HYANNIS – The Centers for Disease Control and Prevention issued a press release recently that one in 10 pregnant women reported drinking alcohol in the past 30 days. Even more alarming, about one third of those women reported binge drinking, which is defined as four or more alcoholic beverages at one time. The CDC analyzed the data that was collected by doing a random digit dialed telephone survey of 206,481 women between the ages of 18 and 44.
One of the limitations of the study is that self-reported alcohol use is generally lower than actual use. That means the figures are probably higher. Another limitation is that a majority of women don’t know that they are pregnant in the first four weeks, so some of the members of the study could have been pregnant without knowing it.
“The stats are that 25 percent of women between the ages of 18 and 24 binge drink, so a lot of those women have a huge risk of getting pregnant,” said Nisha David, MD, at Cape Obstetrics and Gynecology in Falmouth.“There might be people with high alcohol use before they know they’re pregnant.”
Alcohol use during pregnancy can cause a variety of birth defects and developmental delays called Fetal Alcohol Spectrum Disorders (FASD). FASD are entirely preventable if the mother does not drink, so obstetricians generally advise pregnant women to abstain from alcohol completely.
Babies are fully formed sometime between 10 and 14 weeks of pregnancy. A lot of women don’t come in for their first prenatal visit until they are 10 weeks pregnant. Dr. David said women with unplanned pregnancies may wait even longer before admitting they are pregnant and seeking care.
“We do universal screenings on patient’s first prenatal visit, and our numbers definitely don’t match the numbers in the study,” Dr. David said. “That study raises the question, is the number higher than we realized? It sounds like it must be if that many people are anonymously saying they are drinking that much. That means that we need to be screening more and revisiting this issue later in the pregnancy as well.”
According to the National Organization on Fetal Alcohol Syndrome, alcohol use is the leading known cause of birth defects in the U.S., affecting an estimated 40,000 babies each year. That is more than the combined number of children born with spina bifida, Down syndrome and muscular dystrophy.
When pregnant women drink, their unborn babies take in the same amount of alcohol their mothers do. By sheer weight, even one drink is a lot of alcohol for a tiny fetus. The bigger problem is that developing babies do not have the ability to metabolize alcohol because their organs are not fully formed. Alcohol also prevents unborn babies from getting the oxygen and nutrients they need to develop properly.
Fetal Alcohol Syndrome Disorders is an umbrella term to describe the wide range of negative effects alcohol has on a developing fetus. The effects of FASD depend on the timing and frequency of maternal alcohol exposure. For example abnormal facial characteristics are most likely to develop when the mother drinks between weeks 6 to 9 of her pregnancy.
Other effects include growth deficits, brain damage, heart, lung and kidney defects, hyperactivity, behavioral problems, attention and memory problems, poor coordination, motor skill delays, difficulty with judgement and reasoning and learning disabilities.
In the CDC reported survey of 206,481 women, 4 percent were pregnant. The CDC noted that the rate of binge drinking among pregnant women was actually higher than the rate of binge drinking in women who were not pregnant. This indicates that the pregnant binge drinkers are more likely to be alcohol dependent than non-pregnant binge drinkers.
This presents a problem because a lot of women don’t seek the help they need to stop drinking because they fear prosecution or the loss of their children to child protective services.
“We ask patients a lot of very intimate questions during pregnancy so I think the biggest thing we can do is to ask our patients if they are drinking,” Dr. David says. “Whether or not women are going to tell me the truth, I can’t really control. But if I create a welcoming environment then that helps me to screen for it and there’s a better chance that we’ll get more people than we do now.”