To Drink or Not to Drink during Pregnancy: An Update
In early 2014, a paper published in Journal of Epidemiology & Community Health 68: 224-232, by Janni Niclasen et al. entitled, “Prenatal exposure to alcohol, and gender differences on child mental health at age seven years” drew considerable press coverage and debates among researchers in alcoholism and birth defects prevention (for instance, see http://www.today.com; http://www.redorbit.com). These investigators examined data from the Danish National Birth Cohort, which surveyed 37,000 women between 1996 and 2002 about their alcohol intake during pregnancy, and drew associations with the “Strengths and Difficulties Questionnaire (SDQ)” scores that assessed hyperactivity/inattention, conduct, emotional and peer problems in their seven-year old children. The surprising finding of this study was that children whose mothers drank moderately (about two drinks a week) in fact experienced better mental health than those whose mothers abstained completely from drinking, thus rekindling the risks (Fetal Alcohol Syndrome)/benefits controversy of moderate drinking vs. total abstinence during pregnancy
On June 28, 2014, the Research Society on Alcoholism (RSA) held its Fetal Alcohol Spectrum Disorder Study Group (FASDsg) meeting in Bellevue, WA. The theme of the meeting this year was "Low drinking versus no drinking: Matching science with policy and public perception," in part to address the contemporary issue raised by publications such as the one described above. Several Teratology Society members attended this meeting, including Dr. Ludmila Bakhireva. The following is her brief update of RSA’s position on alcohol consumption during pregnancy.
The meeting featured a keynote speaker and a senior author on the Danish study - Dr. Katrine Strandberg-Larson from the Department of Public Health, University of Copenhagen. A panel discussion had addressed the question “Have we established a safe level of alcohol exposure during pregnancy?” Methodological challenges in both human and animal studies in making unequivocal conclusions about low-level drinking were discussed. The panel agreed that no safe level of drinking during pregnancy has been established. According to Dr. James Reynolds, the President of FASDsg, “There were many reasons cited for this, including methodological differences between studies, the relatively limited outcome measures that have been employed in the majority of studies, the lack of consensus on what constitutes "low/moderate" drinking, and the large number of confounding variables (age, race, SES, etc.) that have proven difficult to control in the analyses. In this regard, animal models have clearly established that low levels of alcohol consumption during pregnancy can have detrimental effects on offspring.” The panel also discussed that it would be valuable in the future to see increased interplay between basic and clinical investigations. Full agenda of the meeting can be found at: http://fasdsg.org/page9.php.