From the Guidelines
Alcohol consumed a few days prior to pregnancy is unlikely to affect fetal development, but for optimal fetal health, abstaining from alcohol when trying to conceive is recommended since you may become pregnant before you realize it. Once you know you're pregnant, you should stop drinking alcohol completely for the remainder of your pregnancy. Alcohol clears from your system relatively quickly, typically within 24-48 hours depending on how much was consumed. The greatest risk to fetal development occurs when alcohol is present in the bloodstream during critical developmental periods. The first few weeks after conception (often before pregnancy is confirmed) are particularly vulnerable times for organ development. If you consumed alcohol before knowing you were pregnant, discuss this with your healthcare provider but try not to worry excessively about isolated exposure. The consistent pattern of alcohol consumption throughout pregnancy poses the most significant risk for fetal alcohol spectrum disorders.
According to the most recent study from 2023 1, for women with alcohol-related liver disease, delaying conception is recommended until abstinence is achieved. Additionally, all women should be screened for alcohol use in pregnancy, and the achievement of alcohol abstinence is the most important aspect of preconception and pregnancy management.
Some key points to consider:
- Alcohol use in pregnancy is strongly associated with increased risk of preterm birth and small for gestational age infants.
- Long-lasting impairments of the offspring due to alcohol exposure during pregnancy are well documented and include fetal alcohol spectrum disorder and its most severe form, fetal alcohol syndrome.
- The decision to continue medications for alcohol use disorder during pregnancy must be taken on an individual basis, weighing their risks against the risks connected to alcohol withdrawal syndrome.
- Disulfiram is associated with fetal abnormalities and should be avoided during pregnancy, while naltrexone and acamprosate may be considered on a case-by-case basis.
Overall, the best approach is to prioritize fetal health and safety by abstaining from alcohol when trying to conceive and throughout pregnancy.
From the Research
Alcohol Consumption and Fetal Development
- Alcohol consumption during pregnancy can cause fetal harm, and there is no established safe level of alcohol consumption [(2,3,4)].
- The effects of alcohol on fetal development can be severe and long-lasting, including birth defects, intellectual disabilities, and neurodevelopmental disorders [(2,3)].
Timing of Alcohol Consumption
- There is no safe trimester to drink alcohol during pregnancy, and all forms of alcohol pose a similar risk to the developing fetus 2.
- Binge drinking poses a dose-related risk to the developing fetus, and even occasional, light drinking may not be entirely safe 5.
Screening and Intervention
- Universal screening for alcohol consumption should be done periodically for all pregnant women and women of child-bearing age 4.
- Brief interventions, including education about alcohol's effects on the developing fetus, are effective in reducing alcohol use among pregnant women [(3,4,6)].
Risks of Alcohol Consumption
- Weekly consumption of 5 standard units or more during pregnancy has been linked to an increased risk of cryptorchidism and other birth defects 5.
- Daily alcohol consumption should be avoided during pregnancy, and women who drink during pregnancy should be informed of the risks and offered support and intervention [(5,6)].