Abstain from alcohol in early pregnancy, says updated advice

http://www.theguardian.com/society/2015/feb/10/alcohol-drinking-during-pregnancy-updated-advice

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Women trying to have a baby and those in the first first three months of pregnancy are advised to avoid alcohol altogether under updated advice from the Royal College of Obstetricians and Gynaecologists (RCOG).

The college previously said mothers-to-be should not drink more than two units once or twice a week – a small glass of wine of 125ml is 1.5 units. There is no proven safe amount of alcohol that women can drink during pregnancy, the college said, and it is also often difficult to work out just how much a woman is drinking, especially if they drink at home.

The only way to be certain that the baby is not harmed by alcohol is not to drink at all during pregnancy or while breastfeeding, although small amounts of alcohol after the first trimester do not appear to be harmful, the college said.

“For women planning a family, it is advisable not to drink during this time. Either partner drinking heavily can make it more difficult to conceive,” Philippa Marsden, chair of the RCOG’s patient information committee, said. “During early pregnancy, the safest approach is to abstain from alcohol and after the first trimester keep within the recommended amounts if you do decide to have an alcohol drink.”

The guidance states that drinking alcohol may affect the unborn baby as some will pass through the placenta and into its bloodstream. This can affect the baby’s development, in particular the way its brain develops and how it grows in the womb.

Alcohol can lead to foetal growth restriction, and can increase the risk of stillbirth and premature labour. It could also result in foetal alcohol spectrum disorder (FASD) and the more severe foetal alcohol syndrome (FAS) that can lead to children having physical and mental disabilities.

Children with FASD can have learning disabilities, problems with behaviour, physical disability, and emotional and psychiatric problems that last a lifetime. Whether or not a baby is affected mildly or severely with FASD is directly linked to how much and how often a woman drinks during her pregnancy.

A large study in 2010 offered reassurance for women who might have a very occasional drink during pregnancy.

Dr Yvonne Kelly, of University College London’s department of epidemiology and public health, and colleagues investigated the drinking behaviour while pregnant of the mothers of 11,500 babies, and looked at the health of the children by the age of five. They found that 60% of mothers chose not to drink at all while pregnant and most of the others drank very little. About a quarter drank one or two units a week, while 5.5% were moderate drinkers, consuming three to six units a week, and 2.5% were binge or heavy drinkers, defined as seven or more units a week or six on any one occasion.

The study, published in the Journal of Epidemiology and Community Health, found that the children of heavy drinkers were more likely to be hyperactive and have behavioural and emotional problems, but the babies who were born to light drinkers suffered no ill-effects.

In the latest guidance, Cath Broderick, chair of the RCOG women’s network, a lay-group of women who inform the college about issues affecting women’s health, said: “This updated information aims to help women make informed choices about levels of alcohol and has had direct input from women when developing it.

“Women may receive conflicting advice and be unsure about how alcohol is measured. This advice provides information about what is thought to be a safe amount both before and during pregnancy and chimes with the Nice antenatal guidance.”