Drinking alcohol during pregnancy can cause a wide range of physical and mental birth defects. Although many individuals are aware that heavy drinking during pregnancy can cause birth defects, many do not realise that moderate or even light drinking also may harm the fetus. In fact, no level of alcohol use during pregnancy has been proven safe.
Why is drinking alcohol during pregnancy dangerous?
Alcohol is a teratogen for fetal development. Prenatal use of alcohol can prevent cell adhesion during brain development, and leave the fetus with permanent brain damage and central nervous system abnormalities that can affect cognitive and behavioural functioning.
Alcohol use can also affect the pregnant woman and lead to the following complications:
Preterm labour
Decrease production of breast milk
Spontaneous abortion/miscarriage
What is fetal alcohol syndrome?
This was first described in 1973, but the term was changed in 1996 to fetal alcohol spectrum disorder to recognized, the various changes that may emerge as late as young adulthood.
Children with fetal alcohol spectrum disorder have a number of physical abnormalities, cognitive and behavioural changes and increased vulnerability to substance use and other psychiatric disorders.
Babies with fetal alcohol spectrum are abnormally small at birth and usually do not catch up on growth as they get older. They have characteristic facial features, including small eyes, a thin upper lip and smooth skin in place of the normal groove between the nose and upper lip. Their organs, especially the heart, may not form properly. Many babies also have a brain that is small and abnormally formed. Most have some degree of intellectual disability. Many have poor coordination, a short attention span and emotional and behavioural problems.
Fetal alcohol spectrum disorder is one of the most common known causes of intellectual disabilities.
How much alcohol is too much during pregnancy?
No level of drinking alcohol has been proven safe during pregnancy. Many experts believe that the patterns of drinking that place a baby at greatest risk for fetal alcohol spectrum disorder are binge drinking and drinking seven or more drinks per week; however, fetal alcohol spectrum disorder symptoms can occur in babies of women who drink less.
Researchers are taking a closer look at the more subtle effects of moderate and light drinking during pregnancy.
A 2002 study found that 14-year-old children whose mothers drank as little as one drink a week were significantly shorter and leaner, and had a smaller head circumference (a possible indicator of brain size) than children of women who did not drink at all.
A 2001 study found that 6- and 7-year-old children of mothers who had as little as one drink a week during pregnancy were more likely than children of non-drinkers to have behaviour problems such as aggressive and delinquent behaviours. These researchers found that children whose mothers drank any alcohol during pregnancy were more than three times as likely as unexposed children to demonstrate delinquent behaviours.
Other studies report behavioural and learning problems in children exposed to moderate drinking during pregnancy, including attention and memory problems, hyperactivity, impulsivity, poor social and communication skills, psychiatric problems (including mood disorders) and alcohol and drug use.
The bottom line is: no amount of alcohol can be guaranteed to be safe during pregnancy.
Unplanned pregnancy and alcohol use
Many pregnancies inAnguillaare unplanned and many women do not know they are pregnant in the very early period and, as a result, many women might use alcohol drinks unaware that they are pregnant.
It is unlikely that the occasional drink a woman takes before a woman realises she is pregnant will harm her baby. The baby’s brain and other organs begin developing around the third week of pregnancy; however, all organs are vulnerable to damage in these early weeks. As no amount of alcohol has been proven safe during pregnancy, a woman should stop drinking immediately if she even suspects she could be pregnant, and she should not drink alcohol if she is trying to become pregnant.
Breast feeding and alcohol use
Small amounts of alcohol do get into breast milk and are passed on to the baby. Large amounts of alcohol may interfere with ejection of milk from the breast therefore resulting in less breast milk to the baby.
Treatment interventions
Four main treatment interventions are used to treat or prevent alcohol use in pregnant women:
• Counseling of women of childbearing age who meet the criteria for problem drinking
• Brief interventions for pregnant women who are at risk drinkers, but not alcohol dependent
• Detoxification and referral services for women who are alcohol dependent
• Follow-up services for women who use alcohol when pregnant
Obstetricians and midwives are in an excellent position to help pregnant women who have a problem with alcohol use. They can encourage these women to abstain from drinking alcohol during this unique period in their lives. A pregnant woman should be encouraged to focus on the positive effects of not using alcohol because she will be sure no harm is done to the baby. It will save money. Not drinking will have a lifetime of positive effects on her and her baby.
Conclusion
Many health professions inAnguillabelieve that many more women are using alcohol beverages then previously. This could result in many more pregnant women using alcohol beverages. Alcohol use during pregnancy is associated with increased rates of medical complications for both the woman and her fetus. All pregnant women should abstain from drinking all alcohol beverages during the period that they are pregnant and while they are breastfeeding. Those women needing help should see their health care provider.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over twenty eight years in clinical practice. Dr Hodge has a medical practice in the Johnson Building in The Valley.
