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AAP Says No Amount of Alcohol Should be Considered Safe During Pregnancy

A new clinical report from the American Academy of Pediatrics (AAP) identifies prenatal exposure to alcohol as the leading preventable cause of birth defects and intellectual and neurodevelopmental disabilities in children. The report, "Fetal Alcohol Spectrum Disorders," in the November 2015 issue of Pediatrics (published online Oct. 19) stresses that no amount of alcohol should be considered safe to drink during any trimester of pregnancy.

Fetal alcohol spectrum disorders (FASDs) is an all-encompassing term for the range of effects that can occur in someone whose mother drank alcohol during pregnancy. Neurocognitive and behavioral problems from prenatal alcohol exposure are lifelong, but early recognition, diagnosis and therapy for any FASD condition can improve a child's health.

Unfortunately, a lack of uniformly accepted diagnostic criteria for fetal alcohol-related disorders has critically limited efforts that could lessen the impact of FASDs, says Janet F. Williams, MD, FAAP, one of the report's lead authors.

"Even though fetal alcohol spectrum disorders are the most commonly identifiable causes of developmental delays and intellectual disabilities, they remain significantly under-recognized," said Dr. Williams.

Prenatal alcohol exposure is a frequent cause of structural or functional effects on the brain, heart, bones and spine, kidneys, vision and hearing. It's associated with a higher incidence of attention-deficit/hyperactivity disorder and specific learning disabilities such as difficulties with mathematics and language, visual-spatial functioning, impaired impulse control, information processing, memory skills, problem solving, abstract reasoning and auditory comprehension.

In surveys, about half of all childbearing age women in the United States report consuming alcohol within the past month, and nearly 8 percent of women said they continued to consume alcohol during pregnancy. A recent study found increased risk of infant growth retardation even when a pregnant woman's consumption was limited to 1 alcoholic drink per day (a 1.5-ounce shot of distilled spirits, 5 ounces of wine, or 12 ounces of beer). 

First-trimester drinking, compared to no drinking, results in 12 times the odds of giving birth to a child with FASDs. First- and second-trimester drinking increased FASDs odds 61 times, and women who drink during all trimesters increased the likelihood of FASD odds by a factor of 65.

"The research suggests that the smartest choice for women who are pregnant is to just abstain from alcohol completely," said Dr. Williams.

The AAP offers several resources for on prenatal alcohol exposure, including an FASD Toolkit for physicians ( and a set of frequently asked questions for parents on Fetal Alcohol Syndrome Disorders (,  

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