When is alcohol most dangerous during pregnancy

Alcohol and pregnancy: MedlinePlus Medical Encyclopedia

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Pregnant women are strongly urged not to drink alcohol during pregnancy.

Drinking alcohol while pregnant has been shown to cause harm to a baby as it develops in the womb. Alcohol used during pregnancy may also lead to long-term medical problems and birth defects.

When a pregnant woman drinks alcohol, the alcohol travels through her blood and into the baby's blood, tissues, and organs. Alcohol breaks down much more slowly in the baby's body than in an adult. That means the baby's blood alcohol level remains increased longer than the mother's. This can harm the baby and can sometimes lead to lifelong damage.

DANGERS OF ALCOHOL DURING PREGNANCY

Drinking a lot of alcohol during pregnancy can lead to a group of defects in the baby known as fetal alcohol syndrome. Symptoms can include:

Behavior and attention problems
Heart defects
Changes in the shape of the face
Poor growth before and after birth
Poor muscle tone and problems with movement and balance
Problems with thinking and speech
Learning problems

These medical problems are lifelong and can range from mild to severe.

Complications seen in the infant may include:

Cerebral palsy
Premature delivery
Pregnancy loss or stillbirth

HOW MUCH ALCOHOL IS SAFE?

There is no known "safe" amount of alcohol use during pregnancy. Alcohol use appears to be the most harmful during the first 3 months of pregnancy; however, drinking alcohol anytime during pregnancy can be harmful.

Alcohol includes beer, wine, wine coolers, and liquor.

One drink is defined as:

12 oz of beer
5 oz of wine
1.5 oz of liquor

How much you drink is just as important as how often you drink.

Even if you don't drink often, drinking a large amount at one time can harm the baby.
Binge drinking (5 or more drinks on one sitting) greatly increases a baby's risk of developing alcohol-related damage.
Drinking moderate amounts of alcohol when pregnant may lead to miscarriage.
Heavy drinkers (those who drink more than 2 alcoholic beverages a day) are at greater risk of giving birth to a child with fetal alcohol syndrome.
The more you drink, the more you raise your baby's risk for harm.

DO NOT DRINK DURING PREGNANCY

Women who are pregnant or who are trying to get pregnant should avoid drinking any amount of alcohol. The only way to prevent fetal alcohol syndrome is to not drink alcohol during pregnancy.

If you did not know you were pregnant and drank alcohol, stop drinking as soon as you learn you are pregnant. The sooner you stop drinking alcohol, the healthier your baby will be.

Choose nonalcoholic versions of beverages you like.

If you cannot control your drinking, avoid being around other people who are using alcohol.

Pregnant women with alcoholism should join an alcohol abuse rehabilitation program. They should also be followed closely by a health care provider.

The following organization may be of help:

Substance Abuse and Mental Health Services Administration -- 1-800-662-4357 www.findtreatment.gov
National Institute on Alcohol Abuse and Alcoholism -- www.rethinkingdrinking.niaaa.nih.gov/about.aspx

Drinking alcohol during pregnancy; Fetal alcohol syndrome - pregnancy; FAS - fetal alcohol syndrome; Fetal alcohol effects; Alcohol in pregnancy; Alcohol related birth defects; Fetal alcohol spectrum disorders

Prasad MR, Jones HE. Substance abuse in pregnancy. In: Resnik R, Lockwood CJ, Moore TR, Greene MF, Copel JA, Silver RM, eds. Creasy and Resnik's Maternal-Fetal Medicine: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 68.

Prasad M, Metz TD. Substance use disorder in pregnancy. In: Landon MB, Galan HL, Jauniaux ERM, et al, eds. Gabbe's Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 8.

Wallen LD, Gleason CA. Prenatal drug exposure. In: Gleason CA, Juul SE, eds. Avery's Diseases of the Newborn. 10th ed. Philadelphia, PA: Elsevier; 2018:chap 13.

Updated by: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Alcohol Risk to Fetus Is Highest at End of 1st Trimester

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Any drinking during pregnancy increases the odds of fetal alcohol syndrome, but the risk to the fetus is highest if a pregnant woman drinks during the second half of her first trimester of pregnancy, a new study finds.

For every one drink per day increase in alcohol intake during that crucial period, a woman’s baby was 25 percent more likely to have an abnormally shaped lip, 12 percent more likely to have a smaller-than-normal head and 16 percent more likely to have low birth weight — all early signs of fetal alcohol syndrome, the study showed.

"The take-home message is that there's not a low threshold level below which drinking alcohol doesn't raise the risk," of fetal alcohol syndrome, said study author Dr. Christina Chambers of the University of California, San Diego. "This supports the surgeon general's recommendation that drinking be avoided entirely."

The new findings were published today (Jan. 16) in the journal Alcoholism: Clinical and Experimental Research.

Pregnancy and substances

Chambers and her colleagues recruited the 992 participants for their study from pregnant women who called a California telephone help line that answers questions on substances that could be harmful during pregnancy — including not only alcohol and illegal drug intake, but also chemical exposures and prescription drug safety.

Women who called the line between 1978 and 2005 were asked if they'd like to participate in a follow-up study. All were contacted by phone for follow-up on levels of alcohol consumption throughout pregnancy, and their infants were screened after birth with a full physical exam.

"You're dealing with an issue here in which it's really hard to get good information on both exposure and outcomes," Chambers said. "Most kids don't get diagnosed until they're in school and having learning difficulties," Chambers said.

In the study, the doctors who examined the infants did not know whether the child had been exposed to alcohol or some other substance in utero.

Higher alcohol consumption of a mother during pregnancy, the researchers found, was linked with a higher chance of a baby having physical characteristics associated with fetal alcohol syndrome, including abnormal head size and altered shape of the eyes and lips. Such symptoms suggest the presence of related neurological problems.

Binge drinking, which involves drinking more than four drinks on a single occasion, didn't affect the risk — the total number of drinks a woman had while pregnant was more predictive of a baby's risk of fetal alcohol syndrome, the researchers found.

During the second half of the first trimester, every one drink per day increase in alcohol intake raised the odds of a certain physical abnormality — in the upper lip — by 25 percent. In contrast, the average number of drinks during the third trimester seemed to affect only the baby's length at birth.

Different mothers, different risk

There are still questions about what factors may influence the risk of fetal alcohol syndrome, Chambers said. "Even if you find 10 women who drink a quart of vodka a day, maybe only five of those babies will have full-blown fetal alcohol syndrome, because there are other factors that influence the risk."

Those factors could include diet, body fat levels, genetic differences, or other environmental exposures, said Ed Riley of San Diego State University, who also studies prenatal exposure to alcohol.

Other studies have found little or no affect on babies born to mothers who drank only occasionally — having one or two drinks a week — throughout pregnancy. But most previous studies relied on mothers' recall of their drinking after birth, whereas in the new study, researchers interviewed women periodically throughout pregnancy.

Riley said the new study adds weight to the argument against drinking any alcohol during pregnancy, and emphasized that the new study showed that any alcohol consumption led to an increased risk. "They showed no threshold effect," he said, "so the more you drank, the greater probability of having an adverse outcome."

Future studies, he said, could follow the same method to look at not only physical abnormalities of the infants, but neurological problems as well. "We know that the brain is very sensitive to prenatal alcohol exposure," he said.

Pass it on: Any amount of alcohol consumption during pregnancy raises the chances that the fetus will develop birth defects, new research concludes. The risk is highest when pregnant women drink during the second half of the first trimester.

This story was provided by MyHealthNewsDaily, a sister site to LiveScience. Follow MyHealthNewsDaily on Twitter @MyHealth_MHND.

ALCOHOL AND PREGNANCY - Outpatient medical facility

The fact that you can not drink alcohol during pregnancy is known to most. However, different situations can arise in life: one woman is planning a pregnancy, continuing to drink alcohol on holidays in order to avoid uncomfortable questions; another drinks a glass of wine, unaware that she is already pregnant; the third during pregnancy cannot cope with the desire to drink beer, believing that "a little bit is possible." Let's look at these situations in more detail.

Alcohol consumption during pregnancy planning.

Alcohol is a toxin that adversely affects the human reproductive system. In women, alcohol consumption leads to disruption of the menstrual cycle and hormonal balance, which significantly affects the ability to conceive. There are also opinions that even episodic alcohol consumption can have a negative effect on the eggs, leading to their inferiority. Also, alcohol consumption affects the male reproductive system, significantly reducing the number of sperm capable of fertilization. Therefore, a couple planning a pregnancy should stop drinking alcohol at least 3 months in advance in order to increase the likelihood of conception.

Drinking alcohol in the first weeks after conception.

Without a special examination, a woman usually discovers the fact of pregnancy at 3 weeks after conception, when the next menstruation does not come. By this time, the embryo has already firmly attached to the uterine cavity and began to receive nutrition from the mother's blood. If negative factors, including alcohol, affect him before the moment of attachment, then this will lead to his rejection and death, and he will simply leave the uterus with the next menstruation. Thus, a woman may not know that she was pregnant.

According to most scientists, if alcohol did not disrupt the attachment process and the embryo continued to develop, then this would not lead to the formation of malformations in it. Thus, alcohol accidentally drunk during the first two weeks after conception will either lead to the termination of pregnancy or will not affect its further development.

Alcohol use in early pregnancy.

As mentioned above, as early as the 3rd week after conception, the embryo begins to come into contact with maternal blood. This means that all the substances in the mother's blood come to him. including ethyl alcohol. From the 3rd to the 13th week of development, the laying of all the main systems of the body of the unborn child occurs and the effect of alcohol no longer leads to rejection and death of the embryo, but to the formation of malformations and deformities of the nervous, cardiovascular, and digestive systems.

Alcohol use in late pregnancy.

The negative impact of alcohol on the course of pregnancy is observed after the 13th week. Ethanol and its decay products lead to spasm of the vessels of the placenta and umbilical cord, impairing the delivery of oxygen and nutrients, leading to a delay in the development of the fetus, disruption of its nervous system and brain. A prolonged lack of oxygen can even lead to the death of a child. Violation of the nervous system in the prenatal period leads to problems in the later life of the child - such children have reduced stress resistance, problems in learning, in communication, a tendency to mental illness and alcohol consumption.

The systematic use of alcohol during pregnancy leads to the formation of fetal alcohol syndrome in a child - this is a complex of physical, mental and intellectual abnormalities in a child that cannot be treated.

Thus, alcohol and pregnancy are not compatible and it is necessary to refuse it at the planning stage.

You need to understand that one glass of wine, drunk before 2 or after 13 weeks of pregnancy, most likely will not lead to disastrous consequences, but is it worth the risk? Remember that your child will “drink” half of this glass.

What happens to the child if the mother drinks alcohol?

03.12.2019

Alcohol and pregnancy are incompatible - doctors do not get tired of talking about this to expectant mothers. But pregnant women sometimes allow themselves to skip a glass of wine, thinking that nothing bad will come of such an amount. However, alcohol can interfere with fetal development at any stage of pregnancy, even very early.

Studies show that excessive (four or more drinks at a time) and/or regular drinking by an expectant mother puts the fetus at the greatest risk of serious problems. But even a smaller amount of alcohol can be harmful, since there is no safe dose.

Alcohol easily passes from the mother's bloodstream into the child's bloodstream, which can affect the development of the brain and other vital organs, structures and physiological systems of the baby's body, leading to malformations that can begin in a child in early childhood and last a lifetime. The most profound effects of prenatal alcohol exposure are brain damage and associated behavioral and cognitive impairment.

Scientists define a wide range of effects and symptoms caused by prenatal alcohol exposure, termed "fetal alcohol spectrum disorders". These include conditions such as intrauterine alcohol syndrome, alcohol-related nervous system disorder, and alcohol-associated birth defects. All these cases have one common feature - damage to the central nervous system (CNS) as a result of prenatal alcohol exposure to the fetus.

The effect of alcohol on the CNS may be structural (eg, reduction in brain size, changes in certain areas of the brain) or functional (eg, cognitive and behavioral deficits, motor and coordination problems). Extended studies using modern imaging techniques (MRI, CT, etc.) have revealed differences in the structure and activity of the brain that are consistent with neuropsychological testing data, including a disorder in processing information from the senses, changes in cognitive processes and behavior in adults with the disorder alcohol spectrum of the fetus compared to healthy people.

The most profound effects of prenatal alcohol exposure are brain damage and associated impairments in behavioral and cognitive functioning.

How are the disorders different?

Fetal alcohol syndrome was the first form of alcohol spectrum disorder and is still the most well-known syndrome. It manifests itself with excessive alcohol consumption by the expectant mother during the first trimester of pregnancy. The impact of harmful substances on the fetus can disrupt the normal development of not only the brain, but also the face. Thus, in addition to CNS developmental anomalies, the child will have a specific pattern of three facial anomalies: narrow eye openings, a smooth area between the lip and nose (compared to a normal ridge), and a thin upper lip. Also, the baby may experience growth deficiency in utero and (or) after birth.

Partial fetal alcohol syndrome includes only some of the characteristics listed above.

An alcohol-related disorder of the nervous system is characterized by disorders of the central nervous system, which may be structural or functional. Functional impairments include a complex pattern of cognitive (mental) or behavioral problems that do not correspond to the standard level of development at any given age in a child. At the same time, the reasons for this discrepancy cannot be explained by factors other than prenatal alcohol exposure. Facial abnormalities and growth retardation should not be present.

Alcohol-related birth defects include heart, kidney, bone, and other malformations; difficulties with vision and hearing; decreased function of the immune system. They are rarely considered separately, but rather are a secondary disorder that accompanies other fetal alcohol spectrum disorders.

What will happen to the baby in the future?

Every person whose mother may have abused alcohol during pregnancy experiences a combination of everyday turmoil that includes medical, behavioral, educational, or social problems in the following areas:

learning and memorization;
understanding and following directions;
ability to hold attention;
the ability to control emotions;
communication and socialization;
performing daily life skills (eg, eating, bathing, counting money, taking care of personal safety).

People with fetal alcohol spectrum disorder are more likely than others to make bad decisions, repeat the same mistakes, trust the wrong people, and have difficulty understanding the consequences of their actions. They are also more prone to disorders such as attention deficit hyperactivity disorder, depression, impulse control problems, alcoholism and drug addiction.

People with fetal alcohol spectrum disorder are more likely than others to make bad decisions, repeat the same mistakes, trust the wrong people, and have difficulty understanding the consequences of their actions.

Risk factors

Of course, it is impossible to argue that just one sip of champagne during pregnancy can provoke many anomalies in the development of the fetus and affect the psyche of the unborn child. But the medical community recommends completely avoiding any dose of alcohol during pregnancy.

There are risk factors that contribute to the development of undesirable consequences:

amount of alcohol a pregnant woman drinks at a time;
frequency of drinking by a pregnant woman;
the stage of pregnancy at which a woman drinks alcohol, and how much she drinks during the formation of one or another body system in the fetus.

Prenatal alcohol exposure to children can be exacerbated if their mothers are malnourished, overweight, underweight, or smoke…
In addition, studies show that prenatal alcohol exposure affects children more if their mothers live in unfavorable conditions and experience high levels of stress. These may include, for example, social isolation, living in a society where excessive drinking is common and acceptable, and living in a society where resources for prenatal care are limited.

The prenatal effects of alcohol on children can be exacerbated if their mothers are malnourished, overweight, underweight, smoke…

How to help a child?

First aid for a child is the refusal of the expectant mother from alcohol. But if during pregnancy a woman allowed herself to drink alcohol and the child has symptoms of a fetal alcohol spectrum disorder, special tactics of education and training should be applied.