Alcohol and Pregnancy: A “Safe” Mix?

by Danielle Taubman on February 19, 2013

People tend to freak out about the pregnant lady drinking the small glass of wine at the dinner party.  A flood of whispers inevitably fills the room and the next day this “indiscretion” is the talk of the town.   But is this a blameworthy issue? Are concerns about a sporadic drink during pregnancy valid?

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I have noticed differences in opinion on this issue whenever discussions about healthy pregnancy occur.  The New Year’s party I attended this past year was a case in point.  Two of the guests were pregnant: one was still in her first trimester, and, at 37 weeks, the other woman was close to delivery. At one point, I found myself sitting at a table with both of them.  Also at the table sat a tray full of deliciously-pink cupcakes.  And, as it turned out, these were no ordinary cupcakes—they were baked with real champagne.

What transpired next piqued my interest perhaps even more than the tempting cupcakes themselves.

After hearing that the cupcakes contained some unspecified amount of alcohol (the likelihood of champagne cupcakes actually containing a high amount of alcohol is very low) the newly pregnant woman looked down at the cupcake on her plate with a dismayed look, abruptly removed it, and explained that she was pregnant so she could not eat it.  The woman who was closer to term simply shrugged her shoulders, said she was starving, and inhaled the cupcake.

I first wondered if the newly pregnant woman was being more cautious than the other woman because she was in her first trimester (a time when all of the baby’s major body organs and systems begin to develop).

But I also wondered if the source of the discrepancy in the women’s behaviors was something else.  I wondered if perhaps these women had received different messages about alcohol consumption during pregnancy.

The negative effects of heavy, regular drinking (>9 drinks per week) during pregnancy are well known and widely cited. And major health sources such as the Centers for Disease Control and Prevention (CDC) and the Surgeon General recommend abstaining completely throughout pregnancy.

But what about an occasional drink? Is drinking even a small amount of alcohol during pregnancy not okay?

A Danish study from last summer, which resulted in five scientific articles, examined the effect of different drinking patterns in early to mid-pregnancy on neurodevelopment (intelligence, attention, and executive function) in five-year-old children.  My Risk Communications professor Brian Zikmund-Fisher discussed the study and its implications in class last semester and blogged about it in the Risk Sense blog through the University of Michigan Risk Science Center here.

Since it was published, the study has received a lot of attention…and not all of it has been positive.

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Published by The Lifestyle During Pregnancy Study Group from Denmark, the study suggests that alcohol consumed on occasion may not be a serious concern—a naturally controversial statement.  The study recruited women at their first prenatal visit and focused on women with low average alcohol consumption (defined here as 1 to 4 drinks per week). However, women with moderate (5 to 8 drinks per week) and high (greater than 9 drinks per week) levels of alcohol consumption were also included in the sample.

The researchers followed the recruited women throughout their pregnancy and contacted them again when their children were five.  At that time, the five-year-olds were examined for their IQ, ability to pay attention, self-control, and the ability to organize and plan. The examination took 3 hours. Perhaps Danish children are more well-behaved than American children because I don’t know many five-year-olds who can stay focused for that long to begin with.

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The authors found no effect of light or moderate drinking or infrequent episodes of binge drinking on any of these factors. Yet it may not be wise to take these results at face value.  For one thing, drinks are smaller in Denmark (12 grams of alcohol in the study versus 14 grams in a typical American drink), In other words, Danish women consuming 1 to 8 drinks (light to moderate drinking) are actually consuming less alcohol than an American woman drinking 1 to 8 drinks. Also, individuals differ greatly on their ability to metabolize alcohol and the mother’s and child’s genes both affect the child’s susceptibility to the negative effects of alcohol in the womb.  Finally, and perhaps most importantly, no evidence of associations does not necessarily mean even small amounts of alcohol are “safe”.  More on this from Professor Zikmund Fisher here.

An Ongoing Debate

You can find sources that say any drinking can do damage as well as sources that say a bit of alcohol won’t cause any harm.

Even the study at hand reads: “To date, the scientific literature, including the present study, does not establish a safe level of alcohol consumption during pregnancy.”

Given the uncertainty about what constitutes a “safe” threshold of alcohol during pregnancy, the best available advice is abstinence.  Nevertheless, the research promotes the sense that women should not feel guilty if they have a drink or two during their pregnancy.