Alcohol and pregnancy

Answer 1

Many people assume that any drinking during pregnancy is "a no go" in spite of the scientific medical evidence that it's not necessary to stop drinking in moderation during pregnancy.

Fortunately there is absolutely no evidence that light drinking, even on a daily basis, leads to fetal alcohol syndrome (FAS). Actually, most women who are light or moderate drinkers choose not to drink during pregnancy. The real problem is found among frequent heavy drinkers, who most often are alcoholics consuming heavily on a daily basis throughout their pregnancies.

Additionally, those who give birth to FAS children characteristically smoke, use illegal drugs, are frequently malnourished, and rarely receive adequate medical care during pregnancy. And drinking during pregnancy has not declined among such women over time. Because of their addiction, these women are virtually immune to our current educational approach. This may also be because so many of these women are poorly educated and often lead marginal lives.

The National Institute for Health and Clinical Excellence (NICE), which issues health guidelines in the UK, recently concluded that it is safe for expectant mothers to consume a small drink of alcohol each day.

Similarly, the Australian Alcohol Guidelines state that consuming fewer than seven drinks per week, with no more than two drinks on any one day, is a safe level for drinking during pregnancy. The Guidelines have been endorsed by the Ministerial Council on Drug Strategy, which is Australia's highest decision-making body for alcohol and drug policy.

Reflecting their basis in scientific evidence rather than in speculation or ideology, most medical school textbooks on obstetrics condone drinking at some level by pregnant women. About one-third do not address the question. A minority of the textbooks go beyond the scientific medical evidence to recommend zero alcohol consumption during pregnancy.

Deciding whether to drink during pregnancy and, if so, how much to consume, is a very personal matter. Of course a decision to abstain from Alcoholic Beverages completely throughout pregnancy can never be a bad decision. But it's always best to consult your physician to discuss your own personal situation.

Answer 2

Consuming alcohol abusively, especially along with drugs, during pregnancy sometimes causes birth defects or a severe disease called Fetal Alcohol Syndrome. The risk of FAS is increased if the pregnant women receives no prenatal care, is poorly nourished, and is in a very marginal social position. Children born with FAS suffer lifelong mental and physical disabilities. No amount of alcohol during pregnancy is safe.

It appears that no medically documented case of FAS has been reported in relation to a mother who consumed no more than one drink of beer, wine or spirits per day.

Answer 3

While you are pregnant, you need to do whatever you can to ensure the health and well-being of your unborn baby. In addition to eating well, sleeping well and getting plenty of exercise, there are things you need to avoid. You should never smoke while you are pregnant, and you should avoid drinking alcohol as well. All too often, mothers-to-be downplay the importance of abstaining from alcohol, and their babies often suffer because of it. Learn more about the dangers of mixing alcohol and pregnancy below.

Increased Risk of Miscarriage, Premature Birth and Other Problems

Studies has shown that women who consume even a small amount of alcohol while they are pregnant are at an increased risk of experiencing miscarriages and premature births. Other studies have indicated that there may also be an increased risk of stillbirth. To give your baby the best possible start in life, you should completely avoid drinking alcohol during your pregnancy.

Fetal Alcohol Spectrum Disorders

Your baby could develop many serious problems when you consume alcohol while he is still in the womb. These problems are collectively referred to as fetal alcohol spectrum disorders or FASDs, and they include mental and physical birth defects.

Complete Abstinence is the Best Policy

From time to time, studies suggest that a small amount of alcohol may be okay for expectant mothers. However, there is no conclusive evidence about how much alcohol is okay. Heavy drinking poses definite risks, but light-to-moderate drinking can cause serious problems too. The best thing to do is to completely abstain from drinking alcohol throughout the duration of your pregnancy.

How Alcohol Affects the Fetus

If you drink alcohol while you are pregnant, it is passed along to your unborn baby through the placenta. Fetuses are unable to process alcohol as efficiently as grown adults. As a result, high concentrations of alcohol can remain in a fetus's system for long periods of time. That is why drinking even small amounts of alcohol can be risky while you are pregnant.

Fetal Alcohol Syndrome

In the most serious cases, women who drink while they are pregnant may give birth to babies who suffer from fetal alcohol syndrome. Fetal alcohol syndrome or FAS involves several different physical and mental birth defects. In fact, it is one of the most common causes of mental retardation, and it can be completely avoided by simply not drinking alcohol while you are expecting a baby.

Answer 4

Definition

Pregnant women are strongly urged not to drink alcohol during pregnancy.

Drinking alcohol while you are pregnant has been shown to have damaging effects on the developing baby and may even lead to permanent disability and medical problems in the child after birth.

Information

When a pregnant woman drinks alcohol, the alcohol travels through her blood and into the placenta. The placenta is the organ that develops during pregnancy to provide nutrients to the developing baby. That means when a pregnant mom has a glass of wine, her baby has a glass of wine, too. Drinking alcohol can harm the baby's development. Alcohol breaks down much more slowly in the baby's body than in an adult. That means the baby's blood alcohol level stays elevated longer than the mother's. This is very dangerous, and can sometimes lead to lifelong damage.

Dangers of Alcohol During Pregnancy

Drinking a lot of alcohol during pregnancy can lead to fetal alcohol syndrome in the baby. Fetal alcohol syndrome refers to a group of irreversible physical, mental, and neurobehavioral birth defects including mental retardation, growth deficiencies, attention disorders, heart and nervous system damage, and other lifelong medical problems.

Drinking alcohol during pregnancy may also result in:

• Abnormal heart structure
• Abnormal brain structure
• Behavior problems

Complications seen in the infant may include:

• Cerebral palsy
• Infant death
• Learning disabilities
• Mental retardation
• Miscarriage or stillbirth
• Poor growth before birth
• Premature delivery
• Problems in the structure of the head, eyes, nose, or mouth
• Slow growth and poor coordination after birth

How Much Alcohol is Dangerous?

There is no known "safe" amount of alcohol use during pregnancy. Alcohol use appears to be the most harmful during the first 3 months of pregnancy; however, drinking alcohol anytime during pregnancy can be harmful.

Alcohol includes beer, wine, wine coolers, and liquor.

One drink is defined as:

• 12 oz of beer
• 5 oz of wine
• 1.5 oz of liquor

How much you drink is just as important as how often you drink.

• Even if you don't drink often, drinking a large amount at one time is especially harmful to the baby.
• Binge drinking (5 or more drinks on one occasion) greatly increases a baby's risk of alcohol-related damage.
• Drinking moderate amounts of alcohol when pregnant may lead to miscarriage.
• Heavy drinkers (those who drink more than 2 alcoholic beverages a day) are at greater risk of giving birth to a child with fetal alcohol syndrome.
• The more you drink, the more you raise your baby's risk for harm.

Do Not Drink During Pregnancy

Women who are pregnant or who are trying to get pregnant should avoid drinking any amount of alcohol. The only way to prevent fetal alcohol syndrome is to not drink alcohol during pregnancy.

If you did not know you were pregnant and drank alcohol, stop drinking as soon as you find out. While it is unlikely that the occasional drink you took before finding out you were pregnant will harm your baby, the sooner you stop drinking alcohol, the healthier your baby will be.

If you enjoy alcoholic beverages try replacing them with their nonalcoholic counterparts: for example, you might opt for a nonalcoholic pina colada instead of the real thing.

Pregnant women with alcoholism should join an alcohol abuse rehabilitation program and be checked closely by a health care provider throughout pregnancy.

The following organizations may offer assistance:

National Council on Alcoholism and Drug Dependency -- www.ncadd.org

Substance Abuse Treatment Facility Locator -- 1-800-662-4357

See also: Alcoholism - support group

References

Alcohol and Women. The American College of Obstetricians and Gynecologists. Available at: www.acog.org/publications/patient_education/bp068.cfmAccessed March 16, 2010.

American Pregnancy Association web site. Alcohol and Pregnancy: What You Should Know. www.americanpregnancy.org/pregnancyhealth/alcohol.htmlAccessed March 16, 2010.

Stoll BJ. Metabolic disturbances. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 106.

Bertrand J, Floyd LL, Weber MK. Guidelines for identifying and referring persons with fetal alcohol syndrome. MMWR Recomm Rep. 2005 Oct 28;54(RR-11):1-14.

March of Dimes web site. Drinking Alcohol During Pregnancy. Available at: www.marchofdimes.com/professionals/14332_1170.aspAccessed March 16, 2010.

Cunnigham FG, Leveno KL, Bloom SL, et al. Teratology and medications that affect the fetus. In: Cunnigham FG, Leveno KL, Bloom SL, et al, eds. Williams Obstetrics. 22nd ed. New York, NY: McGraw-Hill; 2005:chap 14.

Reviewed By

Review Date: 03/21/2010

Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Redmond, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.