Pregnant Women and Alcohol

No amount of alcohol is "safe" for consumption during pregnancy. Exposure to alcohol in the womb can lead to a number of serious health issues later in life, including fetal alcohol syndrome (FAS).
Evidence Based
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Drinking alcohol during pregnancy can put both a mother and her child at risk for health problems. Studies show that consistent drinking, as well as binge drinking (consuming four or more drinks per occasion), puts a fetus at high risk for health complications.

No amount of alcohol is safe for consumption during pregnancy. Exposure to alcohol in the womb can have serious adverse health effects on a child that can last into adulthood.

According to a study by the Centers for Disease Control and Prevention (CDC) From 2011 to 2013, 10 percent of pregnant women reported drinking alcohol within the last 30 days, and 3.1 percent reported binge drinking during the same time frame.

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Effects of Drinking Alcohol While Pregnant

The number one preventable cause of congenital disabilities (birth defects), abnormalities, and developmental disabilities in the U.S. is prenatal exposure to drugs or alcohol. Drinking alcohol during pregnancy can cause a variety of severe effects, including:

  • Fetal Alcohol Spectrum Disorders
  • Miscarriage
  • Stillbirth
  • Physical, mental, or intellectual disabilities
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Understanding Fetal Alcohol Spectrum Disorders

Scientists use the term “Fetal Alcohol Spectrum Disorders” (FASD) to define a spectrum of effects and symptoms caused by prenatal exposure to alcohol.

These include Fetal Alcohol Syndrome (FAS), Partial FAS (pFAS), Alcohol-Related Neurodevelopmental Disorder (ARND), Alcohol-Related Birth Defects (ARBD), and Neurobehavioral Disorder Associated with Prenatal Alcohol Exposure (ND-PAE).

Everyone with FASD has a unique set of symptoms that cause long term issues. These symptoms and afflictions present themselves in a variety of ways.

  • Physical FASD may produce abnormal facial features such as narrow eye openings, greater distances between eyes, thin upper lips, and smooth ridges between the nose and upper lip (philtrum). Individuals exposed to alcohol prenatally may also have smaller heads, shorter heights, and lower body weights.
  • Medical Individuals with FASD may experience vision or hearing issues, as well as problems with the heart, kidney, or bones.
  • Mental health They are also at a higher risk to suffer from mental illnesses such as Attention Deficit Hyperactivity Disorder (ADHD), depression, anxiety, and substance use disorders.
  • Behavioral People with FASD often have attention issues and may struggle to focus or shift their attention. They also struggle to control their emotions and impulsivity.
  • Educational Learning disabilities, memory problems, and difficulty understanding and following directions are common symptoms.
  • Social FASD can impact a person’s ability to communicate and socialize. They may make poor decisions, repeat mistakes, and have difficulty understanding the consequences of their actions. They may also struggle with every day life skills such as eating, personal hygiene, money management, telling time, and personal safety.
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Treatment for Alcohol Use Disorder for Pregnant Women

Pregnant women who suffer from Alcohol Use Disorder (AUD) often have co-occurring disorders or especially difficult circumstances, in addition to AUD. It is especially important to treat pregnant women that drink with kindness and compassion.

Treatment for alcohol use disorder for pregnant women should involve:

  • Women-centered care
  • Comprehensive care (prenatal care as well as substance use counseling)
  • Respect and non-judgment
  • A harm-reduction philosophy
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Medication Treatment Options

There are currently three FDA approved medications for treating AUDs in the United States:

  • Naltrexone
  • Disulfiram
  • Acamprosate

All of these are category C medications — meaning that there is evidence of adverse effects of the drug on the fetus of animals, but there have been no experiments to measure the safety when used by humans. Therefore, it is vital to consider the risks of treating pregnant women with alcohol use disorders with medication.

Behavioral Treatment Options

Behavioral treatment options for pregnant women with AUDs are the same as non-pregnant women. They include:

  • Motivational enhancement therapy
  • Brief interventions
  • Cognitive behavioral therapies
  • Supportive counseling and therapy
  • Psychotherapy
  • Educational strategies and programs

There is no one treatment option that is more effective than the others. It’s crucial to review all of the professional treatment options and find the one that best suits the individual’s needs.

If you or someone you love is struggling with alcohol use disorder during pregnancy, it’s important that they get help. Reach out to a professional today.

Resources

May, Philip A, and J Phillip Gossage. “Maternal risk factors for fetal alcohol spectrum disorders: not as simple as it might seem.” Alcohol Research & Health: the journal of the National Institute on Alcohol Abuse and Alcoholism vol. 34,1 (2011): 15-26.

Day, Nancy L., et al. “The Association Between Prenatal Alcohol Exposure and Behavior at 22 Years of Age.” Wiley Online Library, 26 Feb. 2013, http://onlinelibrary.wiley.com/doi/pdf/10.1111/acer.12073.

DeVido, Jeffrey et al. “Alcohol use disorders in pregnancy.” Harvard review of psychiatry vol. 23,2 (2015): 112-21. doi:10.1097/HRP.0000000000000070

“Fetal Alcohol Exposure.” National Institute on Alcohol Abuse and Alcoholism, U.S. Department of Health and Human Services, 24 Dec. 2019, www.niaaa.nih.gov/publications/brochures-and-fact-sheets/fetal-alcohol-exposure.

“Alcohol Use in Pregnancy.” Fetal Alcohol Spectrum Disorders (FASDs), Centers for Disease Control and Prevention, 27 Mar. 2018, www.cdc.gov/ncbddd/fasd/alcohol-use.html.

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Updated on: June 24, 2020
Author
Michael Bayba
About
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Medically Reviewed: March 9, 2020
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Annamarie Coy

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