Light drinking during pregnancy may be safe

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1. Maternal self-reported light drinking (1-2 drinks per week) in pregnancy was not associated with behavioral or cognitive deficits in 7-year-old boys and girls. 

2. Baseline differences in exposure groups existed such that maternal light drinkers were more educated, wealthier and older than women who abstained. They were also less likely to smoke during pregnancy and more likely to have a planned pregnancy. 

Evidence Rating Level: 2 (Good) 

Study Rundown: This nationally representative cohort study found that maternal self-reported light drinking (1-2 drinks per week) in pregnancy was not associated with

behavioral or cognitive deficits in 7-year-old boys and girls. In fact, researchers found that 7-year old boys born to light drinkers (1-2 drinks per week) had fewer teacher-rated behavioral difficulties and higher reading and spatial skill scores on cognitive testing than boys born to abstinent mothers. This finding calls attention to baseline differences in the exposed and unexposed groups: maternal light drinkers were more socioeconomically advantaged and less likely to smoke than abstinent mothers, suggesting that children born to mothers who drank in pregnancy may have benefited from other advantages that could influence results despite multivariate-adjusted models and matched analysis.

Baseline differences in socioeconomic and smoking status between exposure groups may bias results toward the null. Additional limitations include possible recall and social desirability biases during maternal self-report of exposure. Strengths of the study include a large national sample, matched controls and the use of validated assessment tools. Future investigations could employ a prospective design, assess the impact of timing of drinking, and evaluate whether this null association holds in other populations who may have less socioeconomic differences, such as the in vitro fertilization (IVF) population.

Click to read the study in the British Journal of Obstetrics & Gynecology 

Relevant Reading: Guidelines for pregnancy: What’s an acceptable risk, and how is the evidence (finally) shaping up?

Study Author, Dr. Yvonne Kelly, PhD, talks to 2 Minute Medicine: University College of London, Professor of Lifecourse Epidemiology, Department of Epidemiology and Public Health.

“We have known for a long time that exposure to heavy alcohol consumption during pregnancy is linked to a range of developmental problems in children and young people. However, the question of whether low levels of alcohol consumption are harmful in terms of children’s development has until recently been little studied. Numerous studies (including ours) conducted over the last few years suggest that low levels of alcohol are not linked to detrimental developmental outcomes in young children. Many things influence children’s health and development and we need to better understand the complexities at play – it is possible that developmental problems linked to exposures in early life may emerge later in childhood and adolescence, and it is important to continue following these and other study populations in the coming years.”

In-Depth [prospective cohort study]: This study explored the relationship between light drinking (1-2 drinks per week) and behavioral and cognitive outcomes in 7-year-old-children. Among 9,980 singleton infants from the Millennium Cohort Study whose mothers reported abstinence (n=7061, 71%) or light drinking (n=2919, 29%) during pregnancy were included in analysis. Children born to light drinkers were matched on the basis of socioeconomic and psychosocial factors with ≥1 child born to abstinent mothers. Outcomes assessed include behavioral difficulties and reading, math and spatial skills.

Children born to mothers who drank lightly during pregnancy were not more likely to have behavioral or cognitive deficits when compared to matched controls born to abstinent mothers. In fact, boys born to light drinkers had fewer teacher-rated behavioral difficulties (%SD -13.9) and higher performance in reading (%SD 20.9) and spatial skills (%SD 16.2). Maternal light drinkers were less likely to smoke during pregnancy and were more educated, wealthy, older, and more likely to have a planned pregnancy than women who abstained from drinking (all p<0.001).

By Denise Pong and Leah Hawkins

More from this author: Significant racial disparities in preterm births in infants conceived by IVF, Internal monitors associated with fever in laboring mothers, Biennial mammography confers increased specificity for cancer screening

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