Is there any objective source of information on light drinking during pregnancy?
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Anonymous
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I'm sure many of you have by now heard of Emily Oster's new book Expecting Better, in which she states after reviewing the literature that there is no evidence that light drinking (defined as one drink per day or less) during the second and third trimesters has any harmful effects on the fetus. The nonprofit organization NOFAS (National Organization on Fetal Alcohol Syndrome) has begun a smear campaign against her on Facebook, Amazon, and their website, among other places. I am currently reading Oster's book and just finished the section on alcohol. I checked out NOFAS' response to her and their supporting evidence because I am really interested in hearing different interpretations of the evidence on this subject, but I found it emotional and overwrought, somewhat hysterical sounding. Obviously an organization many/most(?) of whose members and supporters are people who are personally affected by FASD are not in the best position to be objective about what the evidence shows. I found Oster's analysis to be rational and colorable, although I would have preferred something a bit more academic (she is clearly writing for a lay audience). She points out that many studies of alcohol consumption, particularly in the United States, have significant confounders -- something that is discussed at length at the beginning of one of the only three studies NOFAS offers to refute Oster's points.
Does anyone know of an objective source of information or another discussion of studies of light drinking during pregnancy that is not authored by someone with a clear anti- (or pro- for that matter) alcohol agenda? |
Anonymous
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I think the only way is to look directly at the studies and judge for yourself. The earliest studies were done on women who were alcoholics, who had >5 drinks per day. Based on that information, alcohol was deemed harmful and "no safe levels" were known. There was a study on women in Britain last year that reported that women who drank lightly (<= 1-2 drinks / day) during pregnancy had kids who did better on cognitive tests than those who did not drink at all. But the problem with all of these studies is that it's unethical to advise women to drink and obviously no way to do a controlled study. You might scan google scholar to look for a broader array of studies. The reality is that people are so emotional about these issues (and all issues surrounding pregnancy) that it is very hard, outside of direct academic studies, and even those can be dogmatic, to find objective information. |
Anonymous
| The PP is right-on in her response. I'll just add that I've found the book "Panic-Free Pregnancy" to be refreshingly unemotional about these issues as well. The author examines pregnancy tips, reveals where they came from and the details of the study on which they were based, and then applies that analysis to a real life "you're a regular woman not a raging alcoholic or drug abuser" lifestyle. He does the same with all the biggies: cold cuts, caffeine, cold medicine, sushi, etc. |
Anonymous
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I did a cursory scan of the literature available on PubMed when I was pregnant (now almost 4 years ago).
The general consensus is that there is no "safe" level of alcohol use--however, what that means is that there have not been studies which determine the safe/dangerous boundary between, say, one drink a week and five a day. No-one has established a minimum level at which there are no adverse effects. Since I wasn't planning to drink anywhere NEAR the amount studied in the studies which found adverse effects, my take-home was that I didn't have a problem with 1-2 drinks per week past the first trimester. |
Anonymous
I did the same research. The fact is no one is going to set about to set a safe level of alcohol to consume during pregnancy. It's impossible to do an ethical controlled study and there is no compelling reason to set a safe level because there is no medical reason why one would need to drink alcohol during pregnancy. Nevertheless, Europeans have been drinking moderately during pregnancy for centuries without causing fetal alcohol syndrome. |
Anonymous
| Regarding studies, I wanted to add on top of what has already been said the answer would be a population-based epidemiological study. These have issues too, however. The big one is that if you are dealing with patient reported data, since there is stigma around drinking in pregnancy for most women, those survey would be generally less likely to admit to any alcohol consumption or even to the specific amount. This is a really big issue of what would seem like a relatively easy question to answer because as PP said, there are many palces where women drink moderately during pregnancy without any documented (key word) adverse outcomes. One day we'll know - maybe. |
Anonymous
| If you can't go nine months without drinking, then perhaps you have a problem. They will do blood work on your newborn in the hospital, fwiw. Ever met a kid who was born ith FAS? Not fun. Seriously, ladies...just take a break from drinking during your pregnancy. |
Anonymous
Seriously, you and the lady who said that she would never drink nonalcoholic beer while pregnant because it might have up to 1% alcohol in it are the exact reason for this thread. Do *you* have any experience with FAS? Do you know of any cases caused by a woman taking a sip or two of champagne at a wedding or enjoying a single glass of wine with a meal in her second trimester? Who accidentally ingested an alcohol-filled chocolate or a meal cooked in wine? Because if you do, I think it would be very helpful to this thread, even if not a controlled study. And good luck finding that 1 glass of wine with dinner in month 6 on that post-labor blood test! |
Anonymous
OP just wanted to know a source of studies. I understand this--- it's frustrating (and insulting) to be constantly told to do or not do certain things during pregnancy, without knowing whether there is a specific, scientific reason behind these instructions. No poster here is saying that she CAN'T go without alcohol for nine months, and it's inappropriate to insinuate that someone has an alcohol problem because she would like to know whether one can safely have a few drinks during pregnancy. It's all about calculated risks, and it's imperative to know what the facts are when assessing these risks. |
Anonymous
| Geez, PP. A sip or two before you know you are pregnant or at a wedding is one thing, but the OP and crazies like you are obviously looking for studies to make you feel better about drinking regularly. Admit it. I didn't drink during my four pregnancies because the health of my babies was more important than my own needs....it's called being responsible. I know two couples who adopted babies with FAS, and they are praying that the kids develop normally. So far, so good....just mild delays...but they are still too young to tell what ultimate delays/disabilities they will have. And, I'm a policy analyst who has done a great deal of work related to child welfare, so I've read the studies, sat through trainings, and met older teens/young adults with FAS. Seriously, ladies....just stay off the sauce during pregnancy. If you can't....or don't want to...then you are simply selfish. |
Anonymous
| Omg 17:42....big difference between being told to avoid deli meat and avoid booze. Wow. Just wow. |
Anonymous
Really? Because I think these are two of the biggest sources of stress for women. You're told to avoid deli meat just in case it has listeria. But you're way more likely to get listeria from veggies. So the risk is minimal, although pretty damn significant if it happens. With alcohol, there is a so much evidence that having a drink from time to time is not a big deal, but people flip out about it all the time. Our mothers were encouraged to have a glass of wine. Some OB's and midwives still encourage it now for irritable uterus. And yet, there continue to be people who act like having a glass of wine is this awful, selfish act and a sign of addiction. I microwaved my deli meat and only had 3 glasses of wine during my pregnancy. It's possible to take some precautions and be thoughtful about your choices. |
Anonymous
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It has more to do with the fact that drinking isnt healthy for a developing baby. Sort of like how Cheetos aren't healthy. So why drink at all? Why not try to eat and drink as healthy as possible for nine months?
I could probably have a few cigarettes during my pregnancy without harming my baby, but why on earth would I? I hope you drink in the privacy of your own home, because society is judging you if you do it in public. Saw a yuppie vegan pregnant lady drinking at our neighborhood pool this summer. She was prattling on about how she's planning a home birth, and eating super healthy, vegan, etc while drinking a beer. So bizarre. |
Anonymous
| Unfit mom ? |
Anonymous
| OP here. The last few posters prove my point about hysterical, emotional, and overwrought. Thanks to those who provided thoughtful and on-topic answers. There will always be a subset of the population who believes that anyone who ever has one drink has a problem -- I can't help those people. How do you know that I'm even pregnant at the moment? I was just asking for information, but this topic always brings out the extremists. |