TORONTO (Canadian Press) -- Health providers should routinely ask women of child-bearing age about their alcohol consumption as a first step in trying to prevent fetal alcohol spectrum disorder in children, says the Society of Obstetricians and Gynaecologists of Canada.

The doctors organization released a set of guidelines Thursday aimed at helping doctors, nurses, midwives and other practitioners broach the subject of drinking with women who are already pregnant or those who could become pregnant.

The recommendations, published in the August issue of the Journal of Obstetrics and Gynaecology Canada, are based on a two-year review of international scientific evidence by an expert committee convened by the SOGC.

"There are a lot of women asking is it safe to have a few drinks in pregnancy or not, and there are many conflicting reports around the world to say yes or no," said SOGC president Dr. Ahmed Ezzat.

"So there are many, many questions and there haven't been clear guidelines for health-care workers to advise these women or to counsel them about it," Ezzat, a professor of obstetrics and gynecology at the University of Saskatchewan, said from Saskatoon.

"So this group of experts thought that it's prudent to advise abstinence, therefore, in women who are or might become pregnant ... However, at very low-level consumption, we don't have enough evidence to say there is harm or how much (alcohol) is safe."

Ezzat said the guidelines encourage health providers to talk to female patients about alcohol consumption in the same way they ask about tobacco use, and to provide counselling or referrals for addiction programs if necessary.

Dr. Gideon Koren, director of the Motherisk Program at Toronto's Hospital for Sick Children, said the women who most need to be identified and given help are those who drink heavily, putting their unborn babies at risk for FASD.

"The problem here is that very many physicians do not even ask the question," he said. "It's not an easy thing to ask. Here you have a patient, who comes to you for something else, to ask about drinking."

"We have a sad reality that physicians and other health professionals are not doing their job on that -- namely that a lot of women are not asked and we do not identify the cases. At the end are kids who are very heavily affected. So we are missing out on a big thing."

He said an estimated three per cent of Canadian children are born with FASD as a result of exposure to alcohol while in the womb. Because metabolism in the developing fetus is slower than in the mother, alcohol's effects are prolonged and potentially harmful.

Koren said research has shown that of 100 women who drink heavily during pregnancy, about 40 per cent will have children with some form of FASD. Symptoms can range from mild attention problems to more serious deficits, such as reduced IQ, poor comprehension and diminished language skills.

"And in the most severe cases, fetal alcohol spectrum disorder is characterized by behavioural changes, and mostly very abrupt behaviour -- aggression, delinquency, inability to follow rules, breaking rules and ... very early involvement with the law."

In fact, said Koren, about half of the inmates in Canadian prisons are the offspring of "heavy-drinking moms."

The only way to prevent FASD is to stop women drinking during pregnancy, he said. "That's exactly why physicians have to be involved and other health professionals."

"Because if you don't know, you don't do anything."

Copyright The Canadian Press, 2010