USE OF ALCOHOL IN PREGNANCY

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(Date of issue: November 2010, Version: 1)

This is a UKTIS monograph for use by health care professionals. For case-specific advice please contact UKTIS on 0344 892 0909. To report an exposure please download and complete a pregnancy reporting form. Please encourage all women to complete an online reporting form.

A corresponding patient information leaflet on alcohol use in pregnancy is available at www.medicinesinpregnancy.org.

Summary

Alcohol (ethanol) is used for a range of industrial, scientific and medical applications, as well as being a common component of beverages. 

Prenatal exposure to alcohol has been associated with an increased risk of spontaneous abortion. 

Alcohol is a known teratogen which, when consumed in pregnancy, may impair development of the fetal nervous system.  This can result in cognitive deficits and behavioural problems in the offspring, as well as perturbing fetal growth and organ formation.  The extent and severity of these effects depends on several factors including the amount of alcohol ingested during the pregnancy, the gestational age at which the fetus was exposed and co-ingestion of other teratogenic substances.  

The characteristic Fetal Alcohol Syndrome (FAS), reported with chronic high (>5 units/day) maternal alcohol consumption during pregnancy, is characterised by pre and postnatal growth retardation characteristic facial features and central nervous system abnormalities.  The less severe Fetal Alcohol Spectrum Disorder (FASD) has been reported at any level of maternal alcohol consumption.  Features include structural malformations, respiratory dysfunction, vision and hearing problems, and mental, behavioural and/or learning disabilities.

There is no conclusive evidence to indicate a safe exposure level during pregnancy.  Adverse effects from acute exposure to alcohol or binge drinking (>5 units on one occasion) are difficult to predict, with outcome depending on timing of exposure, genetic differences in alcohol metabolism (in both the mother and the fetus), and other associated compounding risk factors such as maternal lifestyle.

Topical application of alcohol would not be expected to result in systemic absorption and is not known to cause adverse fetal effects.

Exposure to alcohol would not usually be considered medical grounds for termination of pregnancy but may warrant enhanced antenatal surveillance of fetal growth and development.  Where a diagnosis of a Fetal Alcohol Spectrum Disorder is being considered retrospectively, referral to a clinical geneticist or paediatrician with expertise in this area is recommended to exclude other genetic diagnoses (e.g. Williams syndrome, 22q11 microdeletion syndrome) which may present with overlapping clinical features.

This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to be sure you are using the most up-to-date version.

This is a summary of the full UKTIS monograph for health care professionals and should not be used in isolation. The full UKTIS monograph and access to any hyperlinked related documents is available to health care professionals at www.toxbase.org.

If you have a patient with exposure to a drug or chemical and require assistance in making a patient-specific risk assessment, please telephone UKTIS on 0344 892 0909 to discuss the case with a teratology specialist.

If you would like to report a pregnancy to UKTIS please click here to download our pregnancy reporting form. Please encourage all women to complete an online reporting form.

Disclaimer: Every effort has been made to ensure that this monograph was accurate and up-to-date at the time of writing, however it cannot cover every eventuality and the information providers cannot be held responsible for any adverse outcomes of the measures recommended. The final decision regarding which treatment is used for an individual patient remains the clinical responsibility of the prescriber. This material may be freely reproduced for education and not for profit purposes within the UK National Health Service, however no linking to this website or reproduction by or for commercial organisations is permitted without the express written permission of this service. This document is regularly reviewed and updated. Only use UKTIS monographs downloaded directly from TOXBASE.org or UKTIS.org to ensure you are using the most up-to-date version.