Alcohol Abuse In Pregnancy

According to latest statistics reported by Centers for Disease Control and Prevention, investigators suggested that the prevalence of maternal alcohol abuse in pregnancy is 10% in the United States. According to another study, at least one in 50 women binge drink while pregnant in US (1).

Alcohol and alcoholic products (such as wine, beer etc.) are as hazardous as any other well-known teratogenic products in pregnancy. Even a small amount of alcohol can significantly impair organogenesis (development of organs and organ system in babies).

How Alcohol Abuse Compromise Pregnancy And Fetal Well-Being?

During pregnancy, maternal and fetal circulation are mixed (or interlinked) via umbilical cord and placenta. In other words, any toxin or chemical that gains access into the maternal blood stream can easily transfuse into the fetal circulation.

Alcohol and alcohol breakdown products are especially known to cause deleterious effects in the babies because:

• The detoxification centers in the growing fetus (such as liver and kidneys) have a very limited capacity to filter and remove the toxins. Therefore, the toxins tend to clear off slowly from the fetal blood stream.
• The alcohol breakdown products tend to accumulate in the growing fetal tissues to cause wide range of complications.

According to a new study, various maternal factors can also influence the risk of alcohol abuse in pregnancy. For example, certain genetic factors can alter the normal metabolism of alcohol in the body; thereby increasing the production of an intermediary toxin – acetaldehyde that can lead to a wide range of complications- both in mother and the growing fetus.

There are three categories of alcohol abuse in pregnancy:

• Heavy drinking: Consumption of alcohol in a quantity more than 48–60 g/day is considered extremely dangerous for both mothers and the babies. The risk of developing fetal alcohol syndrome in babies born to mothers who consume more than 48g/ day of alcohol is 6 to 10% (2). In addition, mothers who drink heavily are more likely to develop complications like postpartum depression, pregnancy blues, metabolic syndrome etc.
• Moderate alcohol consumption: Consumption between 24–48 g/ day can aggravate the risk of behavioral and intellectual defects in babies and can adversely affect the health of mother.
• Binge drinking: Consumption of more than 4-5 drinks at once (or more than 90g/ day occasionally)

What Are Some Notable Complications Of Alcohol Abuse In Pregnancy?

No amount or form of alcohol is considered safe in pregnancy. It has been observed that mothers who continue to drink alcohol during pregnancy often experience following complications:

• Miscarriage
• Stillbirth

Some notable complications in babies born to alcoholic mothers are:

• Fetal alcohol syndrome: According to latest statistics reported in the peer reviewed journal Evidence Based Mental Health (2) investigators suggested babies born to alcoholic mothers are more likely to give birth to babies with fetal alcohol syndrome – a severe condition that is characterized by low birth weight, small-sized head, facial deformities, spinal and anatomical defects and permanent damage to central nervous system leading to mental retardation.
• According to a meta-analysis and systematic review published in the Paediatric and Perinatal Epidemiology (3) journal, investigators suggested that mothers who consume alcohol while pregnant have babies with lifelong behavioral, physical, hyperactivity and intellectual disorders (such as disabilities with attention span, learning, language and speech).
• it has been statistically proven by a number of clinical studies that one-third of all the babies who are exposed to excessive quantities of alcohol during fetal life develops congenital cardiac anomalies (such as atrial septal defects, aortic arch defects ventricular septal defects, etc. (4)

Other complications include:

• Sleep problems and feeding issues after birth
• Agitation and irritability in babies
• High risk of developing hearing and visual disorders later in life
• Low IQ, poor judgment and inadequate intellectual capacity
• Poor memory and coordination
• Slow mental and physical growth

Healthcare professionals strongly recommend avoiding all types of alcoholic beverages before planning a pregnancy. If you have a drinking problem, speak to your primary care provider to learn more about the ways you can curb this issue.

References

1. Ornoy, A., & Ergaz, Z. (2010). Alcohol abuse in pregnant women: effects on the fetus and newborn, mode of action and maternal treatment. International journal of environmental research and public health, 7(2), 364-379.

2. Sayal, K. (2007). Alcohol consumption in pregnancy as a risk factor for later mental health problems. Evidence Based Mental Health, 10(4), 98-100.

3. Bell, J. C., Raynes‐Greenow, C., Turner, R. M., Bower, C., Nassar, N., & O'Leary, C. M. (2014). Maternal Alcohol Consumption during Pregnancy and the Risk of Orofacial Clefts in Infants: a Systematic Review and Meta‐Analysis. Paediatric and perinatal epidemiology, 28(4), 322-332.

4. Sun, J., Chen, X., Chen, H., Ma, Z., & Zhou, J. (2015). Maternal Alcohol Consumption before and during Pregnancy and the Risks of Congenital Heart Defects in Offspring: A Systematic Review and Meta‐analysis. Congenital heart disease, 10(5), E216-E224.