The Dangers of Drinking for Two: Alcohol and Birth Defects
by Celeste M. Krauss, MD
Fetal alcohol exposure is one of the leading causes of birth defects and developmental disorders. Estimates place the number of US children affected by fetal alcohol exposure at almost 1 case for every 1,000 live births.
Pick up a bottle of beer, wine or hard liquor, and you'll see the following on the label:
GOVERNMENT WARNING: ACCORDING TO THE SURGEON GENERAL, WOMEN SHOULD NOT DRINK ALCOHOLIC BEVERAGES DURING PREGNANCY BECAUSE OF THE RISK OF BIRTH DEFECTS.
The stark wording is an attempt to prevent fetal alcohol syndrome (FAS) and other fetal alcohol spectrum disorders related to drinking during pregnancy.
Alcohol and Pregnancy Don't Mix
When a woman drinks alcoholic beverages, the alcohol in her blood crosses the placenta freely and enters the embryo or fetus through the umbilical cord. Children affected by prenatal exposure to alcohol may suffer lifelong consequences, including intellectual and physical disabilities, and behavioral problems.
All drinks containing alcohol can hurt an unborn baby. A standard 12-ounce can of beer has the same amount of alcohol as a 5-ounce glass of wine or a 1½-ounce shot of straight liquor. In addition, some alcoholic drinks, such as malt beverages, wine coolers, and mixed drinks, often contain more alcohol than a 12-ounce can of beer. There is no known safe amount of alcohol that a woman can drink while pregnant.
Any time a pregnant woman participates in regular drinking, she increases her chance of having a miscarriage and puts her unborn child at risk. Problems associated with prenatal exposure to alcohol can occur in the first few weeks of pregnancy, before a woman may even knows that she is pregnant.
Findings from the Centers for Disease Control and Prevention (CDC) show that about 1 in 8 pregnant women reported alcohol use during pregnancy.
Fetal Alcohol Spectrum Disorder (FASD)
FASD includes a broad range of defects and deficits caused by drinking alcohol during pregnancy. FASD includes:
Children with FASD may have all or some of the following:
Children with ARBD have malformations of the skeletal system and major organ systems. They may have defects of the heart, kidneys, bones, and/or auditory systems.
Fetal alcohol sydrome (FAS) is the most severe form and is characterized by:
Common Questions About Alcohol and Pregnancy
How are birth defects caused by drinking alcohol during pregnancy?
The exact mechanism(s) by which alcohol damages the fetus and critical times of exposure are not known. Exposure during the first trimester results in the structural defects, such as facial changes, characteristic of FASD, whereas the growth and central nervous system problems could occur from alcohol use during any time in pregnancy.
Does drinking during pregnancy always result in FASD?
Not all women who drink during pregnancy will have a child with FASD. However, avoiding all alcohol during pregnancy ensures the developing baby will not have FASD or any other alcohol-related outcomes.
How much alcohol is reasonably acceptable to drink without running the risk of a child developing FASD?
There is no known safe amount of alcohol that a woman can drink while pregnant. Any time a pregnant woman engages in regular drinking, she increases her chance of having a miscarriage and puts her unborn child at risk for growth deficiencies, learning disabilities, and behavioral problems. In general, FASD severity increases with the amount of alcohol consumed.
Is FASD hereditary or is there a hereditary disposition to getting it?
FASD is not hereditary. It can only occur if a woman drinks alcohol during her pregnancy. Currently, it is not known why some children are more likely to develop FASD than other children if their mothers drank during pregnancy.
Can FASD be treated? How?
FASD cannot be treated, cured, or reversed. It is a condition that affects every aspect of a child's life and the lives of their families. Lifelong therapies and interventions including coordinating medical, educational, and social services will be needed to manage the effects of FASD. The earlier these services are employed, the better the outcomes may be
The easiest way to prevent FASD is to abstain from all alcohol use during pregnancy. Any amount of alcohol consumed during pregnancy is potentially dangerous to an unborn baby. If a your are a pregnant woman who is drinking, it is never too late to stop. The sooner a woman quits drinking, the better it will be for both her and her baby. If a woman is not able to quit drinking, she should contact her local social service agency or health plan for alcohol abuse treatment, if needed. If a woman is not yet pregnant, she should use an effective form of birth control until her drinking is under control.
Mothers aren't the only ones who can help prevent FASD, though. Significant others, family members, schools, social organizations, and communities alike can help prevent FASD through education and intervention.
National Institute on Alcohol Abuse and Alcoholism
National Organization on Fetal Alcohol Syndrome (NOFAS)
The Society of Obstetricians and Gynaecologists of Canada
Alcohol during pregnancy. March of Dimes website. Available at:
...(Click grey area to select URL)
Updated March 2016. Accessed July 8, 2016.
Alcohol use in pregnancy. Centers for Disease Control and Prevention website. Available at:
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Updated April 17, 2014. Accessed July 8, 2016.
Fetal alcohol spectrum disorders. American Academy of Pediatrics Healthy Children website. Available at: https://www.healthychildren.org/English/health-issues/conditions/chronic/Pages/Fetal-Alcohol-Spectrum-Disorders.aspx. Updated November 21, 2015. Accessed July 8, 2016.
Fetal alcohol spectrum disorder. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Updated June 10, 2016. Accessed July 8, 2016.
Where we stand: alcohol during pregnancy. American Academy of Pediatrics Healthy Children website. Available at: https://www.healthychildren.org/English/ages-stages/prenatal/Pages/Where-We-Stand-Alcohol-During-Pregnacy.aspx. Updated October 8, 2015. Accessed July 8, 2016.
Last reviewed July 2016 by Michael Woods, MD
Last Updated: 7/8/2016
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