From the Guidelines
Alcohol consumption during pregnancy is extremely likely to affect the fetus, and complete abstinence is the only recommended approach to prevent fetal alcohol spectrum disorders (FASD) and other complications. The most recent and highest quality study, published in 2023 1, emphasizes the importance of avoiding alcohol consumption during pregnancy due to the significant risks it poses to the fetus at all stages of development. There is no known safe amount or type of alcohol during pregnancy, and exposure can cause a range of conditions, including physical abnormalities, cognitive impairments, behavioral problems, and growth deficiencies.
Some key points to consider:
- The first trimester is particularly vulnerable as critical organ development occurs, but alcohol can damage the developing brain throughout pregnancy.
- The effects of alcohol exposure are permanent and irreversible, making prevention through complete abstinence the only effective approach.
- If a woman has consumed alcohol before realizing she was pregnant, she should stop immediately and consult with her healthcare provider, but should understand that stopping drinking at any point in pregnancy is beneficial for the baby's development.
- All women should be screened for alcohol use in pregnancy, and those with alcohol-related liver disease should achieve abstinence as the most important aspect of preconception and pregnancy management.
The evidence from various studies, including those published in 2005 1 and 2016 1, consistently supports the recommendation to avoid alcohol consumption during pregnancy. More recent studies, such as those published in 2021 1 and 2023 1, further emphasize the importance of complete abstinence and provide guidance on the management of liver diseases in pregnancy. Overall, the evidence is clear: alcohol consumption during pregnancy poses significant risks to the fetus, and complete abstinence is the only recommended approach to prevent FASD and other complications.
From the Research
Alcohol Consumption and Fetal Development
- Alcohol consumption during pregnancy can affect the fetus, leading to a range of adverse developmental effects, including fetal alcohol spectrum disorders (FASD) 2, 3, 4, 5.
- The exact amount, pattern, and critical period of exposure necessary for harm to occur are unclear, although official guidance often emphasizes precautionary abstention 3, 4, 6.
- FASD can cause neurodevelopmental impairment, facial dysmorphology, congenital anomalies, and poor growth, and is a leading preventable cause of birth defects and developmental disability 2, 3, 4, 5.
Risk of Alcohol Consumption During Pregnancy
- No safe amount of alcohol consumption during pregnancy has been established, and all forms of alcohol pose a similar risk to the developing fetus 3, 4.
- Binge drinking poses a dose-related risk to the developing fetus, and there is no safe trimester to drink alcohol 3.
- Alcohol exposure during pregnancy can result in impaired growth, stillbirth, and fetal alcohol spectrum disorder, with lifelong effects on the child 2, 3, 4, 5.
Diagnosis and Prevention of FASD
- Diagnosis of FASD is based on the presence of clinical features, including prenatal and/or postnatal growth retardation, facial dysmorphology, central nervous system dysfunction, and neurobehavioral disabilities 2.
- Management of FASD is multidisciplinary and includes managing comorbid conditions, providing nutritional support, managing behavioral problems and educational difficulties, and referring patients for habilitative therapies 2.
- Prevention of FASD is critical, and all women should be screened for alcohol use during preconception counseling and prenatal care, with brief interventions to address alcohol use 2, 3, 4, 5.