Mild maternal drinking and pregnancy outcome: perceived versus true risks

doi:10.1016/0009-8981(96)06235-3

Clinica Chimica Acta

Volume 246, Issues 1–2, 15 March 1996, Pages 155-162

https://doi.org/10.1016/0009-8981(96)06235-3 Get rights and content

Abstract

Millions of fetuses worldwide every year are exposed to mild maternal alcohol consumption during the first trimester of pregnancy. Health professionals and agencies often suggest that even mild drinking can affect the fetus, despite many studies refuting this fact. To characterize women's perception of the teratogenic risk of alcohol we studied 30 nonpregnant adult women aged 19–52 years. They first watched a videotape which includes alarming information of fetal risk after mild drinking. Following the movie, women's views changed significantly towards believing that even one drink during pregnancy can harm the fetus. Scientists and physicians should refrain from unfounded statement of fetal risks from mild alcohol consumption. These may lead to unnecessary termination of otherwise wanted pregnancies.

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Cited by (19)

Maternal alcohol consumption and oral clefts: a meta-analysis
2019, British Journal of Oral and Maxillofacial Surgery
Citation Excerpt :
All but one of the four studies taking binge-level drinking into discussion reported increased risk for both CL/P and cleft palate. The effect of moderate maternal alcohol consumption on the outcome of pregnancy has long been discussed.24–26 Results of our meta-analyses may lend some support to the opinion that the side-effects of low-level maternal drinking have been exaggerated.27
Our aim was to evaluate the possible correlation between maternal alcohol consumption during the first trimester and the risk of having an offspring with non-syndromic oral cleft. We electronically searched all published papers from 1950 to 2019 about maternal alcohol consumption and oral clefts in PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), and the Institute for Scientific Information (ISI) databases. Descriptive and quantitative data were extracted from eligible studies for systemic evaluation and meta-analysis. A total of 12 publications met our inclusion criteria, and nine of them presented sufficient data for quantitative analyses. The overall odds ratio of the nine reports was 1.00 (95% CI 0.87 to 1.15) for cleft lip with or without cleft palate (CL/P) and 1.02 (95% CI 0.92 to 1.14) for cleft palate only, indicating no significant difference between drinking and non-drinking mothers in the risk of having a child with a non-syndromic oral cleft. We found no confirmatory evidence for the presence of a dose-response relation between alcohol consumption and increase in the risk of oral cleft. Nevertheless, four of the studies enrolled found significantly increased risk of CL/P among mothers in the groups that consumed the most alcohol. All but one of the four studies suggested a positive correlation between binge drinking and the occurrence of non-syndromic oral cleft. Although we found no concrete correlation between mild alcohol consumption during pregnancy and the occurrence of non-syndromic oral cleft, precautions should still be taken to avoid binge drinking during the first trimester.
An experimental study on the effects of ethanol and folic acid deficiency, alone or in combination, on pregnant Swiss mice
2007, Pathology
Ethanol is teratogenic, interferes with folic acid and is extensively used by young women. Our objective was to determine the effects of ethanol and/or folate deficiency on mouse fetuses.
In Experiment 1, pregnant mice receiving a commercial diet were divided into three groups: control (C), low ethanol dose (LE, 0.4 g/kg), and high ethanol dose (HE, 4.0 g/kg). In Experiment 2, pregnant mice receiving a folate- free diet (FFD) were divided into three groups: folate deficiency (FD), folate deficiency plus a low ethanol dose (FDLE), and folate deficiency plus a high ethanol dose (FDHE). Groups C and FD received saline and the remaining groups received ethanol administered i.p. from the 7th to the 9th gestational day (GD) and were sacrificed on the 18th GD.
In Experiment 1, Group HE presented congenital anomalies, late fetal death (LFD), lower fetal length and weight and placental weight and diameter than Groups C and LE. In Experiment 2, there was a smaller number of live fetuses, a larger number of reabsorptions and LFD, a smaller length and lower fetal weight, placental weight and diameter in Groups FDLE and FDHE than in Group FD.
In animals receiving a commercial diet, a high ethanol dose is deleterious to the pregnancy, inducing congenital anomalies, intrauterine growth restriction, reduction of the placenta and increased LFD, events that did not occur with the low dose. However, with a folate free diet, a low ethanol dose is as deleterious as a high dose.
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2006, Journal of Obstetrics and Gynaecology Canada
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2001, Regulatory Toxicology and Pharmacology
This review examines the epidemiological evidence for adverse reproductive outcomes from those occupational studies that present toluene-specific findings. Clinical investigations of the reproductive effects of toluene abuse are also examined. Six occupational studies reported associations between toluene and spontaneous abortion, two between toluene and congenital malformation, and three between toluene and reduced fertility. The spontaneous abortion studies provided the most suggestive evidence for an association with toluene. However, the potential for bias in some of these studies, the relatively homogeneous nature of the populations examined (e.g., four of the six studies evaluated similar groups of Finnish workers), and the multiple chemicals to which most workers were simultaneously exposed suggest cautious interpretation of these findings. Also, spontaneous abortion has generally not been observed as a major problem among highly exposed women who abuse toluene during pregnancy. The results of the occupational studies should be considered “hypothesis generating”. Truly prospective studies with individually monitored data on toluene exposure and early fetal loss are needed to more definitively investigate this issue.
Moderate alcohol consumption: The gentle face of janus
1999, Clinical Biochemistry
Objectives: The regular consumption of alcohol in moderate amounts (defined in North America as up to 2 drinks per day for men and 1 drink per day for females) has been recognized in the last decade as a negative risk factor for atherosclerosis and its clinical sequelae: coronary heart disease (CHD), ischemic stroke, and peripheral vascular disease. Mortality and morbidity attributable to CHD are 40–60% lower in moderate drinkers than among abstainers. Among the mechanisms accounting for these reductions, increased circulating concentrations of HDL-cholesterol and inhibition of blood coagulation appear to be paramount. Additional benefits are, in certain beverages, conferred by the presence of constituents other than alcohol (e.g., flavonoids and hydroxystilbenes), which prevent oxidative damage, free radical formation, and elements of the inflammatory response.
Conclusions: A number of other diseases appear to be beneficially modulated by moderate alcohol consumption based on epidemiologic surveys and, in some instances, experimental evidence. These include duodenal ulcer, gallstones, enteric infections, rheumatoid arthritis, osteoporosis, and diabetes mellitus (type II). Compared with abstainers, moderate drinkers exhibit improved mental status characterized by decreased stress and depression, lower absenteeism from work, and decreased incidence of dementia (including Alzheimer’s disease). Although limits of safe drinking have been conservatively defined, it is regrettable that political considerations are hampering the clinical application of this knowledge and its dissemination to the lay public.
The presence and consequences of abortion aversion in scientific research related to alcohol use during pregnancy
2019, International Journal of Environmental Research and Public Health

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Mild maternal drinking and pregnancy outcome: perceived versus true risks

Abstract

Lancet

Am J Obstet Gynecol

Les enfants des parents alcoholiques: anomalies observees a propos de 127-cas

Arch Fr Pediatr

Fetal alcohol syndrome