Alcohol and Pregnancy Don’t Mix
NOFAS joins the United States Surgeon General in advising women to abstain from alcohol during pregnancy due to the risk of birth defects. Below, NOFAS provides a personal perspective, the latest recommendations, and the science-based facts about the risk of prenatal alcohol exposure.
If you have just found out you are pregnant and you have been drinking alcohol, stop drinking now and talk with your doctor. Any time during pregnancy that you stop drinking you increase the chance that your child will not be affected by alcohol.
If you are finding it difficult to stop drinking, help is available. Visit your doctor to talk about your drinking, or find a professional in your area using the Behavioral Health Treatment Services Locator. You can also contactNOFAS.
Studies have determined that the overall health of the mother, nutritional health, appropriate exercise, and early and regular prenatal care are among the factors that contribute to a healthy baby and could possible reduce the effects of prenatal alcohol exposure.
Men also play a role in preventing alcohol-related birth defects by understanding the risk of prenatal alcohol use, encouraging healthy behaviors, and minimizing or abstaining from alcohol themselves in support of the birth mother.
Check out the NOFAS Circle of Hope, an organization that supports woman who have used alcohol or illicit substances during pregnancy.
What About Light Drinking?
Get more detailed information on the risk of light drinking, such as an occasional glass of wine.
What About Prenatal Exposure to Opioids, Marijuana and Other Substances of Abuse?
Understanding that some mothers-to-be might not only consume alcohol, see information about the risks to fetal development associated with other substances of abuse.
Alcohol and Pregnancy: A Personal Perspective
“Every other week there seems to be another article in the media suggesting that “moderate” alcohol use is safe while pregnant. It’s important to understand that we all have a different view of what moderation is, and that it is very easy to underestimate the amount of alcohol we actually consume. I drank while I was pregnant, all five times. I had no idea that drinking on the weekends would harm my children. Today, I have a 37 year old that plays with baby dolls; she has Fetal Alcohol Syndrome (FAS) and intellectual disability. I have another daughter that suffers with chronic migraines and a host of other health problems. My last two children both died before they were three months old. There is not a day that goes by that I do not regret the fact that I drank while pregnant. I would not wish that on another mother. I love women–they are all my sisters–and I want them to know it is not safe to drink any alcohol while pregnant. Don’t risk it, wait, there’ll be plenty of time to celebrate and consume alcohol, after the baby is born!”
Kathleen Tavenner Mitchell
Vice President and International Spokesperson
National Organization on Fetal Alcohol Syndrome
Centers for Disease Control and Prevention
There is no known safe amount of alcohol to drink while pregnant. There is also no safe time during pregnancy to drink and no safe kind of alcohol.
National Institute on Alcohol Abuse and Alcoholism
No amount of alcohol is safe for pregnant women to drink.
American Academy of Pediatrics
The American Academy of Pediatrics recommends women who are pregnant or planning a pregnancy avoid drinking any alcohol.
American College of Obstetricians and Gynecologists
ACOG reiterates its long-standing position that no amount of alcohol consumption can be considered safe during pregnancy.
March of Dimes
Drinking alcohol when you’re pregnant can be very harmful to your baby. It can cause your baby to have a range of lifelong health conditions.
There is no absolute safe amount of alcohol that a woman can drink during pregnancy. Risk of FASD increase as the amount of alcohol consumed increases.
All public health officials in the United States recommend that pregnant women, as well as women who are trying to conceive, play it safe by steering clear of alcohol entirely.
Alcohol and Pregnancy Science
Alcohol, like the chemical element mercury, is a confirmed teratogen (a substance that interferes with normal prenatal development). Alcohol can cause central nervous system (brain and spinal cord) malformations with associated neurobehavioral dysfunction. By comparison, lead is a neurotoxin but not a teratogen in that it produces neurobehavioral dysfunction in the absence of brain and spinal cord malformations.
Science definitively recognizes that when a pregnant woman consumes alcohol, the alcohol crosses the placenta into the blood supply of the developing embryo or fetus. An embryo or fetus has neither the developed organ systems nor enzymes able to metabolize alcohol.
The first paper in the medical literature describing a constellation of birth defects linked to prenatal alcohol exposure was published in France in 1968 by Dr. Paul Lemoine.
The first paper in U.S. medical literature appeared in 1973, authored by Drs. David Smith and Ken Lyons Jones. As of 2012, nearly 4,000 papers have been published confirming the toxicity of alcohol to the embryo or fetus, the underlying mechanisms of alcohol-induced damage to the embryo or fetus, and the physical and functional birth defects related to prenatal alcohol exposure.
No published study has suggested that alcohol is not a teratogen or demonstrated that prenatal alcohol use has any potential benefit to human development.
As described by the Institute of Medicine, the basic and biomedical research demonstrates that alcohol damages the developing brain through multiple actions at different cellular sites interfering with normal development by disrupting cell migration, cell functions, and causing cell death.
Alcohol can cause damage to multiple regions of the brain, specifically to the corpus collosum (connects brain hemispheres), cerebellum (consciousness and voluntary processes), basal ganglia (movement and cognition), hippocampus (emotional behavior and memory), hypothalamus (sensory input), among other neural regions.
Ethanol is the principal psychoactive constituent in alcoholic beverages. In utero it has been found to:
- Interfere with normal proliferation of nerve cells;
- Increase the formation of free radicals–cell damaging molecular fragments;
- Alter cells ability to regulate cell growth, division and survival;
- Impair the development and function of astocytes, cells that guide the migration of nerve cells to their proper places;
- Interfere with the normal adhesion of cells to one another;
- Alter the formation of axons, nerve cell extensions that conduct impulses away from the cell body;
- Alter the pathways of biochemical or electrical signals within cells;
- Alter the expression of genes, including genes that regulate cell development.
Human development occurs in an orderly process of biochemical and structural transition during which new constituents are being formed and spatially arranged throughout gestation. At any time in the span of development these ongoing processes can be subtly or severely disturbed or abruptly halted resulting in abnormal development or fetal death.
Therefore, at any time alcohol is present it has the potential to harm development. For example, the hallmark facial dysmorphology associated with Fetal Alcohol Syndrome will only occur if alcohol is present during the specific window of development.
Of all the substances of abuse, including marijuana, cocaine and heroin, alcohol produces by far the most serious neurobehavioral effects on the embryo or fetus.
Women at Risk
Factors known to contribute to the risk of having a child with alcohol-related birth defects include: biological susceptibility, poor nutrition, poor general health, and a lack of prenatal care.
Some moderate drinkers have offspring with identifiable birth defects while some women who consume alcohol throughout pregnancy have offspring without any apparent or quantifiable birth defects. Research is currently exploring both the genetic and protective factors involved in the manifestation of alcohol-related birth defects.
An examination of sociodemographic factors indicated that generally a higher proportion of women thirty years of age or older drink during pregnancy, but women around the age of 24 and younger face higher risks of binge drinking or drinking in the few months prior to recognizing they are pregnant (1). With regard to race and ethnicity, White women report a higher prevalence of alcohol use than Black or Hispanic women (2), although Hispanic women may increase use as they become more acculturated in the United States (3). Differences in prevalence based on geographic location appeared potentially important, with binge drinking more prevalent in the North-central sections of the United States and less so in the Southeast (4). Higher education (5) and higher income (6) were linked specifically to higher rates of alcohol use during pregnancy in some studies.
(1): Altfeld et al., 1997; CDC, 2009; Chambers et al., 2005; Floyd et al., 1999; Hollander, 1995; Jones-Webb et al., 1999; Morris et al., 1994; Perriera & Cortes, 2006; Tsai et al., 2007a,b
(2) Floyd et al., 1999; Hanna et al., 1994; Hollander, 1995; Perriera & Cortes, 2006; Project CHOICES, 2002; Tsai & Floyd, 2004; Tsai et al., 2007a,b
(3) Chambers et al., 2005
(4) Tsai & Floyd, 2004
(5) CDC, 2009; Chambers et al., 2005; Floyd et al., 1999; Hollander, 1995; Tsai et al., 2007a
(6) Chambers et al., 2005; Chang et al., 2006; Hollander, 1995; Morris et al., 1994