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Alcohol During Pregnancy; Risk of Fetal Alcohol Spectrum Disorders


Excessive alcohol use is risk factor for a wide range of health and social problems including liver cirrhosis, certain cancers, depression, motor vehicle crashes, and violence. Alcohol use during pregnancy can lead to fetal alcohol spectrum disorders (FASDs) and other adverse birth outcomes. Community studies estimate that as many as 2% to 5% of first grade students in the United States might have an FASD, which include physical, behavioral, or learning impairments.

 

One in 10 (10.2%) pregnant women in the United States ages 18 to 44 years reports drinking alcohol in the past 30 days. In addition, 3.1% of pregnant women report binge drinking – defined as four or more alcoholic beverages on one occasion. This means that about a third of women who consume alcohol during pregnancy engage in binge drinking according to a recent CDC report.

 

“We know that alcohol use during pregnancy can cause birth defects and developmental disabilities in babies, as well as an increased risk of other pregnancy problems, such as miscarriage, stillbirth, and prematurity,” said Coleen Boyle, Ph.D., director of the CDC’s National Center on Birth Defects and Developmental Disabilities. “This is an important reminder that women should not drink any alcohol while pregnant. It’s just not worth the risk.”

 

Fetal alcohol spectrum disorders (FASDs) are a group of conditions that can occur in a person whose mother drank alcohol during pregnancy. FASDs are completely preventable: if a woman does not drink alcohol during pregnancy, her child has zero risk of an FASD.

 

The study used data from the CDC’s Behavioral Risk Factor Surveillance System (BRFSS), a state-based, landline and cell phone survey of the U.S. population. To estimate the prevalence of alcohol use and binge drinking, researchers used 2011-2013 BRFSS data for all 50 states and the District of Columbia for women aged 18-44 years.

 

Among pregnant women, alcohol use was highest among:

 

  • Those aged 35-44 years (18.6%);
  • College graduates (13%); and
  • Unmarried women (12.9%).

 

For comparison, one in two (53.6%) non-pregnant women in the United States aged 18 to 44 years reports drinking alcohol in the past 30 days and 18.2% of non-pregnant women report binge drinking. Among women who reported binge drinking in the past 30 days, pregnant women reported a significantly higher frequency of binge drinking than non-pregnant women (4.6 and 3.1 episodes respectively).

 

The prevalence of any alcohol use and binge drinking among pregnant and non-pregnant women is slightly higher than estimates reported for 2006-2010. However, this is likely due to methodological changes to the BRFSS in 2011, such as the addition of cell phone surveys, rather than actual shifts in the prevalence of alcohol use.

 

“Women who are pregnant or might be pregnant should be aware that there is no known safe level of alcohol that can be consumed at any time during pregnancy. All types of alcohol should be avoided, including red or white wine, beer, and liquor,” said Cheryl Tan, M.P.H., lead author of the study and an epidemiologist in the CDC’s National Center on Birth Defects and Developmental Disabilities.

 

The CDC works to prevent alcohol-exposed pregnancies and FASDs through a variety of activities including:

 

  • Tracking alcohol use among women of reproductive age in the United States;
  • Supporting the implementation of evidence-based interventions to reduce risky alcohol use and alcohol-exposed pregnancies, including through alcohol screening and brief interventions and the CHOICES program- an evidence-based program that works to prevent alcohol-exposed pregnancies;
  • Collaborating with FASD Practice and Implementation Centers and national partners to promote practice changes among healthcare providers in the prevention, identification, and management of FASDs;
  • Promoting effective interventions for children, adolescents, and young adults living with FASDs and their families; and
  • Offering FASD-related educational information and materials for women of reproductive age, healthcare providers, and the general public.

 

Adopting this comprehensive approach to reduce excessive alcohol use among pregnant women and women of childbearing age is an important step toward achieving the Healthy People 2020 objectives of reducing alcohol use among pregnant women, and ultimately reducing FASDs and other alcohol-related adverse birth outcomes.

 

See the CDC Announcement

 

See the CDC Report

 

See also Medical Law Perspectives, January 2015 Report: Mothers, Infants, and Obstetrical Injuries: Labor and Delivery Liability

 

See also Medical Law Perspectives, February 2014 Report: Congenital Heart Conditions: How Infants, Adults, and Healthcare Providers Handle the Risks

 

See the Medical Law Perspectives March 25, 2015, Blog: Risks of Prescription and OTC Pain Medicines During Pregnancy

 

 

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