Introduction
Alcohol consumption during pregnancy is a major public health problem. Despite the recommendation to abstain, many women still continue to drink alcoholic beverages while expecting. According to the report published in The American Journal of Preventive Medicine, in 2018, 11.3% of pregnant women reported having at least one drink in the past 30 days, and 4% of women reported binge drinking (qtd. in Fetal Alcohol Spectrum Disorders (FASDs), 2020).
The studies show that alcohol exposure during pregnancy is harmful to the brain of the baby and may result in fetal alcohol spectrum disorders (FASDs) (Fetal Alcohol Spectrum Disorders (FASDs), 2020). It is one of the leading causes of mental health issues in children, leading to irreversible lifelong consequences (Roozen et al., 2018). In addressing the issue of alcohol consumption during pregnancy, an interdisciplinary team needs to focus on increasing awareness and the development and implementation of prevention strategies and FASD detection and prevention guidelines.
Literature Review
The current literature on the issue of alcohol consumption during pregnancy explores the negative effects that alcohol has on the fetus and mother, the reasons behind current recommendations, and the measures to address the problem. One of the most important questions explored in the studies is the amount of alcohol that can be considered safe during pregnancy. Although most health organizations recommend complete abstinence during pregnancy, there is not enough evidence to claim that low levels of alcohol consumption have serious negative effects on fetus development. Despite the lack of evidence, however, it is recommended for interdisciplinary teams to encourage abstaining from alcohol during pregnancy as a precautionary measure.
The article by Subramoney et al. (2018) reviews the literature on the effects of prenatal alcohol exposure on early child development. Based on the results of the analyzed studies, it concludes that drinking alcohol during pregnancy is proven to have widespread negative effects on fetal growth and development (Subramoney et al., 2018). These effects are believed to spread to the early stages of child development up to the preschool age and include, apart from severe FASDs conditions, lower IQ scores, poorer motor abilities, and emotional and behavioral problems (Subramoney et al., 2018). The article reports the lack of information on the effects of low levels of alcohol consumption and suggests that further studies are required to investigate these effects.
The article by Roozen et al. (2018) studies maternal alcohol consumption patterns with the aim to determine which types of drinking behavior most strongly predict FASD. It concludes that the current knowledge of the effects of different alcohol consumption patterns on pregnancy is limited and requires further research (Roozen et al., 2018). However, it is clear that the more severe alcohol consumption is, the more it is in need of intervention.
The article by Dejong et al. (2020) explores the fetal and neonatal effects of maternal alcohol consumption. It claims that alcohol use during pregnancy poses risks to a developing fetus and is the most common cause of birth defects and developmental disabilities, with FASDs being one of the most severe outcomes (Dejong et al., 2020). Other adverse health effects associated with alcohol consumption include miscarriage, preterm labor, and stillbirth (Dejong et al., 2020).
The article focuses on the recommendations and measures to be taken to prevent alcohol exposure in pregnant women. They include screening, structured questionnaires aimed to determine prenatal alcohol use and identify women with drinking problems, and medical interventions to encourage abstinence (Dejong et al., 2020). The article stresses the importance of better understanding the mechanism of alcohol’s impact on pregnancy, early identification, and the development of therapeutic strategies to mitigate its effects to improve maternal and fetal outcomes.
In most articles, the issue of alcohol consumption recommendations is addressed. It is stated that despite conflicting and inconclusive evidence on the negative effects of small amounts of alcohol on fetus development, public health recommendations are consistent (Roozen et al., 2018). According to Dejong et al. (2020), the American College of Obstetricians and Gynecologists, Center for Disease Control (CDC), Surgeon General, and various international medical societies recommend complete abstinence during pregnancy. The common principle is that abstinence is the safest approach to prevent any possible risks to the unborn child.
However, there are studies that question whether the complete abstinence recommendation is adequate and should be universally applied. Roozen et al. (2018) argue that special attention should be given to specific risk groups, such as heavy drinking women, for whom complete abstinence does not seem feasible. As they may not be able to completely eliminate their alcohol intake due to personal or environmental factors, the complete abstinence recommendation seems unrealistic and unethical (Roozen et al., 2018). For them, the more achievable goal would be to moderate their alcohol intake enough to decrease the risk of FASD.
The article by Armstrong (2017) discusses the recommendations from the perspective of women who experience anxiety and stress after realizing that they have been drinking at the early stage of pregnancy. It claims that complete abstinence advice instills in women the idea that any drinking is as risky as heavy drinking (Armstrong, 2017). Armstrong argues that the recommendations should be evidence-based, and the current evidence does not suggest that low levels of alcohol consumption have serious negative effects on the fetus. FAS occurs mainly in babies born to women who drink heavily during pregnancy, while occasional drinking does not have such an effect and should not be stigmatized.
The study by Mamluk et al. (2017) aims to determine the effects of low-to-moderate in order to understand whether the current recommendations need to be updated. It claims that there is not enough evidence to suggest whether light alcohol consumption during pregnancy affects infant outcomes and what is the safe limit of alcohol consumption (Mamluk et al., 2017). Based on the results of the study, it can be concluded that the current complete abstinence recommendations are a precautionary measure. The lack of evidence creates confusion for health professionals and pregnant women and contributes to inconsistent guidance and advice.
Conclusion
In order to address the issue of alcohol abuse during pregnancy, the interprofessional team should consider the current trends and recommendations on maternal alcohol consumption. The literature on the subject suggests that drinking during pregnancy has serious negative effects on the fetus that also influence early child development. The risks increase depending on the level of alcohol consumption. Although there is not enough evidence to suggest that light drinking during pregnancy is as risky as heavy drinking, most health organizations recommend complete abstinence during pregnancy. It is the recommendation that should be observed when developing prevention strategies, taking measures to increase public awareness, and addressing individual patients’ needs.
References
Armstrong, E. M. (2017). Making sense of advice about drinking during pregnancy: Does evidence even matter? The Journal of Perinatal Education, 26(2), 65–69.
Dejong, K., Olayeai, A., & Lo, J. (2020). Alcohol use in pregnancy. Clinical Obstetrics and Gynecology, 62(1), 142–155. Web.
Fetal Alcohol Spectrum Disorders (FASDs). (2020). Centers for Disease Control and Prevention. Web.
Mamluk, L., Edwards, H., Savovic, J., Leach, V., Jones, T., Moore, T., Ijaz, S., Lewis, S., Donovan, J., Lawlor, D., Smith, G., Fraser, A., & Zuccolo, L. (2017). Low alcohol consumption and pregnancy and childhood outcomes: Time to change guidelines indicating apparently ‘safe’ levels of alcohol during pregnancy? A systematic review and meta-analyses. BKJ Open, 7(7), 1–13.
Roozen, S., Peters, G.-J., Kok, G., Townend, D., Nijhuis, J., Koek, G., & Curfs, L. (2018). Systematic literature review on which maternal alcohol behaviors are related to fetal alcohol spectrum disorders (FASD). BMY Open, 8, 1–12.
Subramoney, S., Eastman, E., Adnams, C., Stein, D., & Donald, K. (2018). The early development outcomes of prenatal alcohol exposure: A review. Frontiers in Neurology, 9, 1108.