You’re all dressed up and ready to head off to the annual party at your office, your neighbor’s house, or maybe with your family. The holidays are so special, festive and romantic, but this year there is a greater sense of excitement because… you are pregnant.
With the holidays fast approaching, the age-old question comes up along with the clinking of glasses: can I join in the festivities with family and friends by drinking an alcoholic beverage to celebrate? Maybe just one?
The general rule has forever been to avoid alcohol in pregnancy. It is estimated that the prevalence of alcohol consumption in pregnancy is approximately 12.2% and 1.9% declare to drink excessively. It has been shown that women have a tendency to underestimate their alcohol consumption during pregnancy, which often also underestimates fetal exposure. Factors associated with alcohol use in pregnancy include educational level, income level, temptation to drink in social situations, previous history of alcohol use before pregnancy, and history of alcohol use at the start of pregnancy. antenatal care.
High levels of chronic heavy prenatal alcohol consumption or frequent and intermittent use is a known cause of birth defects commonly known as Fetal Alcohol Syndrome. Characteristics of this condition include:
- Mental retardation
- fetal growth retardation
- facial abnormalities
- neurobehavioral deficits including learning disabilities, speech and language problems, hyperactivity, and attention deficits.
- high risk of preterm birth and small gestational age babies
Moderate levels of alcohol consumption (1 to 2 drinks per day) during pregnancy may be associated with milder but clinically significant outcomes such as cognitive, learning, attention, and behavioral problems in childhood.
Prenatal alcohol consumption, even at levels of less than one drink per day, can negatively affect fetal growth and development.
The question always arises – Is there a safe level of alcohol consumption during pregnancy? (less than 1 drink per week?) Excessive alcohol consumption has clearly been found to harm a child’s health and development, but the role of moderate alcohol consumption has been much more controversial.
This issue is also relevant since in most industrialized countries, women of childbearing age drink alcohol and often this occurs in the first trimester before pregnancy is recognized.
The mechanism by which alcohol acts as a toxin varies from direct alcohol toxicity to placental dysfunction, fetal hypoxia, acetaldehyde toxicity, and nutritional deficits. The area of the brain that is commonly affected by alcohol is the hippocampus and the developing cerebral cortex.
What determines toxicity is the concentration of alcohol used, the pattern and amount consumed, and the stage of development of the fetus.
How much drinking is considered harmful?
Some studies have reported an association between very low levels of prenatal alcohol exposure and fetal growth, but the association has not been consistent.
A recent 2010 Journal of Epidemiology and Public Health article by Kelly studied data from 11,000 British children born between 2000 and 2002 and found that cognitive deficits and behavioral problems at age 5 were less common among children exposed to light amounts of alcohol (1 or 2 drinks a week during pregnancy). In other words, light drinking may not be as risky for a child’s early development as originally feared.
Robinson in the British Journal of OB/Gyn in 2010 also conducted studies showing that light consumption (2 to 6 drinks per week) of alcohol during pregnancy was not a risk factor for childhood behavioral problems, although this study did not observed results of physical development.
The British Journal of OB/Gyn in 2007, Henderson also found no convincing evidence for the adverse effects of prenatal low-to-moderate alcohol exposure on consumption of less than 84 g of alcohol per week (1/2 pint of regular beer). or lager contains 8 grams of alcohol and an ordinary glass of wine contains 12 g of alcohol). Her study shows that low levels of alcohol consumed during pregnancy, less than 60g/week and no more than two standard drinks per occasion, were not associated with preterm births or SGA babies.
O’Leary wrote an article in the journal Pediatrics in 2009, in which he also found no association between low levels of prenatal alcohol consumption and language delay at any period of the child’s development, compared to mothers who were engaged to intense activities. or drink excessively. She used language development as a significant milestone for children, as he took the position that a delay in that area could indicate a further delay in the child’s overall development.
In contrast, in Pediatrics in 2007, Sayal studied 12,678 pregnant women in England to determine whether very low levels of alcohol consumption during pregnancy (less than 1 drink per week) are independently associated with childhood mental health problems. between 4 and 8 years of age. She concluded in the affirmative that during early pregnancy these low levels can have a negative impact and a persistent effect on mental health outcomes. The developing brain in the first trimester can be especially vulnerable. However, alcohol use before pregnancy was not associated with adverse outcomes. The other surprising finding was that girls appear to be more vulnerable to the effects of low alcohol levels compared to boys, although this may be a chance finding.
The American College of Obstetricians and Gynecologists and the American Academy of Pediatrics continue to feel that no amount of alcohol is safe during pregnancy.
In summary:
The exact safe threshold for the amount of alcohol is unknown, so the best advice is to avoid alcohol altogether. There is no established safe level of prenatal alcohol consumption, which has led to the recommendation of complete abstinence. All physicians caring for pregnant women should routinely inquire about alcohol exposure during pregnancy. On the other hand, the data shows that women who have unexpectedly waited while drinking small amounts of alcohol need to be reassured that they have not put their unborn child at a higher risk of behavioral problems.
Finally, questions about drinking patterns of spouses are also important. It has been found that future parents, or partners, could have a great impact on the health habits of a pregnant woman. The future father could be an influential modifier of prenatal behaviors. Social support is directly related to the degree of alcohol consumption in pregnancy. Screening, evaluation, and intervention with a partner can effectively reduce prenatal alcohol use and minimize fetal risk.
