by Amy Spangler
October 13, 2010

I can see the pictures now, images taken in the 1940s and 50s, of my mother, pregnant with me or one of my five siblings—cigarette in one hand, cocktail in another. Guided by a message of moderation (1-2 drinks per occasion) women smoked and drank during pregnancy. Fast forward 50+ years and the message of moderation has been replaced by one of abstinence. Now when a pregnant woman is seen drinking in public, she is subject to disapproving stares and even some choice words. But if a group of scientists from Britain are right, the message is about to change—again.

In a recent study of more than 11,000 children, researchers found that children born to mothers who drank up to 1-2 alcoholic beverages a week during pregnancy were no more likely to exhibit behavioral or intellectual problems at 5 years of age compared to children born to mothers who abstained.

A previous study by the same scientists yielded similar results in a sample of 3-year-old children. The researchers decided to examine the same group of children again at age 5 to rule out the possibility of delayed effects.

Research
Data were taken from the Millenium Cohort Study, a large study that assessed the health of a nationally representative sample of children born in the United Kingdom (UK) between September 2000 and January 2002.

The children were grouped according to their mothers’ level of drinking—never, not in pregnancy, light (1-2 drinks a week or per occasion), moderate (3-6 drinks a week or per occasion), and binge/heavy (7 or more drinks a week or per occasion).

Nearly 6 percent of mothers reported never drinking, 60 percent reported never drinking while pregnant, and 26 percent, 5.5 percent, and 2.5 percent were described as light, moderate, and binge/heavy drinkers, respectively.

Childrens’ behavior and intellectual development were assessed using the Strengths and Difficulties Questionnaire and British Ability Scales (validated assessment tools).

Results
Children whose mothers drank up to 1-2 alcoholic beverages a week during pregnancy had the same risk for behavioral and intellectual problems at 5 years of age as children whose mothers abstained from alcoholic beverages.

When boys and girls in each of the two groups (not in pregnancy and light drinkers) were evaluated separately and compared, boys of mothers who did not drink during pregnancy were more likely to have behavior problems, hyperactivity, and peer problems compared to boys of light drinkers. Similarly, girls whose mothers did not drink during pregnancy were more likely to have emotional problems compared to girls of light drinkers. But those differences were erased when socioeconomic status was taken into account.

Recommendations
Given that fetal alcohol syndrome is the leading cause of mental retardation in the U.S., scientists urge caution in interpreting these results. While heavy drinking during pregnancy has been shown to harm the fetus (unborn baby), the effects of small amounts of alcohol are less clear. This same debate has taken place with drinking while breastfeeding.

Without knowing what amount of alcohol is safe, pregnant women are urged to avoid alcohol altogether.

Women who have had a drink or two before they realized they were pregnant will find the results of the British study reassuring. But experts worry that women will use the results to excuse drinking while pregnant. Women who are pregnant or may become pregnant should consider the following:

• The results of a single study should not guide decision-making—particularly a decision that is this important.
• The amount of alcohol consumed by mothers of study children was self-reported—raising the risk of underreporting of alcohol use during pregnancy.
• Data obtained from observational studies cannot be used to determine cause and effect. The fact that children of mothers categorized as light drinkers scored higher on certain tests does not mean that alcohol contributed to their higher scores.
• Children were tested at 3 and 5 years of age, but adverse effects may not appear until a child is older.