MDNews - Minnesota

Does Not Apply to Drinking Alcohol while Pregnant D ESPITE 40 YEARS of scientific research demonstrating the clear risks of drinking during pregnancy, many women and their doctors are still not convinced there is no sa fe level of a lcohol consumption during pregnancy. Alcohol is a teratogen that causes birth defects much like another well-known teratogen, thalidomide, albeit at lower rates. Alcohol causes miscarriage, physical deformities, cardiac anomalies, microcephaly and brain damage. In the late 1950s and early 1960s, it was discovered that thalidomide caused miscarriages, missing arms and legs, and facial deformities, and it was taken off the market. Although there may be a dosage below which thalidomide does not cause birth defects, would it be reasonable to consider it safe at low levels? Would it be appropriate to tell women, "It's safe as long as you don't take too much"? No, the mantra "Everything in moderation" simply doesn't apply to teratogens such as thalidomide or alcohol during pregnancy. Drinking at any stage of pregnancy poses risks. The develop- ing fetus is at risk for a wide range of physical, intellectual, developmental and behavioral problems that may ultimately be diagnosed as a fetal alcohol spectrum disorder (FASD). A recent survey by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicated that almost one in five pregnant women drinks alcohol early in pregnancy, and some continue to drink throughout pregnancy. In Minnesota, approximately 8,500 babies are born each year with lifelong effects of prenatal alcohol exposure. FASD is the single-most common known cause of intellectual disability, and it is 100 percent preventable. Prevention only requires abstaining from alcohol during pregnancy. As a healthcare provider, you are a primar y source of health information for women of childbearing age, pregnant or not yet pregnant. You are in the position to deliver this critical message and dispel myths about alcohol use during pregnancy. Unfortunately, many clinicians and their patients mistakenly believe that only women with alcoholism are at risk; many believe there are "safe" or "safer" periods during pregnancy; and many believe wine is safe to consume during pregnancy. In fact, social drinking can easily result in blood alcohol levels that cause brain damage. This brain damage can occur at any point in gestation, and research has never established a "safe" level of alcohol during pregnancy and likely never will because of tremendous variability in maternal genetics, nutrition, age, and other factors that substantially and unpredictably increase risk. Forty years of scientific evidence supersedes public opinion and the popular media. The U.S. Surgeon General, the CDC, the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists could not be clearer in stating that women who are pregnant or could become pregnant should not consume any alcohol. Please ask all women of childbearing age in your practice about alcohol use and provide information about FASD as routine preventative medicine. Ask every woman, every time, and prevent FASD. Jeffrey R. Wozniak, PhD, Associate Professor, FASD Research Program, University of Minnesota, submitted this article on behalf of the Minnesota Organization on Fetal Alcohol Syndrome. ■ FASD-RELATED STATISTICS: + Eighteen percent of U.S. women 18–44 report drinking alcohol in their first trimester. + Seven percent report binge drinking — five or more drinks within a couple of hours — during their first trimester. (Source: SAMHSA) + Fifty percent of pregnancies are unplanned. + Fetal alcohol syndrome occurs in two per 1,000 live births. + FASD is estimated to occur in 2–5 percent of live births. (Source: CDC, Morbidity and Mortality Weekly Reports) + Sixty percent of women underestimate the size of a drink or overpour, especially when pouring hard liquor. + A balloon glass of wine contains two to three times more alcohol than a standard drink. 'Everything in Moderation' By Jeffrey R. Wozniak, PhD SPECIAL CLINICAL SECTION: WOMEN'S HEALTH 1 6 | Minnesota MD NEWS ■ M D N E W S . CO M 1 6 | Minnesota MD NEWS ■ M D N E W S . CO M

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