Total abstinence is the only way to protect the unborn baby against Foetal Alcohol Syndrome

Sep 15 2004

Is there a safe level of alcohol consumption during pregnancy? Biochemist Kathy Kitson says the answer is no – total abstinence is the only way to protect the unborn baby against Foetal Alcohol Syndrome.

But New Zealand is not officially recognising the risk, says Associate Professor Kitson of Massey University.

“In the United States Foetal Alcohol Syndrome is now considered to be the most common non-hereditary cause of mental retardation. There is not a clear threshold below which we can be certain that alcohol has no effect on a developing baby; conversely, not every baby exposed to high alcohol concentrations during development shows some or all of the characteristic symptoms of full FAS.

“However, research indicates that relatively modest alcohol intakes of as little as one to two drinks per day during pregnancy may have effects on learning ability and behaviour in children.”

Dr Kitson says a new term, Foetal Alcohol Spectrum Disorder (FASD), has emerged to describe the full spectrum of effects of alcohol on foetal development. Characteristic problems include poor judgement and impulse control, an inability to foresee consequences and to learn from previous experience, inappropriate or immature behaviour and speech, language and other communication problems. Behavioural changes may also present as attention deficit hyperactivity disorder.

Dr Kitson says the United States recognised the dangers of any drinking to the foetus more than 20 years ago. They have strong recommendations against any consumption during pregnancy. While the Alcohol Advisory Council and the College of Midwives support abstinence during pregnancy, New Zealand officially follows the lead of the United Kingdom and Australia, which suggest there is “no conclusive evidence of adverse effects in either growth or IQ at levels of consumption below 120gms (15 units) per week. Nonetheless it is recommended that women should be careful about alcohol consumption in pregnancy and limit this to no more than one standard drink per day” - Royal College of Obstetricians and Gynaecologists in the United Kingdom.

The Australian Alcohol Guidelines 2003 recommend pregnant women should consider not drinking at all; but if they choose to drink, they “should have less than seven standard drinks over a week, and no more than 2 standard drinks (spread over at least two hours) on any one day”.

The problem with these recommendations, says Dr Kitson, is that they suggest that there is a ‘safe’ level of consumption adequate to avoid overt, measurable deficits in growth and mental ability. “There is no scientific evidence to show conclusively that consumption of one to two drinks per day during pregnancy is completely safe, and some evidence to suggest that it may not be.

“The simple solution, therefore, is an unequivocal recommendation of abstinence: If you are pregnant, planning to become pregnant, or in a situation where you could become pregnant, don’t drink alcohol.”

Dr Kitson says there has been little research done in New Zealand to determine the level of FAS in New Zealand children. Dr Kitson recently supervised the PhD research of Sherly Parackal that surveyed New Zealand midwives about the drinking habits of their pregnant clients. Dr Parackal found New Zealand mothers drink two to three times more on average during pregnancy than their American sisters. Teenage mothers consumed alcohol in pregnancy at eight times the average rate in the United States (the survey was conducted before the drinking age was lowered to 18). Data from studies in the United States suggest FAS and FASD rates of about 0.3-1.5 per 1,000 births. Dr Parackal’s results would indicate a significantly higher risk for FAS and FASD in New Zealand than in the United States, says Dr Kitson.