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JAMA Pediatrics Patient Page
August 2017

Prenatal Alcohol Exposure: No Safe Amount

JAMA Pediatr. 2017;171(8):820. doi:10.1001/jamapediatrics.2017.1093

Prenatal alcohol exposure is important for every mother to consider. Many women know that it is important to avoid alcohol during the first trimester of pregnancy, but there are some myths that suggest that drinking a small amount of alcohol in the second or third trimester is okay. No amount of alcohol use is safe at any time during pregnancy. Prenatal alcohol exposure represents a preventable cause of developmental and health problems for children.

Fetal alcohol spectrum disorder (FASD) describes the range of effects that can occur in an individual whose mother drank alcohol during pregnancy. It is estimated that FASD may affect 3% to 5% of children, but many cases of FASD are undiagnosed. There are many effects of alcohol on the developing fetus. Cognitive impairment includes irreversible brain damage. Children exposed to alcohol when their mother was pregnant often have learning difficulties, such as poor memory, speech impairments, and behavioral problems like hyperactivity. Growth abnormalities associated with alcohol exposure include growth deficiencies (eg, children having a height or weight under the 10th percentile for their age), a smaller brain, and difficulty with coordination. Children exposed to alcohol often have similarities in their facial appearance, such as small eyes, a thin upper lip, and a smooth area between their nose and upper lip.

Children with FASD may be diagnosed with fetal alcohol syndrome, which is the most severe of the conditions represented by FASD. Children with fetal alcohol syndrome have problems in cognitive impairment, growth abnormalities, and facial appearance. Partial fetal alcohol syndrome is diagnosed if a child has most, but not all, of these features. Two other FASD conditions are static encephalopathy, which refers to children with severe cognitive delays and alcohol exposure, and neurobehavioral disorder, which refers to children with moderate cognitive delays and alcohol exposure.

A study in this month’s JAMA Pediatrics looked at all levels of alcohol use during pregnancy, including avoiding alcohol in the first trimester and only having small amounts of alcohol later in pregnancy. The researchers found that facial changes were present at every level of alcohol use in pregnancy, even if the mother avoided alcohol during the first trimester or only drank moderately. The most severe results were seen among mothers who drank alcohol in the first trimester of pregnancy. The results show that even low levels of alcohol use can influence a baby’s development. The first trimester remains the most important time point to avoid alcohol, but there is no safe amount of alcohol use during pregnancy.

What women need to know:

  • If you are pregnant, or are trying to get pregnant, no amount of alcohol use is safe.

  • All types of alcohol—including wine, beer, and hard liquor—have similar risks for your baby.

  • When a pregnant woman drinks, so does her baby.

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Article Information

Published Online: June 5, 2017. doi:10.1001/jamapediatrics.2017.1093

Conflict of Interest Disclosures: None reported.