Page last updated: Tuesday, November 18, 2008
The safe use of alcohol during pregnacy
by Criena Stockley, Health and Regulatory Manager, the Australian Wine Research institute
In some western countries, such as Australia and the UK, health authorities and practioners are beginning to reconsider the research that linked the consumption of any amount of alcohol during pregnacny with a certain medical condition in children, foetal alcohol syndrome(FAS). FAS is characterised by three diagnostic criteria-reduced growth, craniofacial and neurological abnormalities and certain cardiac, central nervous system, limb and urogenital malformations. Primarily under consideration is the amount and frequency of alcohol consumed by the mother that causes FAS.The National Health & Medical Research Council of Australia is currently reviewing its 1987 and 1992 publication, 'Is there a safe level of daily consumption of alcohol for men & women? in which they concluded that no amount of alcohol was safe for a pregnant woman.In 1995, however, The Dept. of Human Services & Health in their publication 'The quantification of drug caused morbidity & mortality in Australia' concluded that there is no ill effect of light alcohol consumption, that is, 10g alcohol per day, on the foetus. The same conclusion was drawn by the UK Dept of Health and The Royal College of Obstetricians & Gynaecologists in1997.The US Dept of Agriculture, Health & Human Services in 'Nutrition and your health: dietary guidelines for Americans' still consider that "a safe level of alcohol intake during pregnancy has not been established".

A review of the literature reveals that:

* FAS only occurs in babies whose mothers habitually consume alcohol excessivelyduring pregnancy, at a level of 50-60gper day.

* The diagnosis of FAS (and that of foetal alcohol effects) is confounded by other factors common to these women, such as nutrition, the ingestion of drugs-including caffeine and nicotine,her age,education,ethnicity, genetic, marital, parity and socio-economic status.

* FAS does not occur in babies born to women who consume alcohol at between 10 - 20g per day during pregnancy.The majority of the literature does not support the 'no threshold theory' that any amount of alcohol will have a harmful effect on the foetus.

* Effects such as reduced growth may occur in utero, but not post partum, in babies whose mothers consume above 20- 30g daily.

* The critical period of exposure to alcohol is in the first trimester. The incidence of FAS is also extremely small; in Australia, only 1.6% of the 20% of women who drink while pregnant, consume excessively and continually.The incidence of FAS is less than 0.1/10,000 live births; in the USA the incidence is 0.9/10,000 and in Europe approximately 20 times less than in the USA.

* The 'at risk' groups in all countries or populations are the minority groups with a lower socio-economic status, such as Native Americans, Native Australians and African Americans.

 The literature clearly demonstrates that there are identifiable 'at risk' groups that behave significantly differently to the 'not at risk' groups, whose amount and pattern of alcohol consumption is consistent during pregnancy. It is these 'at risk' groups rather than the population per se that should be educated by their community health-care centres, medics, gynaegolgists and pediatricans.

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