June 22, 2012
New research suggests that light to moderate drinking during early pregnancy might not harm the baby's brain development. In the United States, pregnant women are advised to drink no alcohol. But there's little research on the effects of light to moderate drinking on a fetus. The new research consisted of 5 related studies. They included 1,600 Danish women. Researchers compared groups who drank different amounts of alcohol during pregnancy. Light drinking was defined as 1 to 4 drinks per week. Moderate drinking was 5 to 8 drinks. High consumption was 9 or more. In Denmark, a drink is defined as 0.4 ounces of pure alcohol. That's two-thirds of the U.S. definition, 0.6 ounces. At age 5, the women's children were given tests of IQ and attention span. Tests also measured executive function. This governs self-control and the ability to plan. Test scores were similar whether mothers drank light to moderate amounts during pregnancy or did not drink at all. Binge drinking -- 5 or more drinks at a time, usually once during pregnancy -- also made no difference. But children of heavier drinkers had less attention span. The journal BMJOG published the study. CBS News reported on it June 20.
What Is the Doctor's Reaction?
It's a common fear among young women: "Oh my God, I just learned I'm pregnant. I was out to dinner last week and had a glass of wine. Did I hurt my baby?"
Drinking alcohol during pregnancy has been taboo for some time. Not without reason. Heavy drinking during pregnancy can result in fetal alcohol syndrome. It causes problems in the child, including:
But is a little alcohol during pregnancy really that dangerous? No one has been able to identify a safe amount of drinking during pregnancy. So doctors tell women to steer away from alcohol entirely.
A series of five studies from Denmark looked at the effects of drinking during pregnancy. The findings from this work suggest that low to moderate alcohol use in early pregnancy did not harm the brain or psychological development of children. Low alcohol use was defined as one to four drinks per week. Moderate use was five to eight drinks per week.
The children were tested at age 5 for IQ, attention span and executive function. Executive function includes self-control and age-appropriate abilities to plan and organize. Children of mothers who drank low or moderate amounts during pregnancy had about the same scores as children whose mothers did not drink alcohol.
Drinking more appears to be a different story. In one of the studies, 5-year-olds whose mothers had 9 or more drinks per week during pregnancy were significantly more likely to have lower test scores.
The study results were published in the June 20 issue of BJOG: An International Journal of Obstetrics and Gynaecology.
What Changes Can I Make Now?
The authors of the study do not argue that drinking alcohol during pregnancy is wise or to be encouraged. In fact, most doctors, including me, will continue to advise pregnant women not to drink alcohol.
Is this stance too conservative? Perhaps it is. But personally I will need more convincing before I change my advice. Only a very small number of women took part in the studies. And the children were tested just once, at age 5. This is just one snapshot of a child's development.
There is no denying that heavy drinking during pregnancy is harmful for babies and moms. But women who have consumed a little alcohol before realizing they were pregnant shouldn't beat themselves up about it.
What about a sip (or glass) of champagne at a special occasion during pregnancy? Although I am still reluctant to say it's okay, it may not be an unreasonable or unsafe choice. In many parts of the world, light drinking during pregnancy is common and culturally acceptable. It's a choice each woman has to make for herself. Ideally, she should talk with her doctor or midwife about this issue.
What Can I Expect Looking to the Future?
The general advice to avoid alcohol in pregnancy will stand until research clearly defines a safe level of drinking. But these studies open the door for taking another look at this conservative stance in the future.
What we do know is that women who drink more than moderately should seek help, whether they are pregnant or not.