It’s a question that’s asked all the time: how much alcohol is safe to drink during pregnancy? Globally, Fetal Alcohol Spectrum Disorder (the term used to describe all developmental abnormalities caused by alcohol consumption during pregnancy) is the most common form of mental and intellectual disability, and is 30 to 50 times more prevalent than the next most common disability, which is Down Syndrome.
According to the World Health Organization, South Africa has the 7th highest per capita reported rate of alcohol consumption in the world. And while the worldwide rate of FASD sits at 1,5%, in South Africa the prevalence rate ranges between 2,7% and up to 28% in some communities.
So exactly how much alcohol is safe to drink during pregnancy?
According to the Foundation for Fetal Alcohol Research (FARR), the answer is none. Because alcohol is metabolized differently by everyone – affected by body weight, gender, and general health, among other factors – some people might feel tipsy after just a few sips of alcohol, while others are able to tolerate more. When a woman is pregnant, her body’s ability to metabolize alcohol also changes, which is compounded by how susceptible the fetus’s nervous system is to the harmful effects of alcohol, as well as the inability of the immature fetal liver to metabolize alcohol.
Here’s how alcohol affects an unborn baby at each stage of pregnancy
What is Fetal Alcohol Spectrum Disorder (FASD)?
FASD is the broad term used for all developmental abnormalities caused by alcohol consumption during pregnancy.
Fetal Alcohol Spectrum Disorder (FASD) is caused by alcohol exposure during pregnancy. Alcohol acts as a powerful toxin (poison) to the developing fetus and can affect the fetus within 20 minutes after the ingestion of alcohol. It affects the development of all fetal tissue and organs, although the brain and the nervous system are the most vulnerable.
After birth, the baby may present with a range of physical, neurological, behavioral and intellectual abnormalities that become more evident over time. In addition to intellectual deficits, an individual with FASD may present with the following:
- Growth retardation (small for age before and after birth)
- Organ damage, especially the brain, eyes, ears and heart
- Abnormal facial features
- Brain damage, which result in lifelong challenges such as learning disability, interpersonal relationship problems, developmental disability such as fine motor development and coordination. In addition, most of these children also present with attention and hyperactivity symptoms.
In Adolescence an individual with FASD may present with additional challenges such as:
- Poor scholastic performance
- Mental health- and substance abuse problems
Fetal Alcohol Syndrome (FAS) is the most severe form of Fetal Alcohol Spectrum Disorders. Other disorders within the FASD spectrum are:
- Alcohol Related Neurodevelopmental Disorders (ARND): Any of the developing fetus’ organs can be affected by the poisonous (toxic) effect of alcohol; however, the brain is especially vulnerable. Children with ARND will present with brain (neurological) damage, but few of the other obvious signs or symptoms of FASD. Diagnosing ARND demands specialized neuro-developmental assessments (psychological testing) using scientifically developed assessment measures for FASD. This needs to be corroborated by a positive history of alcohol consumption during pregnancy, through an extensive maternal interview. Children with this condition are often wrongly labelled as naughty, hyperactive and / or with attention deficit disorder (ADHD-like behaviour).
- Alcohol Related Birth Defects (ARBD): ARBD is characterized by organ damage caused by alcohol consumption during pregnancy. These individuals do not present with any other signs of FASD, only developmental abnormalities of organ systems, i.e. heart, eye, hearing, skeletal. Diagnosing ARBD would include an extensive maternal interview confirming alcohol consumption during pregnancy as well as clinical examination by a trained medical specialist.
- Partial FAS (PFAS): An individual with PFAS usually presents with some of the facial and physical signs of FASD, but do not show all features associated with FAS.
How much alcohol is safe to consume during pregnancy?
No amount of alcohol is safe to consume during pregnancy.
Alcohol is metabolized differently in all individuals. Some people may feel intoxicated from a few sips of wine while others may be able to tolerate more alcohol. The body’s response to alcohol will vary from person to person due to various factors such as body weight, nutritional status, general health and gender. When a woman is pregnant, her body’s ability to metabolize alcohol also changes. This is compounded by the fetus’ susceptible nervous system to the harmful effect of alcohol as well as the inability of the immature fetal liver to metabolize alcohol.
What is the extent of FASD?
The prevalence and extent of FASD is a worldwide challenge. Formal figures of the incidence for a few countries such as America (0,1 3%), France (2,1%) are available. Prevalence studies conducted by FARR (see table below) has shown that South-Africa has the highest reported rate of FASD worldwide. It is 30 – 50 times more common than the next most common birth defect, namely Down Syndrome.
SOURCES: https://farrsa.org.za/library/#toggle-id-2
BabyYumYum – 9 SEPTEMBER 2020
