February 18th, 2010
A number of questions from readers, as well as some of the searches that have landed users on this site (yes, we get to see that) have made me realize that many of you are wondering about the effects of drugs and alcohol on pregnancies. Especially given the fact that my wife is now pregnant with our first child, I think this is an important topic that deserves attention; for this reason, I’m going to dedicate a few posts to it, paying close attention to different classes of drugs. Given the fact that one of the most commonly used substance among my readers (per this poll) is alcohol, we’re going to start there.
Alcohol and pregnancy
Doctors frequently advise mothers-to-be to abstain from alcohol during their pregnancy. However, avoiding alcohol is difficult given how common it is in social situations. Also, many mothers-to-be are unconvinced and continue drinking, perhaps reducing their consumption, but not stopping altogether. So, can a glass of wine a day really have any impact on an infant’s health?
The most critical effects of alcohol consumption during pregnancy, aside from stillbirth (1), are a collection of symptoms known as Fetal Alcohol Syndrome (FAS), estimated to occur in approximately 1-7 per 1000 live births (2). FAS individuals suffer a wide range of mental handicaps including diminished intellectual ability, and learning difficulties. Children with FAS exhibit poor socialization and frequently engage in disruptive and maladaptive behaviors. Additionally, they are more susceptible to drug abuse, criminal behavior, and psychiatric disorders. Research seems to indicate that drinking more than a single daily drink at least doubles the probability of producing a significantly growth-retarded infant (3). Drinking less than one daily drink seems to bring about a much lower risk for serious growth-related effects, though the more subtle effects of any alcohol consumptions are still being investigated. Even a single drink a day has been shown to be associated with reduced infant weight and an increased probability of preterm birth (4).
Remember: When considering alcohol in research, a single drink means the equivalent of a single ounce of pure alcohol. A 12 oz. beer or an 8 oz. glass of wine, but no more, would be equivalent. Also, an average of one drink per day does not mean that drinking five drinks on Friday and laying off alcohol for the rest of the week is okay. Even a single binge drinking episode greatly increases the risk of complications! Finally, drinking during the first trimester is far more dangerous to a growing fetus than doing so later in the pregnancy.
So in short, toasting champagne at a wedding, or enjoying an occasional glass of wine with dinner will most likely not do great harm to an ongoing pregnancy. Just be very conscientious of your behavior and be sure not to let things get out of hand. This is certainly an issue where a single night of letting go could result in a lifetime of regret. If you find it difficult to reduce your use after finding out about a pregnancy, it could be an early sign of trouble drinking or even alcoholism…
Look for upcoming posts on smoking and drug use risks to pregnancy!
1) Kesmodel, U. Wisborg, K, Olsen, S.F., Henriksen, T.B., & Secher, N.J. (2002). Moderate alcohol intake during pregnancy and the risk of stillbirth and death in the first year of life. American journal of epidemiology, 155(4), 305-312
2) Niccols, A. (2007). Fetal alcohol syndrome and the developing socio-emotional brain. Brain and cognition, 65, 135-142.
3) Mills, J.L., Graubard, B.I., Harley, E.E., Rhoads, G.G. & Berendes, H.W. (1984). Maternal alcohol consumption and birth weight. How much drinking during pregnancy is safe? Journal of the American Medical Association, Vol. 252.
4) Dew, P.C., Guillory, V. J., Okah, F.A., Cai, J., & Hoff, G.L. (2007). The effect of health compromising behaviors on preterm births. Maternal and child health journal, 11(3), 227-233.