The only way to avoid alcohol-related risks to the fetus is to refrain from drinking alcohol during pregnancy. This message, which has been circulating more or less successfully for decades, is once again confirmed by a systematic review of the available evidence prepared by researchers in the United Kingdom. According to this research there is no specific range of consumption that can be estimated as safe because even "moderate" consumption has negative effects. “We have gathered all the results of the studies that have measured the damage caused by alcohol in pregnancy and thus we have been able to conclude with greater certainty that alcohol during pregnancy has negative effects even at levels that have nothing to do with abuse or addiction, ”says Luisa Zuccolo, director of the study and senior professor of Epidemiology at the University of Bristol School of Medicine.
In the same vein, Miguel Marcos, doctor and researcher of the "Alcohol and Alcoholism" Working Group of the Spanish Society of Internal Medicine (SEMI), explained in a report on fetal alcohol spectrum disorder that even at low doses the consumption of Alcohol during pregnancy can cause damage to brain development, growth disorders or malformations. Why can't you talk about a "safe" amount during pregnancy? The answer, spoiler, is much more complex than it may seem.
It is impossible to talk about a safe dose
In a scene of the third season of Mad Men, Betty Draper appears smoking and having a glass of red wine lying on her bed. Alcohol, you know, is one more character in the series: there is no possible scene without a glass of wine, a whiskey with ice only or a Gimlet vodka. It is the 50s and 60s of a United States that seems willing to recover lost time, and in which alcohol has no sex, age or vital stage. The series reflects it perfectly. Today, further away from this alcoholic coexistence, the center of attention is situated in what Betty's fine nightgown reveals: an advanced third trimester of pregnancy. Maybe the message has gotten through.
A little alcohol can't hurt? What do we interpret as "little"? Little once or little each time? How often? Luisa Zuccolo acknowledges the ethical and moral problem involved in an investigation in this field: “It happens that to obtain better evidence about the true effects of alcohol in pregnancy, randomized controlled trials must be carried out, and these are not ethical: we cannot randomly assign consumption and withdrawal groups to pregnant women, and compare how their babies develop. ”
But there is also the question of how alcohol consumption affects the individual. According to Consuelo Guerri, researcher and head of the Laboratory of Cellular Pathology at the Prince Felipe Research Center, in humans the weight of the mother influences, food, if alcohol has been taken with or without food (the latter, according to Guerri, is important by the blood alcohol spikes that pass to the brain immediately) and the genetic differences. “It is impossible to talk about a safe dose because it depends on so many things. As we do not know what the characteristics of each woman are, you cannot assure that nothing can happen because you drink alcohol, even in a minimal amount, during pregnancy, ”he explains.
MORE INFORMATION
Fetal alcohol spectrum disorder: if you are going to have a child, do not drink alcohol
Pregnancy: "the mistake is to think that 'for a little ham or sushi I take, nothing happens"
Luisa Zuccolo explains to El País that during the investigation they found that alcohol has a causal role in many health and development problems such as shorter pregnancy and premature birth, low birth weight and impaired cognitive and / or behavioral abilities ( for example, reduced executive function and memory and shorter attention span). That said, Zuccolo shares with Guerri the idea that the effects of alcohol on pregnancy are not the same for all babies: “Based on previous work, we know that small and moderate amounts of alcohol are likely (for example, a glass of wine a week) have very small effects on individual babies. However, a minority of babies could be more severely affected, and there is no way to know in advance who they are. ” The researcher adds that some of the studies provided evidence that even moderate alcohol consumption in pregnancy is associated with a small increase in the risk of preterm birth and that babies are born small for their gestational age.
To Guerri the study does not seem to contribute more than what is already known. “This study you are talking about has not amazed me,” he says on the other side of the phone. The researcher recalls that in the 70s, work began on the effects of alcohol on pregnant women in detail and cites the conclusions of Americans Jones and Smith regarding fetal alcohol syndrome as an important milestone: “What they found in common in children with very characteristic fascias it was that the mother had drunk alcohol. They were children from families of a low social class, so it was not yet clear about what was happening. ”
The prevalence of the syndrome, as well as other effects related to alcohol consumption, continued to be investigated in the 1980s, both in the United States and in Europe, finding as the main evidence that alcohol is an agent that produces fetal malformations. According to the researcher, for four decades there are many information and prevention programs carried out in the world to reduce the risk of the occurrence of Fetal Alcohol Syndrome and other damages caused by alcohol consumption during pregnancy, which is why it considers important continue along this line as a "reminder" of the effects of alcohol. "There is no safe dose because many factors influence, so the message must be zero consumption," he concludes.
There is not always low weight, but brain damage
According to Consuelo Guerri, it has been shown that the first thing that affects alcohol is the development of the child's brain. "You can have a completely normal child, of normal weight and with a normal fascia, but affected at the developmental level (delay in some developmental milestones, attention deficit, behavioral or learning problems ...)". He points out that, although the aforementioned review finds low birth weight common, the researcher considers that in order to affect the weight the mother must have drunk “enough”; on the contrary, even when drinking “little”, the brain is affected because alcohol has no barrier: the same alcohol the mother has in blood is also the fetus.
It also influences the moment: the brain is in development until age 21, but the involvement is greater when it comes into contact in the prenatal stage. “Alcohol affects the fetus in the three trimesters of pregnancy, even during breastfeeding, because alcohol passes into the milk, so the baby can also be affected. But it is true that the sooner you are in contact with alcohol, the effects are more irreversible. ” And the effects get worse for each child: “When the mother drinks, the following children at first are more and more affected. This happens because the mother is more affected, has more liver damage, and this affects fetal development, ”concludes Guerri.
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