Pregnant Women and Alcohol Consuming - Essay Example

Women should be advised not to consume any alcohol during their pregnancy The issue of effects of alcohol on pregnant women has been discussed for many years. The question of whether to completely abstain from alcohol during pregnancy was difficult to answer. It has been difficult to determine the exact effects on the baby since some of the effects can be long term or only show up later in the child’s life. The exact amount that is harmful is also not clear. However there has been enough evidence to show that alcohol does in indeed have serious effects and so the best advice is not to consume alcohol during pregnancy. The British Medical Association Board of Science (2007) explains that alcohol “is a teratogenic compound (i.e. a substance which interferes with the normal development of the embryo or foetus) that readily crosses the placenta” (p.1). There is enough research evidence now to confirm that drinking alcohol during pregnancy can have many different effects physically, neurologically and mentally. The severity of these effects varies widely. According to The American Pregnancy Association these effects are categorized as ‘Foetal Alcohol Spectrum Disorders’ (FASD). The incidence of FASD in children indicates the seriousness of the issue. Statistics presented by the British Medical Association show that 0.21 per 1000 live births in 2004 in England and Scotland, between 0.5 and 2 per 1,000 live births in the US; 4.7 per 1,000 live births in Australian aboriginal populations; 68.0- 89.2 per 1,000 children in part of South Africa and 10 in every 1,000 live births in Canada (p.2-3). The effects of alcohol on the foetus have been adequately documented. The US Surgeon sums it up in their news release when they state “Based on the current, best science available we now know the following: Alcohol consumed during pregnancy increases the risk of alcohol related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioural disorders, and impaired intellectual development”. More specific effects include disrupting cellular activity which alters the transport and utilization of glucose and this can cause premature cell death. Normal development is therefore interfered with. This is what causes the abnormalities in the physical structure of the foetus and in the central nervous system. For the mother there are also dangerous effects such as risk of miscarriage, infertility, menstrual disorder, pre-term deliveries or even still-births. The National Institutes of Health (2007) attribute the following to prenatal alcohol exposure – “deficits in growth, behaviour, and neurocognition such as problems in arithmetic, language, memory; visual-spatial abilities; attention; deficits in speed of information processing” (pg.1) A large study involving 4,719 women in Western Australia who gave birth between 1995 and 1997 was conducted to examine the effects of drinking alcohol on the mother and child. The data collected included how often the mother drank during pregnancy, how much alcohol was consumed and the type of alcohol. The results showed that preterm birth was highest among the women who binged or drank heavily, even if they had stopped drinking prior to the second trimester. (Telethon Institute for Child Health research, 2009). The study suggested that even if the mother stops drinking before the second trimester it triggers a metabolic response that can still lead to preterm delivery. These researchers also indicted a link between smoking and alcoholism. They found that those who smoked were less likely to abstain from alcohol. Other studies have shown similar negative effects of alcohol consumption during pregnancy. The BMA Board of Science reports that a small-scale study of children with school problems showed that prenatal exposure to exposure can damage the cerebellum of the brain. (p.6). And another study of 501 mother- child dyads found that low-to-moderate levels of prenatal exposure to alcohol was related to behaviour issues in the children at age six and seven.(p.7) The Women’s Health Organisation in Australia have reported some conflicting views on the whether women should be advised to abstain from alcohol during pregnancy. There are varying definitions of what constitutes a standard drink and the frequency of drinking. The National Health and Medical Research Council issued guidelines that were based on a review that found that less than one drink a day has no effect on children’s mental and physical development. The Council suggested that abstinence may cause greater anxiety and therefore might also be disadvantageous to the mother and child. On the contrary the Australian Medical Association, the Salvation Army and the World Health Organisation are all reported to be in disagreement and support abstinence (2007). Sayal et al (2009) conducted a study to add to the data that would help clear up the issue about the amount of drinking that causes harm. Their large study investigated the patterns of alcohol consumption and child mental health and cognitive functioning. They found that a consumption of four drinks a day was associated with greater risk of mental health problems in girls four years old and in both genders at seven years old, particularly hyperactivity and inattention problems. Their conclusion was that there were consistent effects on mental health from both low level alcohol consumption and occasional episodes of heavier drinking. The long term effects of alcohol consumption in pregnancy are not always clearly understood or accepted. Disney et al in 2008 investigated this effect on conduct disorders in adolescents and looked at the drinking patterns of both parents. They reported that “drinking during pregnancy plays a strong and significant role on offspring development” (p.1228). The rates of conduct disorder symptoms were increased by even low rates of alcohol consumption (3 drinks per week) prenatal alcohol exposure. The results were consistent with other similar research studies. Even though research exists to show the harm of alcohol consumption during pregnancy, many women still continue to drink. The Centres for Disease Control and Prevention put overall drinking rates in the US at 16.3% of pregnant women in 1995, 12.8% in 1999 and 10.1% in 2002. (St.John, 2008, p.6). The study revealed that the women knew the risk of drinking alcohol but consumed it anyway. It showed that there were misconceptions about alcohol use during pregnancy and emphasised the need to clearly explain these effects to pregnant women. One of the reasons for the conflicting views is that women are affected differently by the alcohol depending on their body size, hydration levels, hormonal changes and tolerance to alcohol. This has made it difficult to set standards. Another reason is that most women are not aware that they are pregnant for the first two months and may continue to drink during that time. Guidelines are therefore necessary for women who are planning to or may become pregnant, though that is hard to determine. Eriksson ( ) points out that research must be on-going to increase the knowledge of FAS/FASD in all countries but that nevertheless intervention measures have been shown to be effective in treating children with FAS/FASD and the earlier the treatment the better. Several agencies are working to eliminate the occurrence of FASD. The American College of Obstetrics and Gynaecology recommend counselling for women about alcohol use in their first prenatal visit and the complete avoidance of alcohol during pregnancy. Warnings about using alcohol when pregnant have also been put on labels of alcoholic beverages in the US. Despite the controversy and the differences in perspectives, because of the demonstrated problems, such as FAS, it is better to abstain and be safe than to take the risk. References American Pregnancy Association. 2007. Fetal Alcohol Spectrum disorders (FASD); Fetal Alcohol Syndrome (FAS). Available at http://www.americanpregnancy.org/pregnancycomplications/fetalalcohol.html [Accessed 19 February 2009] BMA Board of Science 2007. Fetal alcohol spectrum disorders. A guide for health care professionals. Available at http://www.bma.org.uk/images/FetalAlcoholSpectrumDisorders_tcm41-158035.pdf [Accessed 19 February 2009] Disney, E.R., Iacono, W., McGue, M., Tully, E. and Legrand, L. (2008). Strengthening the case: Prenatal alcohol exposure is associated with increased risk for conduct disorders. Pediatrics 122, 1225-e1230 Available online at http://pediatrics.aappublications.org/cgi/content/full/122/6/e1225 Eriksson. U. J. (2007). Fetal ethanol exposure during pregnancy – how big is the problem and how do we fix it? Acta Paediatrica, 96 (11), 1557-1559 National Institutes of Health 2007 Fetal Alcohol Spectrum Disorders Fact Sheet Available online at http://www.nih.gov/about/researchresultsforthepublic/FetalAlcohol.pdf [Accessed 19 February 2009] Sayal, K., Heron, J., Golding, J., Alati, R., Davey Smith, G., Gray, R., and Emond, A. 2009 Binge pattern of alcohol consumption during pregnancy and childhood mental health outcomes: Longitudinal population-based study. Pediatrics 123,289-296 Available online at http://pediatrics.aappublications.org/cgi/content/full/123/2/e289 St.John,B. 2008. Social drinking among pregnant women. International Journal of Childbirth Education. 23 (2), 6-9 Telethon Institute for Child Health Research. 2009 Binge Drinking Leads To A Greater Risk Of Preterm Birth. ScienceDaily [Online]. Available at http://www.sciencedaily.com­ /releases/2009/01/090121123055.htm. [Accessed 19 February 2009] US. Department of Health and Human Services. Office of the Surgeon General 2005. News Release. Available online at http://www.surgeongeneral.gov/pressreleases/sg02222005.html [Accessed 19 February 2009] Women’s Health. 2007. Alcohol use during pregnancy. Available online at http://www.womhealth.org.au/healthjourney/alcohol_pregnancy.htm [Accessed 19 February 2009] Read More