Episode Transcript
Dr. Kirtly Jones: Everyone knows you aren't supposed to drink alcohol when you're pregnant. Well how much is not drinking, and when in pregnancy does it matter? This is Dr. Kirtly Jones from the Department of Obstetrics and Gynecology at University of Utah Health Care and this is the scope of drinking and pregnancies on The Scope.
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Dr. Kirtly Jones: In 1987 fetal alcohol exposure was the leading known cause of intellectual disability in the western world. Now this comes before the more recent public awareness of diagnosis of autism spectrum disorder and ADD attention deficit disorder which occupied our thoughts about intellectual disability in children. But we know from controlled studies in animals and observation of human pregnancies that alcohol consumption can stunt fetal growth, damage brain development and lead to problems in children's cognitive function.
Fetal alcohol syndrome is a pattern of mental and physical deficits in a fetus and child associated with high levels of alcohol consumption in pregnancy. Alcohol easily passes through the placenta and can cause growth restrictions in the fetus and damage neurons and brain structure. The consequences can be poor memory, attention deficits, impulsive disorder, and poor reasoning in a child. There may also be secondary problems such as a predisposition to mental health problems and addiction. It isn't clear whether these secondary problems were inherited, the mother was addicted and often depressed, whether these fetal exposures were genetic or a little bit of both. There are also some facial features associated with fetal alcohol syndrome but that's a little controversial.
Alcohol exposure can present a risk to the fetal brain at any time in development as the fetal brain is rapidly developing throughout pregnancy. In the first trimester it can affect the actual development of brain structures. In the third trimester it can affect later developing structures that have to do with judgment and memory. It's estimated that 1 in 100 children are affected by alcohol consumption during pregnancy in the U.S. Surveys in the U.S. suggest that 30% of women have consumed alcohol sometime during their pregnancy, and 10% to 15% have consumed some recently. Didn't they read the label?
How much? Here is where it gets difficult. There is no normal consumption of alcohol as in some cultures alcohol is consumed daily, and in some cultures alcohol is forbidden. A study of 400,000 women who had consumed some alcohol in pregnancy suggested that women who had more than 15 drinks a week or about 2 a day had growth problems in the fetus and subsequent cognitive difficulty. The authors of the study suggested limiting alcohol to no more than one drink a day. A number of other studies have suggested that drinking no more than one to two drinks a week doesn't appear to pose a risk to the fetus and subsequent child. But, the only certain way to prevent fetal alcohol syndrome is to simply avoid drinking alcohol during the pregnancy.
The Surgeon General of the United States, the British Department of Health, and the Australian Government National Health and Medical Research Council have made that recommendation. In the United States the Surgeon General recommended in 1981 and again in 2005 that women abstain from alcohol during pregnancy or while planning a pregnancy. Women don't know that they are pregnant until the fetal brain has already started its development. You would want to avoid damage even in its earliest stages, the earliest weeks of pregnancy. So federal legislation has required that warning label be placed on all alcoholic beverages since 1988.
So what's the takeaway? One, plan your pregnancies. If you are trying to get pregnant limit your drinking to one to two drinks a week or none. If you had a single drink before you knew that you were pregnant don't worry. If you're pregnant don't drink alcohol. If you have a sip of champagne at your sister's wedding, okay. But if you know that alcohol goes right to your brain, then think about it going right to your baby's brain. And we don't serve alcohol to minors. Your baby deserves the best start in life and that starts before you're even pregnant. Clean out the incubator, give your kid the best chance, and that's the scope of the issue.
This is Dr. Kirtly Jones tipping a glass of non-alcoholic fizzy grape juice to all of you pregnant ladies and pregnant wannabes. Thanks for joining us on The Scope.
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