The Dangers of Alcohol During Pregnancy
When a woman uses drugs during pregnancy, it can result in negative health effects for her and her baby, and alcohol is no exception. Drinking during pregnancy can lead to fetal alcohol spectrum disorders (FASDs) and a number of other birth defects.
Using alcohol during pregnancy is the leading preventable cause of developmental disabilities, and it is estimated that as many as 2-5% of first grade students in the United States might have FASDs.3
If you are addicted to alcohol and you are pregnant, or you are thinking about getting pregnant, it is not too late to get help. Continue reading to learn about risks of drinking while pregnant and helpful treatment options if you’re struggling with alcohol use.
Facts About Alcohol and Pregnancy
Drinking alcohol during pregnancy is more common than you think: In a survey done by the CDC, 10.2% of pregnant women drank alcohol in the past 30 days and 3.1% of pregnant women reported binge drinking (drinking more than 4 drinks per occasion) during that time frame.3
Pregnant women report binge drinking more frequently than nonpregnant women: Among binge drinkers, pregnant women reported binge drinking 4.6 times in the past 30 days compared to nonpregnant women who reported binge drinking 3.1 times in the past 30 days. Additionally, the survey found that, among binge drinkers, pregnant women consumed more than nonpregnant women with 7.5 versus 6.0 drinks.3
Drinking alcohol during pregnancy is associated with high health care costs: The United States spends an estimated $5.5 billion dollars in health care and related costs related to drinking during pregnancy every year.9
An estimated 3.3 million women ages 15 to 44 years old are at risk for unintentionally exposing their unborn child to alcohol: Many women drink alcohol while they are sexually active and not using birth control to prevent pregnancy.8 Additionally, over half of the pregnancies in the United States are unintended: an unintended pregnancy is either unplanned or planned but not monitored so that women continue drinking through the beginning of their pregnancy before discovering they are pregnant.10
3 in 4 women do not stop drinking alcohol when they stop using birth control: When a woman wants to get pregnant she will usually stop taking birth control, yet according to a report by the CDC, 3 in 4 women reported that they still drank alcohol after going off their birth control. This is worrisome given that the majority of women do not know they are pregnant until they are 4-6 weeks pregnant, meaning their baby could be exposed to alcohol during this critical stage of development.10
Pregnant women are typically motivated to change their drinking behaviors to ensure that their child is born healthy: One survey found that 87% of women who drank prior to becoming pregnant quit during pregnancy, 6.6% reduced the amount they drank, and about 6.4% reported not changing the amount they drank.11
Effects of Alcohol on the Mother
Any amount of drinking is considered at-risk alcohol use during pregnancy.
Alcohol consumption among women of childbearing age in the United States is a public health issue. When a woman drinks during her pregnancy she increases the risk of harming her unborn baby as well as her own body.
According to the National Institute on Alcohol Abuse and Alcoholism, any amount of drinking is considered at-risk alcohol use during pregnancy. In consensus with this recommendation, the U.S. Surgeon General advises that pregnant women should not drink any alcohol while they are pregnant.1 Excessive alcohol consumption is a risk factor for miscarriage due to damage to the developing cells of the baby.
Aside from miscarriage risk, drinking during pregnancy is associated with negative health outcomes for the mother that include both maternal psychosocial and physical risks for both mother and developing fetus.1,2
Physical Risks of Drinking While Pregnant
- Sexually transmitted infections (STIs) which, depending on the infection, may harm the pregnancy.
- Injuries, such as falls, which may lead to miscarriage
- Cancer of the breast, liver, mouth, and esophagus
Psychosocial Risks of Drinking While Pregnant
- Conflicts with a spouse or partner
- Work disability
- Sexual assault
- Child neglect or abuse
- Domestic violence
- Driving under the influence
- Trading sex for drugs
For women who want to get pregnant, alcohol misuse can also threaten fertility. If you or a loved one is currently pregnant or hoping to get pregnant and is abusing alcohol, it is important to talk to your doctor immediately. Your doctor can help you take the steps to reduce the possibility that your child is further exposed to alcohol in utero.
Effects of Alcohol on a Developing Fetus
Alcohol crosses the placenta and results in the fetus receiving nearly equal the concentration of alcohol as the mother.12 In addition, fetal metabolism of alcohol occurs more slowly than it does in an adult—the result being that fetal blood alcohol levels (BAC) can become more elevated than their mother’s BAC, and persist in that manner for a longer period of time.13
Excess alcohol consumption can abruptly result in miscarriage. For many, however, the risks don’t end there. A developing baby, carried to term after in utero exposure to alcohol, is subject to a number of negative effects described below.
Fetal Alcohol Spectrum Disorders (FASD)
When a fetus is exposed to alcohol it can disrupt their development and increase their risk of developing FASDs. FASDs is the umbrella term for a range of disorders caused by fetal alcohol exposure. FASDs include:14
- Fetal Alcohol Syndrome (FAS).
- Partial Fetal Alcohol Syndrome (pFAS).
- Alcohol-Related Neurodevelopmental Disorder (ARND).
- Alcohol-Related Birth Defects (ARBD).
FASDs are completely preventable if the mother does not drink during pregnancy.
Credit: SAMHSA FASD Center for Excellence
The CDC estimates that up to 1 in 20 school children living in the United States may have FASDs.9 When a child is born with FASDs they can experience a range of unwanted problems, including:9
- Low birth weight.
- Intrauterine growth retardation.
- Problems with vital organs like the heart and kidneys.
- Damage to the brain.
These physical issues can manifest as behavioral and intellectual disabilities as the child grows up and progresses through certain developmental milestones.
- Lower IQ
- Attention problems
- Learning disabilities
- Impaired judgment and reasoning skills
These types of disabilities can create lifelong problems for an individual. A person born with FASDs may face broader challenges for the rest of their life.
- Problems with social interactions
- Increased risk of using substances such as drugs and alcohol
- Difficulties keeping a job
- Problems with the law
Fetal Alcohol Syndrome (FAS)
Fetal alcohol syndrome (FAS) is one of the most severe types of FASDs. FAS presents with specific facial abnormalities, including:14
- Narrow eye openings.
- Smooth area between lip and the nose.
- Thin upper lip.
In addition to facial dysmorphology, features of FAS also include:
- Central nervous system (CNS) abnormalities, e.g., a small head circumference and/or CNS dysfunction.
- Growth deficiencies either in utero or post-natal.
Research shows that a few factors play a major role in how severe the effects of alcohol are on a developing fetus. These risk factors include:4
- Amount: the number of drinks a pregnant woman has per occasion.
- Rate: how often a woman drinks.
- Timing: when the mother drinks. (When considering distinct points in time throughout fetal development that drinking occurs, the timing of alcohol use could have particular effects on the development of a specific brain region or physical feature.)
In addition to how often a woman drinks and how much she drinks, other factors may affect the risk of a child being born with FASDs. These risk factors include:4,5,6
- History of multiple pregnancies.
- Low body mass index (BMI).
- Whether the mother smokes cigarettes and/or marijuana.
- Older age.
- Being in a family of heavy drinkers.
- Inadequate prenatal care.
- Social isolation.
- Exposure to high levels of stress.
- Substance abuse by one’s partner.
Getting into treatment can help you learn healthy ways to address some of these risk factors. For example, women who are addicted to alcohol may choose alcohol over other things, such as eating a healthy diet during her pregnancy. In fact, many individuals addicted to alcohol are deficient in a number of essential nutrients—some of which may be crucial to a developing fetus.7 This may also make her more prone to becoming hypoglycemic or nutrient-deficient.8
Given that a mother’s eating habits during pregnancy can affect the severity of fetal alcohol impairment, it is important to address nutrition, in addition to all aspects of your health during addiction treatment.
Quitting Alcohol While Pregnant
If a pregnant woman attempts to withdraw from alcohol without medical help, she can place herself and her baby at risk. Women who are dependent on alcohol may need specialized counseling and, potentially, medical supervision while they withdraw.
Accordingly, treatment should be managed by doctors and nurses who are experienced in treating pregnant women with substance use disorders (SUDs). Depending on a woman’s level of alcohol use, her doctor may recommend specialized inpatient detoxification treatment or outpatient treatment.
Inpatient detoxification treatment may be recommended if a pregnant woman is:6
- Physiologically dependent on alcohol.
- Drinking 5 days a week or more.
- Actively drinking.
- At risk for alcohol withdrawal, which can be dangerous to both mother and baby.
Withdrawing from alcohol during pregnancy is a threat to the brain of a developing fetus. One potential damaging effect is that withdrawal can activate the brain’s NMDA receptor. NDMA plays a major role in brain development, learning, and memory.15 When this receptor is activated excessively, which occurs during withdrawal, it can cause neuronal cell death in the baby.16
Newborns can experience withdrawal after birth if their mothers have used alcohol or other substances during pregnancy. Not every baby born to a mother who used alcohol will experience withdrawal, and researchers are still examining why this is the case. However, many newborns who were exposed to alcohol in utero will experience symptoms that are mild or severe as they adjust to life outside the womb.
Signs of withdrawal in an infant include:17
- Trouble with feeding, such as having a weak suck.
- Poor sleeping patterns.
- Hyperphagia (increased appetite).
- Diaphoresis (sweating).
Medical providers will assess your newborn’s withdrawal symptoms after birth in order to make a proper diagnosis. In some cases, your baby may need medication and/or frequent check-ups to help manage their withdrawal symptoms.
After the baby is born, many women who stopped drinking alcohol during pregnancy may begin to drink again. If this happens, it is important to tell your doctor during your next follow-up visit. Your doctor may recommend inpatient or outpatient treatment to help you resolve your addiction issues. Getting the help to become alcohol-free postpartum could significantly impact not only your health, but the health and wellbeing of your entire family.
Studies have shown that children raised in a household where the parent(s) abuse alcohol are increasingly prone to having adverse childhood experiences that negatively impact them throughout development and their entire lifetimes, such as abuse or neglect.18 Finally, if you unintentionally became pregnant, it may be an opportunity to talk to your doctor about long-term reversible contraception such as an IUD or other method of birth control to support future family planning.
Treatment for Alcohol Addiction
Inpatient programs usually last 30 to 90 days and individuals are required to live at the facility for the duration of the program. Inpatient programs will provide a combination of:
- 24/7 medical supervision.
- Individual therapy.
- Group therapy.
- Support groups, such as Alcoholics Anonymous.
Depending on the facility, inpatient programs may offer other amenities such as individualized case management services as well as postpartum support. Some treatment centers, such as those offering dual diagnosis treatment, will be able to effectively address any concurrent mental health issues that may be present such as mood, anxiety, thought and affective disorders.
Outpatient programs offer a pregnant woman the flexibility of living at home while she receives care. In many cases, outpatient programs are less expensive than inpatient programs. Individuals who receive treatment at an outpatient program will often attend group therapy for several hours each week.
In addition to therapy and case management, doctors may prescribe certain medications during treatment to help a woman withdraw from alcohol safely. While these medications are sometimes prescribed, it is important to note that there is a limited amount of data on how safe the following medications are for a pregnant woman to take:19,20
- Naltrexone: Used during pregnancy because it does not have any known, harmful effects.
- Disulfiram: Although this drug is sometimes used during pregnancy, it may cause harm to the fetus by increasing levels of acetaldehyde. Because of the potential danger with this drug, it is not used regularly in pregnancy.
- Acamprosate: According to animal studies, this drug is a teratogen, which means it could negatively affect pregnancy. Today, there are not enough studies to conclude whether it is safe to take during pregnancy and will only be used if the benefit justifies the risk to the fetus.21
- Topiramate: Sometimes used as an off-label adjunct treatment for alcohol dependence, this drug has been found to be teratogen in animal studies. Its safety for use in human pregnancy is unknown.22
Before considering going through withdrawal, detox, and/or rehab for alcohol use, it is best to first talk to your doctor about your current alcohol use. Your doctor can complete an assessment and direct you to the proper resources.
If you or a loved one is looking for treatment or struggling with alcohol use, we are here to help. American Addiction Centers’ caring admissions navigators are available 24/7 to answer your questions and help you find a treatment center that’s right for you, so give us a call today at 1-888-744-0069 to start your recovery journey.
- Tan, C. H., Denny, C. H., Cheal, N. E., Sniezek, J. E., & Kanny, D. (2015). Alcohol use and binge drinking among women of childbearing age—United States, 2011–2013. ‘ occurs during withdrawal, it risk for alcohol-exposed pregnancy. lcohol Use and Risks to Women’ occurs during withdrawal, it
- National Institutes of Health. (2015). Fetal Alcohol Exposure.
- May, P. A., & Phillip Gossage, J. (2011). Maternal risk factors for fetal alcohol spectrum disorders: not as simple as it might seem.Alcohol Research and Health, 34(1), 15.
- Bhuvaneswar, C. G., Chang, G., Epstein, L. A., & Stern, T. A. (2007). Alcohol use during pregnancy: prevalence and impact.Primary care companion to the Journal of clinical psychiatry, 9(6), 455.
- Young, J. K., Giesbrecht, H. E., Eskin, M. N., Aliani, M., & Suh, M. (2014). Nutrition implications for fetal alcohol spectrum disorder. Advances in Nutrition: An International Review Journal, 5(6), 675-692.
- Carter, R. C., Jacobson, J. L., Sokol, R. J., Avison, M. J., & Jacobson, S. W. (2013). Fetal Alcohol?Related Growth Restriction from Birth through Young Adulthood and Moderating Effects of Maternal Prepregnancy Weight.Alcoholism: Clinical and Experimental Research,37(3), 452-462.
- Centers for Disease Control and Prevention. (2016). Alcohol and Pregnancy.
- Centers for Disease Control and Prevention. (2016). More than 3 million US women at risk for alcohol-exposed pregnancy.
- Kitsantas, P., Gaffney, K. F., Wu, H., & Kastello, J. C. (2014). Determinants of alcohol cessation, reduction and no reduction during pregnancy. Archives of gynecology and obstetrics, 289(4), 771-779.
- Nykjaer, C., Alwan, N. A., Greenwood, D. C., Simpson, N. A., Hay, A. W., White, K. L., & Cade, J. E. (2014). Maternal alcohol intake prior to and during pregnancy and risk of adverse birth outcomes: evidence from a British cohort.Journal of epidemiology and community health, jech-2013.
- National Institutes of Health. (2014). Alcohol and Pregnancy.
- National Institute on Alcohol Abuse and Alcoholism. (n.d.). Fetal Alcohol Exposure.
- Murawski, N. J., Moore, E. M., Thomas, J. D., & Riley, E. P. (2015). Advances in diagnosis and treatment of fetal alcohol spectrum disorders: from animal models to human studies.Alcohol research: current reviews, 37(1), 97.
- Thomas, J. D., & Riley, E. P. (1998). Fetal alcohol syndrome: does alcohol withdrawal play a role?.Alcohol Health & Research World, 22(1), 47-54.
- Hudak, M. L., Tan, R. C., Frattarelli, D. A., Galinkin, J. L., Green, T. P., Neville, K. A., … & Bhutani, V. K. (2012). Neonatal drug withdrawal.Pediatrics,129(2), e540-e560.
- Anda, R. F., Whitfield, C. L., Felitti, V. J., Chapman, D., Edwards, V. J., Dube, S. R., & Williamson, D. F. (2002). Adverse childhood experiences, alcoholic parents, and later risk of alcoholism and depression. Psychiatric services.
- (2016). Pharmacotherapy for alcohol use disorder.
- Rayburn, W. F., & Bogenschutz, M. P. (2004). Pharmacotherapy for pregnant women with addictions.American Journal of Obstetrics and Gynecology,191(6), 1885-1897.
- Mason, B. J., & Heyser, C. J. (2010). Acamprosate: a prototypic neuromodulator in the treatment of alcohol dependence.CNS & Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS & Neurological Disorders), 9(1), 23-32.
- Hunt, S., Russell, A., Smithson, W. H., Parsons, L., Robertson, I., Waddell, R., … & Craig, J. (2008). Topiramate in pregnancy Preliminary experience from the UK Epilepsy and Pregnancy Register. Neurology, 71(4), 272-276.