Newborn behavioral effects of intrauterine alcohol exposure were examined in 417 infants given the Brazelton Neonatal Assessment Scale. In this longitudinal prospective study, maternal alcohol use was obtained by self-report during the fifth month of pregnancy. Factor analysis of the Brazelton scale yielded 6 factors that were entered into a multiple regression analysis as dependent variables. Maternal alcohol use in mid-pregnancy was significantly related to poorer habituation and increased low arousal in newborn infants, even after adjusting for smoking and caffeine use by mothers, maternal age and nutrition during pregnancy, sex and age of the infant, and obstetric medication. This study lends further support to recognition of maternal alcohol use during pregnancy as a risk factor for alterations in newborn behavior.