Is any amount of alcohol safe in pregnancy? What to know

People who are pregnant or trying to get pregnant are advised by their health-care providers to stay away from alcohol because of the potential risks to their baby.
But what are these risks as U.S. data suggests a small increase in recent years in the number of people drinking during pregnancy and amid Fetal Alcohol Spectrum Disorder Awareness Month?
According to the CDC, 13.5 per cent of pregnant adults in the U.S. reported current drinking between 2018 and 2020, and 5.2 per cent reported binge drinking. These measures were up by 2 percentage points compared to the 2015-17 period.
In Canada, it is estimated that 10 to 15 per cent of pregnant women use alcohol during pregnancy.
“We know that there is no safe amount of alcohol that should be consumed during pregnancy, and as a result, the impact of alcohol consumption in pregnancy can vary depending on the exposure,” Dr. Naana Jumah, an obstetrician-gynecologist in Thunder Bay, Ont., said in an interview with Global News.
The Society of Obstetricians and Gynecologists of Canada (SOGC) also states that “abstaining from alcohol during pregnancy is the safest option.”
Jumah said it doesn’t matter which trimester a person is in; the no-alcohol guidance applies throughout pregnancy.
“We can’t say that there’s a certain amount that won’t result in having any problems at all. So really, the safest thing is to not consume alcohol in pregnancy, and that will prevent these issues with growth and development for the child.”
For people who are not pregnant, the latest national guidance in Canada that was released last year recommends limiting alcohol consumption to two drinks or less per week.
One of the known risks of drinking during pregnancy is fetal alcohol spectrum disorder (FASD), which is estimated to impact approximately four per cent of the Canadian population.
FASD is a life-long but preventable disability that affects the brain and body of someone who was exposed to alcohol in their mother’s womb, according to Health Canada.
Jocelyn Cook, chief scientific officer of SOGC, said FASD is a “constellation of effects” of prenatal alcohol exposure during pregnancy and these impact different people differently.
“When an individual has FASD, they meet criteria for brain effects, neurodevelopmental disabilities and issues with learning and development,” said Cook, who is also the senior research lead for the Canada FASD Research Network (CanFASD).
A diagnosis can sometimes be made as early as when the baby is still in the womb through an ultrasound, Jumah said. But oftentimes this is something that is picked up after a baby is born, she said.
In newborns, there are three facial features strongly associated with prenatal alcohol exposure that doctors look for, Cook said.
These include small eye openings, a thin upper lip and a little dent between the nose and upper lip.
If a baby is not gaining weight as well as they should or rolling over, this could also point to FASD, Jumah said.
However, most of the diagnosis is made later in school-aged children.
Neurobehavioral clues that signal FASD include having trouble sitting and paying attention in class, lagging behind academically, difficulty in learning language or reading, as well as issues with social interactions, experts say.
According to CanFASD, this disorder impacts more people in Canada than autism, cerebral palsy and Down syndrome combined.
September marks FASD Awareness Month – and experts say drawing attention to this disorder is key to preventing it and supporting those who suffer from it.
The only way to prevent FASD is to not consume alcohol during pregnancy.
“It’s really a simple intervention, but for some people it can be quite difficult, especially people who have issues with alcohol use and it’s really important to support those individuals to limit their consumption during pregnancy and to help them to make better choices,” Jumah said.
Cook said individuals with FASD have many strengths and they can be very successful, but they do need “some patience and understanding and that comes from awareness and education.”
A Senate bill by an independent senator is calling to develop a national framework on FASD that would set out standards for prevention, diagnosis and support measures for those who are impacted by it.
Besides the potential risks to the baby, alcohol may also have negative health implications for the expectant mother.
Cook said alcohol is “an empty source of nutrition,” so it replaces calories from other healthy options that can fuel both mom and baby.
Physiologically speaking, alcohol is “ubiquitous” as it affects different cells and organs and that can put “chemical stress” on the developing body, she said.
Binge-like alcohol exposure late in pregnancy is also associated with preterm birth and small for gestational age (SGA) babies.
Preterm birth is when the baby is born before 37 weeks of pregnancy.
SGA birth is when the baby is born with a birth weight below the 10th percentile among an infant population of the same sex and gestational age.