Recent findings by the American Academy of Pediatrics (AAP) regarding alcohol consumption during pregnancy are quite clear: Don’t drink at all while pregnant. This warning from the AAP is consistent with advice from the American College of Obstetricians and Gynecologists (ACOG) and the Centers for Disease Control and Prevention: No safe level of alcohol consumption during pregnancy has been identified, and no period during pregnancy appears to be safe for alcohol consumption.
In fact, ACOG has recommended screening for alcohol use early in pregnancy since 1977. However, the CDC reports that 1 in 10 pregnant women aged 18-44 years has consumed alcohol in the past 30 days. Some recent studies claim that a small number of drinks during pregnancy could be safe, and I’ve even seen some reports of ob.gyns. allowing alcohol use during pregnancy.
Dr. Jeanne A. Conry
With such disparities between recommendations and patient behavior, the role of the obstetrician is more crucial than ever. Education, prevention, and intervention are essential to good health for mother and baby.
It has long been recognized that heavy drinking during pregnancy is associated with Fetal Alcohol Syndrome, but there are more subtle effects that fall under the umbrella of Fetal Alcohol Spectrum Disorders. These effects may include physical, mental, behavioral, and learning disabilities with lifelong implications and may not be detected until a child starts school.
Screening for alcohol use is of the utmost importance. Three simple steps have been proven effective in identifying women who drink at risky levels and engage them in changing behavior to reduce their risk for an alcohol-exposed pregnancy. These steps include asking about alcohol use, providing brief motivation-enhancing interventions, and follow-up for women who engage in risky drinking. See ACOG’s Fetal Alcohol Syndrome Prevention Tool Kit for more detail.
It is worth noting that a positive screen does not always mean a woman needs to be referred to treatment. Brief intervention by an ob.gyn. is effective and has been shown to reduce risky behavior by 70%. Randomized studies reported significant reductions in alcohol use and improved newborn outcomes after intervention.
Prenatal exposure to alcohol is one of the leading preventable causes of birth defects. With so many risk factors out of a mother’s control during pregnancy, why risk it?
Dr. Conry is assistant physician in chief at the Permanente Medical Group in Roseville, Calif., and associate clinical professor of ob.gyn. at the University of California, Davis. She has been a practicing ob.gyn. with the Permanente Medical Group for more than 20 years. She is a past president of the American College of Obstetricians and Gynecologists.