The Dangers of Drinking for Two: Alcohol and Birth Defects
by Celeste M. Krauss, MD
Fetal alcohol exposure is one of the leading causes of birth defects and developmental disorders. Estimates place the number of US children affected by fetal alcohol exposure at almost one case for every 1,000 live births.
Pick up a bottle of beer, wine or hard liquor, and you'll see the following on the label:
GOVERNMENT WARNING: ACCORDING TO THE SURGEON GENERAL, WOMEN SHOULD NOT DRINK ALCOHOLIC BEVERAGES DURING PREGNANCY BECAUSE OF THE RISK OF BIRTH DEFECTS.
The stark wording is an attempt to prevent fetal alcohol syndrome (FAS) and other alcohol-related problems.
Alcohol and Pregnancy Don't Mix
When a woman drinks alcoholic beverages, the alcohol in her blood crosses the placenta freely and enters the embryo or fetus through the umbilical cord. Children affected by prenatal exposure to alcohol may suffer lifelong consequences, including intellectual disability, learning disabilities, physical problems (like abnormal facial features or abnormal growth) and serious behavior problems.
All drinks containing alcohol can hurt an unborn baby. A standard 12-ounce can of beer has the same amount of alcohol as a four-ounce glass of wine or a one-ounce shot of straight liquor. In addition, some alcoholic drinks, such as malt beverages, wine coolers, and mixed drinks, often contain more alcohol than a 12-ounce can of beer. There is no known safe amount of alcohol that a woman can drink while pregnant.
Any time a pregnant woman participates in regular drinking, she increases her chance of having a spontaneous abortion and puts her unborn child at risk for growth deficiencies, learning disabilities, and behavioral problems. Problems associated with prenatal exposure to alcohol can occur in the first few weeks of pregnancy, before a woman may even knows that she is pregnant.
Findings from the Centers for Disease Control and Prevention (CDC) show that about 1 in 8 pregnant women reported alcohol use during pregnancy.
Fetal Alcohol Syndrome (FAS) TOP
Fetal alcohol syndrome (FAS), caused by drinking alcohol during pregnancy, is characterized by:
Children with FAS may have problems with learning, memory, attention span, problem solving, speech, and/or hearing. These problems often lead to difficulties in school and problems getting along with others. FAS is an irreversible condition that affects every aspect of a child's life and the lives of his or her family. FAS is 100% preventable—if a woman does not drink alcohol while she is pregnant.
Fetal Alcohol Effects (FAE), Alcohol-related Neurodevelopment Disorder (ARND), and Alcohol-related Birth Defects (ARBD) TOP
Many terms have been used to describe children who have some, but not all, of the clinical signs of FAS. Three such terms are:
Fetal Alcohol Effects (FAE)
Alcohol-Related Neurodevelopmental Disorder (ARND)
Alcohol-Related Birth Defects (ARBD)
Common Questions About Alcohol and Pregnancy TOP
How are birth defects caused by drinking alcohol during pregnancy?
The exact mechanism(s) by which alcohol damages the fetus and critical times of exposure are not known. Exposure during the first trimester results in the structural defects (eg, facial changes) characteristic of FAS, whereas the growth and central nervous system problems could occur from alcohol use during any time in pregnancy.
Does drinking during pregnancy always result in FAS?
Not all women who drink heavily during pregnancy will have a child with FAS. But by not drinking at all during pregnancy, women can ensure that their babies will not have FAS or any other alcohol-related outcomes.
How much alcohol is reasonably acceptable to drink without running the risk of a child developing FAS?
There is no known safe amount of alcohol that a woman can drink while pregnant. Any time a pregnant woman engages in regular drinking, she increases her chance of having a miscarriage and puts her unborn child at risk for growth deficiencies, learning disabilities, and behavioral problems.
Is FAS hereditary or is there a hereditary disposition to getting it?
FAS is not hereditary. It can only occur if a woman drinks alcohol during her pregnancy. Currently, it is not known why some children are more likely to develop FAS than other children if their mothers drank during pregnancy.
Can FAS be treated? How?
There is no cure for either fetal alcohol syndrome or fetal alcohol effect. They are irreversible, lifelong conditions that affect every aspect of a child's life and the lives of his or her family members. With early identification and diagnosis, a child with FAS can receive services that can help maximize his or her potential.
Preventing FAS TOP
The easiest way to prevent FAS is to abstain from alcohol use during pregnancy. Any amount of alcohol consumed during pregnancy is potentially dangerous to an unborn baby. If a pregnant woman is drinking during pregnancy, it is never too late for her to stop. The sooner a woman quits drinking, the better it will be for both her and her baby. If a woman is not able to quit drinking, she should contact her local social service agency or health plan for alcohol abuse treatment, if needed. If a woman is not yet pregnant, she should use an effective form of birth control until her drinking is under control.
Mothers aren't the only ones who can help prevent FAS, though. Significant others, family members, schools, social organizations, and communities alike can help prevent FAS through education and intervention.
National Institute on Alcohol Abuse and Alcoholism
National Organization on Fetal Alcohol Syndrome (NOFAS)
The Society of Obstetricians and Gynaecologists of Canada
A 2005 message to women from the U.S. Surgeon General. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncbddd/fasd/documents/sg-advisory.pdf. Accessed September 10, 2012.
Alcohol and drugs. March of Dimes website. Available at: http://www.marchofdimes.com/pregnancy/alcohol_indepth.html. Updated July 2012. Accessed September 10, 2012.
Alcohol use in pregnancy. Centers for Disease Control and Prevention website. Available at: http://www.cdc.gov/ncbddd/fasd/alcohol-use.html. Updated October 6, 2010. Accessed September 7, 2012.
Fetal alcohol spectrum disorders. American Academy of Pediatrics Healthy Children.org website. Available at: http://www.healthy.... Updated June 29, 2012. Accessed September 7, 2012.
Fetal alcohol syndrome (FAS). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated June 28, 2010. Accessed September 10, 2012.
Where we stand: alcohol during pregnancy. American Academy of Pediatrics Healthy Children.org website. Available at: http://www.healthy.... Updated April 12, 2012. Accessed September 7, 2012.
Last reviewed September 2012 by Brian Randall, MD
Last Updated: 9/11/2012