Complete avoidance of alcohol during pregnancy is necessary to prevent alcohol-related birth defects, including intellectual disabilities in children.

That’s not new advice for mothers hoping to avoid fetal alcohol spectrum disorders in their newborn babies. But repeated claims that small amounts may be safe, along with surveys showing that a percentage of women continue drinking alcohol during pregnancy, have prompted the American Academy of Pediatrics to publish an updated report this week in its online journal Pediatrics. Alcohol-related disorders in newborns occur at even greater frequency than previously thought, it found, because such disorders have been “significantly unrecognized.”

Such disorders, in fact, are the most commonly identifiable cause of developmental delays and intellectual disabilities in children, said Janet F. Williams, a University of Texas physician and lead author of the report.

“The research suggests that the smartest choice for women who are pregnant is to just abstain from alcohol completely,” she said. “This message has been out there for a long time, that alcohol use is not healthy, and a lot of people just want that to be wrong.”

No amount of alcohol is considered safe during any trimester of pregnancy, the report says, but “about half of all childbearing-age women in the United States report consuming alcohol within the past month. In truth, some don’t yet realize they are pregnant. But nearly 8 percent of women said they continued consuming alcohol during pregnancy, the report found.

The U.S. Centers for Disease Control and Prevention reported on Sept. 24 that 10.2 percent of pregnant women, ages 18 to 44, drank alcohol in the past 30 days, with 3.1 percent reporting they engaged in binge drinking, which is four or more alcoholic beverages consumed on one occasion. That means about one-third of the women who consume alcohol during pregnancy engaged in binge drinking, the CDC said.

Higher alcohol-consumption levels also were found among pregnant women who were either 36 to 44 years old, college educated or unmarried.

The academy notes another study that found an increased risk of retardation of growth in infants even when a pregnant woman’s consumption was limited to one alcoholic drink per day — a 1.5-ounce shot of distilled spirits, 5 ounces of wine or 12 ounces of beer.

Drinking in the first trimester of pregnancy compared with no drinking resulted in 12 times the odds of giving birth to a child with fetal alcohol spectrum.

First- and second-trimester drinking increased those odds by 61 times, with those drinking throughout the duration of pregnancy increasing the odds by a factor of 65.

Dr. Williams, a professor of pediatrics at the University of Texas Health Science Center in San Antonio, said that alcohol is toxic. Its greatest impact is on rapidly growing cells, which explains why it affects fetuses so dramatically. Livers also involve rapidly growing cells, explaining why adults develop liver diseases from alcohol abuse.

Children affected by fetal alcohol spectrum, Dr. Williams said, are notably smaller with smaller or less apparent facial features and flatness in the middle region of the face. Attention deficit hyperactivity disorder also is strongly associated with alcohol, while neurological and cognitive problems can include the inability to form concepts, make plans and speak fluently. Additional problems can occur with social interaction and relationships.

“No alcohol is the safe choice,” Dr. Williams said. “No alcohol means no (fetal alcohol spectrum disorders). I don’t want people to feel badly if they were using alcohol and found out they were pregnant. That happens. But they must know at that moment, if they stop, they have a definitely lower risk of their child having problems than they would if they continue drinking.”

The report includes a toolkit for physicians at aap.org/fasd with key questions answered at healthychildren.org.

© 2015 the Pittsburgh Post-Gazette
Distributed by Tribune Content Agency, LLC

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