Adverse Effects of Alcohol in Pregnancy

Alcohol consumption in pregnancy can produce a spectrum of abnormalities in the developing foetus, ranging from minor retardation of growth to the fully developed ‘foetal alcohol syndrome’. This syndrome comprises a constellation of physical and mental defects associated with a charateristic facial appearance that is found in children: born to chronic alcoholic women. Although it was thought to be extremely rare in the U.K., several case studies have recently appeared in the literature, and its incidence is probably increasing. In moderately drinking pregnant women increased rates of spontaneous abortion, stillbirth and congenital malformation as well as growth retardation have been reported, though some of these findings await confurmation. It is likely also that certain behavioural abnormalities are consequent on maternal alcohol intake. The major U.K. finding so far is that consumption of more than 100g alcohol per week in the early stages of pregnancy is associated with reduced birth weight. There is no doubt that alcohol is teratogenic in laboratory animals and that the effects are dose-related. In humans the threshold dose necessary to produce damage to the foetus and the time in pregnancy that alcohol is particularly likely to have deleterious effects have not yet been established. In the present state of knowledge there are difficulties in recommending safe limits. It is obvious that abstinence before and during pregancy is the safest course, but one drink a day is unlikely to be harmful. Greater efforts are needed to educate women about the dangers of alcohol consumption in pregnancy.