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Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Obstet Gynecol. May 10, 2016; 5(2): 162-174
Published online May 10, 2016. doi: 10.5317/wjog.v5.i2.162
Risks and guidelines for the consumption of alcohol during pregnancy
Ulrik Schiøler Kesmodel
Ulrik Schiøler Kesmodel, Department of Obstetrics and Gynaecology, Herlev University Hospital, 2730 Herlev, Denmark
Ulrik Schiøler Kesmodel, Institute for Clinical Medicine, University of Copenhagen, 2200 Copenhagen N, Denmark
Author contributions: Kesmodel US performed the literature search and wrote the paper.
Conflict-of-interest statement: The author declares no conflict of interest for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Ulrik Schiøler Kesmodel, Professor of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, Herlev University Hospital, Herlev Ringvej, 2730 Herlev, Denmark. ulrik.schioeler.kesmodel@regionh.dk
Telephone: +45-3868-1612
Received: June 28, 2015
Peer-review started: July 5, 2015
First decision: September 17, 2015
Revised: November 13, 2015
Accepted: January 21, 2016
Article in press: January 22, 2016
Published online: May 10, 2016
Abstract

Daily average intake of alcohol during pregnancy has consistently been associated with short term adverse outcomes such as miscarriage, preterm birth and intrauterine growth restriction, a large variety of malformations, as well as long term adverse outcomes such as foetal alcohol syndrome, mental retardation and general impairment of cognitive functions including intelligence, attention, learning abilities as well as social and behavioural functions. Weekly average consumption and alcohol binge drinking (usually defined as ≥ 5 drinks on a single occasion) independently of high daily average intake has not been consistently associated with short and long term adverse outcomes. Health authorities in most countries recommend that pregnant women completely abstain from alcohol. Even so, many health professionals including doctors, midwives and nurses do not provide information to pregnant women in accordance with the official recommendations, although a large proportion of women of child bearing age and pregnant women drink alcohol, especially before recognition of pregnancy. The discrepancy between guidelines and the information practice of health personnel is likely to continue to exist because guidelines of abstinence are not clearly evidence-based and not in line with current focus on autonomy and informed choice for patients, and because guidelines do not consider the everyday clinical communication situation.

Keywords: Alcohol, Binge drinking, Pregnancy, Adverse pregnancy outcomes, Neuropsychological development

Core tip: Daily average consumption of alcohol during pregnancy has been systematically associated with short and long-term adverse outcomes, while lower weekly average consumption and alcohol binge drinking independently of high daily average intake has not. Health authorities in most countries recommend that pregnant women abstain from alcohol. Even so, many health professionals do not provide information to pregnant women in accordance with the official recommendations. The discrepancy between guidelines and the information practice of health personnel is likely to continue, because guidelines of abstinence are not clearly evidence-based and not in line with current focus on patient autonomy.