For some women, one of the hardest things about being pregnant is having to become a teetotaller, forgoing that glass of wine with dinner or turning down that flute of champagne at a special event. It’s tempting to have just a little sip or maybe even a full glass later in pregnancy—especially when you’re getting mixed messages from healthcare providers, family and friends on how much alcohol is safe and at what point in your pregnancy it’s OK to imbibe.
But the lead researcher of a large study conducted at the Centre for Addiction and Mental Health (CAMH) in Toronto is saying the message should be clear: “There is no safe amount of alcohol, no safe time and no safe type of alcohol to drink during pregnancy,” says Dr. Svetlana Popova, a senior scientist in social and epidemiological research at CAMH. In fact, if you want to become pregnant, Dr. Popova suggests that you completely avoid alcohol for at least two months before conception.
The key message from her meta-analysis, published in The Lancet, is that drinking alcohol in pregnancy is associated with a whopping 428 distinct conditions and that no amount of alcohol during pregnancy is considered safe.
Dr. Popova and her team reviewed 127 studies that looked at fetal alcohol spectrum disorders (FASD), an umbrella term for the range of disorders with symptoms like poor memory, slow and inconsistent cognitive and auditory processing and impulsivity and poor judgment that can result from alcohol exposure in utero. Fetal alcohol syndrome (FAS), characterized by facial anomalies, poor growth and cognitive and behavioural problems, is the most severe form of FASD.
Previously, it was unknown how many conditions were associated with FASD. And while some of the disorders, like developmental issues and facial anomalies, were already known to be caused by alcohol exposure, others were not.
The researchers found that about 90 percent of people with FAS have conduct and behaviour problems, 80 percent have receptive and expressive language deficits, 70 percent have developmental or cognitive disorders and more than half have attention and hyperactivity issues. The main target of the disorders is the central nervous system—in other words, the brain.
“That’s why they have so many learning, behavioural and mental health problems,” says Dr. Popova. “But if you look at the study, you’ll see that the damage is spread across the whole body.”
To show how these disorders were linked to alcohol exposure, researchers compared people with FAS to the rest of the U.S. population (where the studies were conducted). They found that conduct disorder and receptive language deficits among those with FAS were 10 times higher than among the general population, hearing loss was 129 times higher and blindness was 31 times higher.
So will your kid develop one of those associated conditions? After all, you had that glass of wine before you found out you were pregnant. Or is your kid’s attention deficit hyperactivity disorder the result of that beer you drank in your third trimester?
Dr. Popova says that there is evidence that binge drinking (four or more standard drinks per occasion) and regular heavy drinking put a fetus at greater risk of developing FASD. But she stresses that even smaller amounts can cause brain damage and that having no alcohol at all is the safest choice.
“Based on the findings of this study, paediatricians and other health professionals should consider FASD when evaluating developmental and behavioural problems in children, such as hyperactivity, school failure, language disorders, attention problems and learning disabilities, which will ultimately improve the screening and diagnosis of FASD,” says Dr. Popova.
For a kid who is affected, getting an FASD diagnosis actually leads to better outcomes. “Studies show that kids who are diagnosed with FASD do four times better in their future lives than those kids who are not diagnosed,” says Dr. Popova. “They may need special attention from specialists like paediatricians, psychiatrists, psychologists, speech and language therapists and occupational therapists to prevent secondary difficulties, such as school interruption, unemployment and other problems.”
Dr. Popova stresses that even if her study didn’t look at the amount of alcohol consumed—something that is difficult to do because of the tendency for it to be underreported—the safest bet is to refrain from consuming any alcohol at all.
“There is no safe amount of alcohol,” says Dr. Popova. “We don’t know how much is too much.”