definitive trials. The announcement is labeled "Clinical Trial Optional," meaning applicants are allowed to propose projects that include a clinical trial component, but they do not have to; strong applications could be entirely observational, mechanistic, or biomarker-focused. The FOA encourages investigators to connect prenatal alcohol exposure to later disease risk using approaches that can plausibly identify causal pathways, such as leveraging well-characterized longitudinal human cohorts, pairing epidemiologic work with mechanistic laboratory studies, or applying modern molecular profiling methods.

NIAAA highlights three main research directions. First, the agency wants researchers to take advantage of existing prospective birth cohorts, especially those that have documented maternal alcohol use during pregnancy and have long-term follow-up data on offspring health. This includes studies that can clarify how the timing, pattern, and dose of prenatal alcohol exposure relate to later outcomes, and how that relationship fits into the DOHaD process. Second, the FOA calls for work on biological, cellular, and molecular mechanisms, meaning studies that can explain how prenatal alcohol exposure might "program" later disease risk through pathways such as altered organ development, stress-response systems, metabolic regulation, immune and inflammatory signaling, vascular development, endocrine and neuroendocrine function, or long-lasting gene regulation changes. Third, it encourages identification of biomarkers of gestational alcohol exposure that could help predict who is most vulnerable to later disease. That biomarker emphasis could involve biochemical measures, epigenetic signatures, transcriptomic or proteomic patterns, imaging markers, or other quantifiable indicators that link prenatal exposure with later susceptibility, ideally in ways that could be validated and used in future risk stratification or preventive interventions.

In terms of who can apply, eligibility is broad and includes many types of U.S. organizations and governments as well as some non-U.S. entities. Eligible applicants listed in the opportunity include state, county, city, township, and special district governments; independent school districts; public and state-controlled universities; private universities; nonprofit organizations with or without 501(c)(3) status; public housing authorities and Indian housing authorities; federally recognized tribal governments and other tribal organizations; for-profit organizations (including small businesses and other for-profits); and an "Others" category that is commonly used in NIH listings. The FOA also explicitly mentions a range of institution types that NIH seeks to include in its funding ecosystem, such as Historically Black Colleges and Universities (HBCUs), Hispanic-serving institutions, Tribally Controlled Colleges and Universities (TCCUs), Alaska Native and Native Hawaiian-serving institutions, Asian American Native American Pacific Islander Serving Institutions (AANAPISIs), faith-based or community-based organizations, regional organizations, U.S. territories or possessions, and foreign (non-U.S.) organizations.

Administratively, the program is categorized as a discretionary grant in the health area and is associated with CFDA number 93.273. The Funding Opportunity Number is PA-18-508, and the title is "Effects of In Utero Alcohol Exposure on Adult Health and Disease (R21 - Clinical Trial Optional)." The listing shows an award ceiling of $200,000, reflecting the smaller, exploratory nature typical of R21 projects. The record also notes an original closing date of January 7, 2021, and a creation date of December 19, 2017, which is useful context for anyone checking whether the announcement is still active or whether a newer reissued FOA has replaced it.

Overall, the program is trying to build a clearer, mechanistically grounded picture of whether and how prenatal alcohol exposure contributes to adult chronic disease, not just to fetal alcohol spectrum disorders as traditionally defined. By encouraging studies that connect long-term cohort data with biological mechanisms and measurable biomarkers, NIAAA is aiming to generate evidence that can guide future screening strategies, prevention efforts, and possibly interventions that reduce lifelong health burdens linked to alcohol use during pregnancy.

• The National Institutes of Health in the health sector is offering a public funding opportunity titled "Effects of In Utero Alcohol Exposure on Adult Health and Disease (R21 - Clinical Trial Optional)" and is now available to receive applicants.
• Interested and eligible applicants and submit their applications by referencing the CFDA number(s): 93.273.
• This funding opportunity was created on 2017-12-19.
• Applicants must submit their applications by 2021-01-07. (Agency may still review applications by suitable applicants for the remaining/unused allocated funding in 2026.)
• Each selected applicant is eligible to receive up to $200,000.00 in funding.
• Eligible applicants include: State governments, County governments, City or township governments, Special district governments, Independent school districts, Public and State controlled institutions of higher education, Native American tribal governments (Federally recognized), Public housing authorities/Indian housing authorities, Native American tribal organizations (other than Federally recognized tribal governments), Nonprofits having a 501 (c) (3) status with the IRS, other than institutions of higher education, Nonprofits that do not have a 501 (c) (3) status with the IRS, other than institutions of higher education, Private institutions of higher education, For-profit organizations other than small businesses, Small businesses, Others.

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