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. 1990 Dec;44(4):297–301. doi: 10.1136/jech.44.4.297

Is there a fetal effect with low to moderate alcohol use before or during pregnancy?

I Walpole 1, S Zubrick 1, J Pontré 1
PMCID: PMC1060673  PMID: 2277251

Abstract

STUDY OBJECTIVE--The aim was to investigate the effect of low or moderate alcohol consumption upon fetal outcome. DESIGN--This was a prospective randomised cohort study with mother and infant follow-up sample stratified on level of maternal alcohol intake. SETTING--A large maternity hospital in Western Australia. PARTICIPANTS--2002 randomly selected pregnant women were recruited over a 3 year period for questionnaire survey (19 mothers refused participation). From 665 women in a stratified subsample selected on the basis of prepregnancy alcohol consumption, 605 newborns were available for study. INVESTIGATION AND MAIN RESULTS--All 2002 women completed a comprehensive questionnaire on demographic, lifestyle (including diet), health, and obstetric factors. Of the 665 mothers who were followed through pregnancy, 605 liveborns were available at birth for measurement and detailed clinical evaluation. Low to moderate prepregnancy maternal alcohol intake was not associated with any untoward effect upon weight, length, head circumference at birth, or clinical well-being as indicated by Apgar score, respiratory distress syndrome, and overall clinical state. Other factors, particularly nicotine, were of much greater importance. CONCLUSIONS--This study fails to show any significant relationship between low to moderate prepregnancy maternal alcohol intake and newborn clinical status. The outcome suggests that cautionary advice to pregnant women warning that any alcohol taken during pregnancy is potentially harmful to the fetus is inaccurate and therefore probably counterproductive.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Abel E. L. Fetal alcohol effects: advice to the advisors. Alcohol Alcohol. 1985;20(2):189–193. [PubMed] [Google Scholar]
  2. Alpert J. J., Day N., Dooling E., Hingson R., Oppenheimer E., Rosett H. L., Weiner L., Zuckerman B. Maternal alcohol consumption and newborn assessment: methodology of the Boston City Hospital prospective study. Neurobehav Toxicol Teratol. 1981 Summer;3(2):195–201. [PubMed] [Google Scholar]
  3. Barrison I. G., Waterson E. J., Murray-Lyon I. M. Adverse effects of alcohol in pregnancy. Br J Addict. 1985 Mar;80(1):11–22. doi: 10.1111/j.1360-0443.1985.tb05284.x. [DOI] [PubMed] [Google Scholar]
  4. Clarren S. K., Bowden D. M. Fetal alcohol syndrome: a new primate model for binge drinking and its relevance to human ethanol teratogenesis. J Pediatr. 1982 Nov;101(5):819–824. doi: 10.1016/s0022-3476(82)80340-5. [DOI] [PubMed] [Google Scholar]
  5. Clarren S. K., Smith D. W. The fetal alcohol syndrome. N Engl J Med. 1978 May 11;298(19):1063–1067. doi: 10.1056/NEJM197805112981906. [DOI] [PubMed] [Google Scholar]
  6. Davis P. J., Partridge J. W., Storrs C. N. Alcohol consumption in pregnancy. How much is safe? Arch Dis Child. 1982 Dec;57(12):940–943. doi: 10.1136/adc.57.12.940. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Edwards L. E., Alton I. R., Barrada M. I., Hakanson E. Y. Pregnancy in the underweight woman. Course, outcome, and growth patterns of the infant. Am J Obstet Gynecol. 1979 Oct 1;135(3):297–302. doi: 10.1016/0002-9378(79)90693-8. [DOI] [PubMed] [Google Scholar]
  8. Ernhart C. B., Morrow-Tlucak M., Sokol R. J., Martier S. Underreporting of alcohol use in pregnancy. Alcohol Clin Exp Res. 1988 Aug;12(4):506–511. doi: 10.1111/j.1530-0277.1988.tb00233.x. [DOI] [PubMed] [Google Scholar]
  9. Ernhart C. B., Sokol R. J., Martier S., Moron P., Nadler D., Ager J. W., Wolf A. Alcohol teratogenicity in the human: a detailed assessment of specificity, critical period, and threshold. Am J Obstet Gynecol. 1987 Jan;156(1):33–39. doi: 10.1016/0002-9378(87)90199-2. [DOI] [PubMed] [Google Scholar]
  10. Fox S. H., Brown C., Koontz A. M., Kessel S. S. Perceptions of risks of smoking and heavy drinking during pregnancy: 1985 NHIS findings. Public Health Rep. 1987 Jan-Feb;102(1):73–79. [PMC free article] [PubMed] [Google Scholar]
  11. Gibson G. T., Baghurst P. A., Colley D. P. Maternal alcohol, tobacco and cannabis consumption and the outcome of pregnancy. Aust N Z J Obstet Gynaecol. 1983 Feb;23(1):15–19. doi: 10.1111/j.1479-828x.1983.tb00151.x. [DOI] [PubMed] [Google Scholar]
  12. Hanson J. W., Jones K. L., Smith D. W. Fetal alcohol syndrome. Experience with 41 patients. JAMA. 1976 Apr 5;235(14):1458–1460. [PubMed] [Google Scholar]
  13. Hanson J. W., Streissguth A. P., Smith D. W. The effects of moderate alcohol consumption during pregnancy on fetal growth and morphogenesis. J Pediatr. 1978 Mar;92(3):457–460. doi: 10.1016/s0022-3476(78)80449-1. [DOI] [PubMed] [Google Scholar]
  14. Hingson R., Alpert J. J., Day N., Dooling E., Kayne H., Morelock S., Oppenheimer E., Zuckerman B. Effects of maternal drinking and marijuana use on fetal growth and development. Pediatrics. 1982 Oct;70(4):539–546. [PubMed] [Google Scholar]
  15. Kaminski M., Franc M., Lebouvier M., du Mazaubrun C., Rumeau-Rouquette C. Moderate alcohol use and pregnancy outcome. Neurobehav Toxicol Teratol. 1981 Summer;3(2):173–181. [PubMed] [Google Scholar]
  16. Kolata G. B. Fetal alcohol advisory debated. Science. 1981 Nov 6;214(4521):642-3, 645. doi: 10.1126/science.7197392. [DOI] [PubMed] [Google Scholar]
  17. Kuzma J. W., Sokol R. J. Maternal drinking behavior and decreased intrauterine growth. Alcohol Clin Exp Res. 1982 Summer;6(3):396–402. doi: 10.1111/j.1530-0277.1982.tb04998.x. [DOI] [PubMed] [Google Scholar]
  18. Little R. E., Asker R. L., Sampson P. D., Renwick J. H. Fetal growth and moderate drinking in early pregnancy. Am J Epidemiol. 1986 Feb;123(2):270–278. doi: 10.1093/oxfordjournals.aje.a114235. [DOI] [PubMed] [Google Scholar]
  19. Little R. E., Grathwohl H. L., Streissguth A. P., McIntyre C. Public awareness and knowledge about the risks of drinking during pregnancy in Multnomah County, Oregon. Am J Public Health. 1981 Mar;71(3):312–314. doi: 10.2105/ajph.71.3.312. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Little R. E. Moderate alcohol use during pregnancy and decreased infant birth weight. Am J Public Health. 1977 Dec;67(12):1154–1156. doi: 10.2105/ajph.67.12.1154. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Little R. E., Streissguth A. P., Barr H. M., Herman C. S. Decreased birth weight in infants of alcoholic women who abstained during pregnancy. J Pediatr. 1980 Jun;96(6):974–977. doi: 10.1016/s0022-3476(80)80620-2. [DOI] [PubMed] [Google Scholar]
  22. Lumley J., Correy J. F., Newman N. M., Curran J. T. Cigarette smoking, alcohol consumption and fetal outcome in Tasmania 1981-82. Aust N Z J Obstet Gynaecol. 1985 Feb;25(1):33–40. doi: 10.1111/j.1479-828x.1985.tb00599.x. [DOI] [PubMed] [Google Scholar]
  23. Majewski F. Alcohol embryopathy: some facts and speculations about pathogenesis. Neurobehav Toxicol Teratol. 1981 Summer;3(2):129–144. [PubMed] [Google Scholar]
  24. Mau G. Moderate alcohol consumption during pregnancy and child development. Eur J Pediatr. 1980 May;133(3):233–237. doi: 10.1007/BF00496082. [DOI] [PubMed] [Google Scholar]
  25. Mills J. L., Graubard B. I., Harley E. E., Rhoads G. G., Berendes H. W. Maternal alcohol consumption and birth weight. How much drinking during pregnancy is safe? JAMA. 1984 Oct 12;252(14):1875–1879. [PubMed] [Google Scholar]
  26. Plant M. L., Plant M. A. Family alcohol problems among pregnant women: links with maternal substance use and birth abnormalities. Drug Alcohol Depend. 1987 Nov 30;20(3):213–219. doi: 10.1016/0376-8716(87)90030-5. [DOI] [PubMed] [Google Scholar]
  27. Raymond C. A. Birth defects linked with specific level of maternal alcohol use, but abstinence still is the best policy. JAMA. 1987 Jul 10;258(2):177–178. doi: 10.1001/jama.258.2.177. [DOI] [PubMed] [Google Scholar]
  28. Rosett H. L., Ouellette E. M., Weiner L., Owens E. Therapy of heavy drinking during pregnancy. Obstet Gynecol. 1978 Jan;51(1):41–46. [PubMed] [Google Scholar]
  29. Rosett H. L., Weiner L. Prevention of fetal alcohol effects. Pediatrics. 1982 Jun;69(6):813–816. [PubMed] [Google Scholar]
  30. Rosett H. L., Weiner L. Prevention of fetal alcohol effects. Pediatrics. 1982 Jun;69(6):813–816. [PubMed] [Google Scholar]
  31. Silva V. A., Laranjeira R. R., Dolnikoff M., Grinfeld H., Masur J. Alcohol consumption during pregnancy and newborn outcome: a study in Brazil. Neurobehav Toxicol Teratol. 1981 Summer;3(2):169–172. [PubMed] [Google Scholar]
  32. Streissguth A. P., Darby B. L., Barr H. M., Smith J. R., Martin D. C. Comparison of drinking and smoking patterns during pregnancy over a six-year interval. Am J Obstet Gynecol. 1983 Mar 15;145(6):716–724. doi: 10.1016/0002-9378(83)90579-3. [DOI] [PubMed] [Google Scholar]
  33. Streissguth A. P., Martin D. C., Martin J. C., Barr H. M. The Seattle longitudinal prospective study on alcohol and pregnancy. Neurobehav Toxicol Teratol. 1981 Summer;3(2):223–233. [PubMed] [Google Scholar]
  34. Streissguth A. P., Sampson P. D., Barr H. M., Clarren S. K., Martin D. C. Studying alcohol teratogenesis from the perspective of the fetal alcohol syndrome: methodological and statistical issues. Ann N Y Acad Sci. 1986;477:63–86. doi: 10.1111/j.1749-6632.1986.tb40322.x. [DOI] [PubMed] [Google Scholar]
  35. Sulaiman N. D., Florey C. D., Taylor D. J., Ogston S. A. Alcohol consumption in Dundee primigravidas and its effects on outcome of pregnancy. Br Med J (Clin Res Ed) 1988 May 28;296(6635):1500–1503. doi: 10.1136/bmj.296.6635.1500. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. Tennes K., Blackard C. Maternal alcohol consumption, birth weight, and minor physical anomalies. Am J Obstet Gynecol. 1980 Dec 1;138(7 Pt 1):774–780. doi: 10.1016/s0002-9378(16)32735-1. [DOI] [PubMed] [Google Scholar]
  37. Véghelyi P. V., Osztovics M., Kardos G., Leisztner L., Szaszovszky E., Igali S., Imrei J. The fetal alcohol syndrome: symptoms and pathogenesis. Acta Paediatr Acad Sci Hung. 1978;19(3):171–189. [PubMed] [Google Scholar]
  38. Walpole I., Zubrick S., Pontré J. Confounding variables in studying the effects of maternal alcohol consumption before and during pregnancy. J Epidemiol Community Health. 1989 Jun;43(2):153–161. doi: 10.1136/jech.43.2.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. Wright J. T., Waterson E. J., Barrison I. G., Toplis P. J., Lewis I. G., Gordon M. G., MacRae K. D., Morris N. F., Murray-Lyon I. M. Alcohol consumption, pregnancy, and low birthweight. Lancet. 1983 Mar 26;1(8326 Pt 1):663–665. doi: 10.1016/s0140-6736(83)91964-5. [DOI] [PubMed] [Google Scholar]

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