Sunday, May 30, 2010

The Russian Roulette of pregnancy

Is it really okay to have the odd alcoholic drink when you’re pregnant?

Quite often when you’re pregnant, the subject of alcohol comes up, particularly if you’re at a wedding, family event or ladies luncheon.
You’ve probably had a few glasses of wine before you found out you were pregnant, and most women will then abstain from drinking alcohol throughout the pregnancy, and beyond if they are breastfeeding.
But talking to a some friends, it seems there are very different opinions on what’s safe, what’s acceptable, and what is not.
One example is the woman pregnant with her first baby who said she was allowing herself to have the “standard recommended amount” of one glass of wine per day. Yes, per day!
She later found out her GP had said one glass per week would be okay, and promptly changed her ways.
Then there are women who have been trying for a baby for so long that they wouldn’t dare jeopardise the baby’s health or increase their risk of miscarriage.
I tend to fall into the latter category, but will admit to having a couple of glasses of champagne in February at my cousin’s wedding, as well as a glass of wine at a work lunch.
But there’s no alcohol in my house so there’s no temptation.
So what exactly is the “standard recommended amount” and what does alcohol do to the developing foetus?

Queensland Health advises that there is no known safe level of alcohol consumption during pregnancy, so the safest option is not to drink alcohol at all.
The National Health and Medical Research Council (NHMRC) also stipulates in their guidelines that maternal alcohol consumption can harm the developing foetus or breastfeeding baby, so not drinking is the safest option.
It is recommended that you give up drinking before getting pregnant, but if you didn’t, don’t worry.
Thousands of women have had a drink or two before they knew they were pregnant, or conceived around the time of a binge drinking session, and their babies have been fine.
High levels of alcohol consumption during pregnancy can lead to foetal alcohol syndrome (FAS), a condition that causes growth restriction, intellectual disabilities and changes to the shape and size of the skull.
FAS has devastating long-term consequences for the individuals themselves and their families and the number of reported cases in Australia is increasing.
It is well recognised that FAS is associated with heavy drinking throughout the pregnancy or repeated episodes of binge drinking. It is most prevalent in babies born to alcoholic mothers.
But even moderate drinking during pregnancy has been linked with foetal alcohol spectrum disorders (FASD). This term covers a wide range of disorders that can occur in babies and children who are exposed to alcohol during pregnancy.
The disorders involve physical, mental, behavioural and learning disabilities, and can include:

  • Alcohol related neural developmental disorder (ARND) which typically manifests as functional or cognitive impairments
  • Alcohol related birth defects (ARBD) including heart, skeleton, kidney or other organ malformations
  • Foetal alcohol effects (a term used to describe several different conditions that do not meet the criteria for full blown FAS).

More recently, researchers at the Queensland Institute of Medical Research (QIMR), in collaboration with the Sigrid Juselius Foundation, Finland, and the University of Washington, Seattle, have shown that consumption of moderate amounts of alcohol during pregnancy affects the activity of genes in the developing foetus and that these changes last into adulthood.
“We have long known that alcohol consumption during pregnancy can harm the developing foetus and have life-long effects on the individual’s health and well being,” said researcher Dr Suyinn Chong at QIMR.
“What our current research helps to explain is the underlying mechanism. This is a new and exciting area where instead of studying the sequence of the genes, we are looking at the mechanisms that control our genes – known as epignetics.
“This is an extra layer of information attached to your DNA which helps regulate the expression of genes – in other words whether they are switched on or off.
“These epigenetic changes determine whether a gene is converted into protein, which ultimately controls physical traits.
“Using mice as a model, we have shown for the first time that alcohol consumed during the first trimester affects the developing foetus by altering the epigenetic information.”
Dr Chong is hopeful her team’s research will further our understanding of FAS disorders and in the future these epigenetic changes may be used to aid diagnosis of this condition, allowing for early intervention.
Pregnant women need to always keep in mind that whatever goes into their body is absorbed by the baby through the bloodstream and across the placenta.
So if you have a drink, your unborn child is also taking the same drink.
For the unborn child, the alcohol interferes with the baby’s ability to get enough oxygen and nourishment for normal cell development in the brain and other body organs.
Research has shown that a developing foetus has very little tolerance for alcohol and infants born to mothers who drink during pregnancy can have serious problems. It can also cause problems such as miscarriage and premature birth.
There is a belief that pregnant women should only avoid alcohol in the first trimester when major organs are being formed.
But damage from drinking is not just limited to this period in the pregnancy. It can also happen later on, when the baby is growing more and the baby’s brain is developing.

For those who might think drinking during pregnancy is no big deal, here is a list of the potential problems their newborns could be facing as a result:
  • Small body size and weight
  • Slower than normal development and failure to "catch up".
  • Deformed ribs and sternum
  • Curved spine and hip dislocations
  • Bent, fused, webbed, or missing fingers or toes
  • Limited movement of joints
  • Small head
  • Facial abnormalities
  • Small eye openings
  • Skin webbing between eyes and base of nose
  • Drooping eyelids
  • Nearsightedness
  • Failure of eyes to move in same direction
  • Short upturned nose
  • Sunken nasal bridge
  • Flat or absent groove between nose and upper lip
  • Thin upper lip
  • Opening in roof of mouth
  • Small jaw
  • Low-set or poorly formed ears
  • Organ deformities
  • Heart defects or heart murmurs
  •  Genital malformations
  • Kidney and urinary defects
  • Central nervous system handicaps
  • Small brain
  • Faulty arrangement of brain cells and connective tissue
  • Mental retardation - occasionally severe
  • Learning disabilities
  • Short attention span
  • Irritability in infancy
  • Hyperactivity in childhood
  • Poor body, hand, and finger coordination

These effects are not temporary; they can cause a lifetime of physical and emotional.

I believe drinking when pregnant is like playing Russian Roulette. You really don’t know what you’re doing to your unborn baby, so why take a chance?
If you have tried to stop drinking and find it difficult, there is help and support available. Speak to your GP or Alcoholics Anonymous (


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