News Articles

Foetal Alcohol Syndrome

Publish Date: 01 May 2013

Authored by: James Halliday

I have followed the health and alcohol debate for well over 30 years, indeed closer to 40 years. I have attended symposia, including a major event in Sydney in the 1980s organised by the Australian Medical Friends of Wine that assembled a marvelous list of speakers from many parts of the world, none of whom with any financial links to any producer or marketer of alcohol; I have addressed the National Press Club in Canberra on the very issue (not very well, I fear); have written many articles on the health pros and cons of wine; and subscribed to a US magazine devoted to demolishing the unsubstantiated drivel disseminated by the murky Centre for Science in the Public Interest, in particular its grossly biased jihad on the subject of Foetal Alcohol Syndrome.

The emotive power of a warning to pregnant women that any consumption of wine may cause harm to your unborn child evokes the primeval response of protection at all cost. It is deeply embedded across the human and animal kingdoms, and any erosion of that instinct must be prevented.

In the wake of the massive change across society in the western world (though less so in the eastern world) which has shown how smoking dramatically shortens life expectancy, attention has turned to alcohol, and to the easy target of mothers-to-be.

It has so alarmed the Winemakers’ Federation of Australia (WFA) that it has endorsed the pregant woman pictogram on wine labels (still yet to be mandated by Federal regulations), and likewise supports the National Health and Medical Research Council (NHMRC) recommendation that for women who are pregnant, planning a pregnancy or breastfeeding, the safest option is not to drink alcohol.

I do not speak for WFA, and do not serve on any of its committees, so the views I express are min, and I am free to disassociate myself from its policies in this arena. There are always political sub-agendas in matters such as this, but I am free to be politically incorrect.

So, I am totally opposed to WFA’s position, and I'll explain why. First, the opaque nature of the warnings, which all turn around the word ‘may’. Next, and more importantly, three papers published over the past five years add significant research data to support what the overwhelming majority of moderate consumers of wine intuitively believe.

In the first paper, three academics at Oxford University’s National Perinatal Epidemiology Unit reviewed 3543 papers published between 1970 and 2005, their funding provided by the UK Department of Health. They searched for studies that compared a daily intake of one glass of wine a day by pregnant women with those who consumed no alcohol.

They screened the data for miscarriage, intrauterine growth restriction (IUGR), premature birth, low birthweight, and berth defects including foetal alcohol syndrome (FAS). Their conclusions were (and I quote):
‘This systematic review found no convincing evidence of adverse effects of prenatal alcohol exposure at low-moderate levels of exposure. However, weaknesses in the evidence preclude the conclusion that drinking at these levels during pregnancy is safe.’

They expanded on this when they wrote:
‘In summary, from the existing evidence, it is difficult to determine whether there was any adverse effect on pregnancy outcome associated with low-moderate levels of prenatal alcohol consumption. Although there was no consistent evidence of adverse effect, this does not mean that it is safe for women to drink at these levels during pregnancy; the existing evidence is inconclusive.

Small amounts of alcohol appeared to have a mildly protective effect for several of the outcomes, including stillbirth, IUGR and birthweight, i.e. babies of women who abstained had poorer outcomes than babies of women who drank small amounts of alcohol during pregnancy. One possible explanation of this may be the “healthy drinker effect” in which women with a poor obstetric history were more likely to abstain from drinking alcohol. It may also be that low-moderate drinking during pregnancy is genuinely beneficial, but further research is required to test this hypothesis rigorously.’

More recent studies have appeared in several journals cited by Decanter Magazine. The first is reported in BJOG: An International Journal of Obstetrics and Gynaecology. This study took data from a national study of 10,000 infants born in the UK between 2000 and 2002.

The study assessed whether light drinking – defined as to two units of alcohol or the equivalent of one 175ml glass of wine per week – in pregnancy was linked to unfavourable developmental outcomes in seven-year-old children.

Researchers from University College London used information on over 10,000 seven-year-olds, looking at their social and emotional behaviour as well as their cognitive performance in maths, reading and spatial skills.

The sample was made up of mothers who never drank, those who did drink but gave up during pregnancy, light drinkers, and those who drank more during pregnancy than otherwise.

Children who were born to light-drinking mothers were found to have lower (ie better) behavioural difficulties scores than those born to abstainers. The difference was insignificant except in the case of boys, the study says. Furthermore, BJOG reports, ‘children born to light drinkers were also found to have more favourable (higher) cognitive test scores compared to children born to non-drinkers, but these differences mostly lost statistical significance, except for reading and spatial skills in boys.’

The report concludes that drinking lightly during pregnancy has no adverse affect on children up to the age of seven. Indeed, children born to light drinkers appeared to have more favourable developmental profiles than those born to abstainers. But, the paper says, when statistically adjusted the differences are negligible.

Another study, the Avon Longitudinal Study of Parents and Children (ALSPAC), using similar samples and the similar tests but on 11-year-olds, came to very similar conclusions. ‘Light drinking in pregnancy does not appear to be associated with clinically important adverse effects for mental health and academic outcomes at age of 11 years,’ it said.

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