Alcohol in pregnancy

Perhaps there is too much talk about the risks of alcohol during pregnancy since the guidelines in this regard are absolutely clear, and deliberately leave no room for different interpretations.

Of course there will always be some woman who will claim to have been drinking alcohol and having a completely normal child.
However, it must be said in this regard that the experience of one or a few women has no statistical value. In other words: it is possible that the fetus does not suffer damage despite the mother having drunk during pregnancy in the same way that driving under the influence it is possible not to have had road accidents.
In both cases, however, tempting fate is too big a gamble.

We all know that both heavy drinking and binge drinking are harmful during pregnancy .
Their most serious consequence is fetal alcohol syndrome (FAS): that is, in anomalies that involve severe behavioral and neuro-cognitive disabilities in children.
This fetal alcohol syndrome affects about 2 to 7 out of 1,000 babies. Another 2-7% of babies are thought to suffer from milder forms of cognitive impairment as a result of their exposure to alcohol in the womb.

But what about a moderate and occasional consumption of an aperitif or a glass of wine with dinner?

There is no amount of alcohol that can be defined as safe in pregnancy

According to our National Institute of Health , and according to the American CDC Center for Disease Control and other public health control bodies in other developed countries, no amount of alcohol is safe during pregnancy.

Consumption of alcohol – whatever it is – could pose risks to the baby: therefore you should not drink alcohol if you are pregnant, if you are thinking of becoming pregnant, or even if you could become pregnant.

The risks associated with drinking alcohol during pregnancy

The following indications are based on scientific evidence that leaves no doubt whatsoever.

  1. According to a Danish study conducted on over 90,000 pregnant women, drinking 1-2 glasses of wine a week during the first trimester increases the chances of a miscarriage by about 30%, and the chances of a miscarriage by about 70% in the second. quarter.
  2. The risk of an alcohol-related miscarriage increases more than proportionally in relation to the amount consumed: the chances of a miscarriage more than double if you drink 4 or more alcoholic beverages a week during the first trimester.
  3. Both poor diet and smoking seem to exacerbate these effects of alcohol . This deterioration makes sense since alcohol reduces the amount of nutrients reaching the fetus.
    4. Alcohol is known to be a neurotoxin. While it is not fully understood how alcohol causes harm, neuronal loss due to excessive alcohol consumption is evident in both animals and humans. Its harmful effects may be particularly pronounced in a child’s developing brain (particularly) during the first trimester when many of the changes in facial morphology appear to originate.
  4. Damage to the baby’s brain structures that, such as the cerebellum, are slow to grow most likely occurs during pregnancy.

In addition, the following was also noted:

  1. Women who drink alcohol during their first trimester may have less nausea, possibly because underdeveloped pregnancies have fewer symptoms.
  2. The baby’s problems could be due not only to the alcohol consumed by the mother in the early stages of pregnancy, but also to the fact that she drank before pregnancy.
    Alcohol can cause chromosomal abnormalities in the egg before ovulation. Alcohol has been shown to impair meiosis (remember that meiosis is the process by which female egg cells and male sperm mature) leading to the formation of chromosomally abnormal eggs.
    Chromosomal abnormalities are the cause of more than half of first trimester miscarriages.
    What’s worse is that (since eggs take several months to fully mature) drinking in the months leading up to conception could also be harmful.
    The extent of egg damage depends on several factors such as age, alcohol tolerance, amount of alcohol consumed, etc.

Fortunately, even women who drink alcohol regularly can have perfectly healthy pregnancies, so the negative effect of alcohol is not absolute, but only probabilistic.

The increase in chromosomal abnormalities can be more problematic for couples who already suffer from fertility problems.
For example, in couples who are in the in vitro fertilization phase, the fact of drinking alcohol seems to reduce the chances of later getting pregnant.

Until the 4th week of pregnancy, the week in which beta HCG doubles, and pregnancy tests are able to indicate a pregnancy, alcohol still does not reach the developing embryo. This is good news for expectant mothers.
On the other hand, based on research done on animals, it is believed that after the fourth week of pregnancy, the fetus has the same level of alcohol present in her mother’s blood.

Studies against

There are also some studies that indicate that moderate alcohol intake, particularly in the second and third trimester, has no repercussions on the fetus first and then on the child.

One of the largest studies, the UK Millennium Cohort, followed a representative sample of 11,000 children born between 2000 and 2002. It
found that, at ages 3 , 5 and 7 , both children that girls whose mothers drank (drank) about 1-2 alcoholic drinks a week, had better overall cognitive performance and also fewer behavioral and attention problems than boys whose mothers abstained from drinking during the week their pregnancy.
On the other hand, he had found that higher alcohol consumptions were associated with worse cognitive performance and more serious behavioral problems.

Skeptics argue that the highest test scores of the children of these ;drinkers; they were definitely not due to any beneficial effects of alcohol on their development, but to the fact that moderately drinking women were better educated and of higher socioeconomic status than women who abstained.
The influence of socioeconomic conditions on children’s performance represents a huge obstacle in interpreting the results of this study: parental education, income, and social class certainly predispose to better cognitive performance and fewer problems behavioral.
So who on earth could say with certainty that these same children would (or would not) benefit even more if their mothers abstained from alcohol during pregnancy?

Other studies conducted on this topic, have not found,

  • no children’s mental health effect (ages 11) on test scores of children of mothers who drank less than 1 drink per week during their first trimester;
  • no cognitive deficits, in learning or attention, among 14-year-olds whose mothers in the early and late stages of pregnancy drank less than one drink a day on average;
  • no reduction in IQ and attention span of 5-year-old children born to women who drank an average of up to 5 alcoholic beverages per week during their pregnancy.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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