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Pregnant Drinkers Have Undersized Kids

The problem can last well into the teen years

WEDNESDAY, Oct. 16, 2002 (HealthDayNews) -- If you're pregnant, don't drink. Not even a drop.

A new study says women who drank less than one drink a day not only tended to have smaller babies, but those children remained small well into their teens.

When the children of drinkers were examined at 14 years of age, they were smaller and shorter than the children of mothers who abstained from alcohol during pregnancy.

Researchers say the study shows the threshold for danger to the fetus may be even lower than thought, especially if the drinking is continuous throughout the early part of pregnancy.

"I'd just like to get the message out that drinking during pregnancy is not a good idea," says Nancy Day, lead author of the study and a professor of psychiatry, pediatrics and epidemiology at the University of Pittsburgh School of Medicine.

"There's always been some debate about whether there is a safe level of drinking or not. This data shows that there clearly is not," Day says.

The study appears in the October issue of the journal Alcoholism: Experimental and Clinical Research.

Researchers interviewed 565 women during pregnancy, after delivery and when their children were 14 years old. The women were healthy, had low incomes and were at least 18 years old.

One-quarter of the women had one or more drinks a day. One-quarter drank no alcohol. The rest drank occasionally during pregnancy.

The women were divided into four categories: "abstainers" (no alcohol), "light drinkers" (less than 1.5 drinks per week), "moderate" (1.5 drinks per week to less than one drink per day) and "heavy" drinkers (one or more drinks per day).

Drinking even lightly during the first and second trimester resulted in lower weights for the children, as well as smaller stature and smaller head circumference at age 14. The more the woman drank, the smaller the child.

The average weight of a 14-year-old child of a woman who didn't drink during pregnancy was 152 pounds. For light drinkers, it was 149 pounds. For moderate drinkers, it was 143 pounds. For heavy drinkers, it was 136 pounds.

Alcohol -- specifically binge drinking -- has been linked with fetal alcohol syndrome, says Dr. Andrei Rebarber, a specialist in high-risk pregnancies at New York University Medical Center.

Children with this condition can have a range of physical and mental birth defects, including small heads, facial malformations, growth deficiency, irritability and low IQs.

In the new study, the children's small size didn't mean they suffered from fetal alcohol syndrome. But, Day says, "their small size means there is a marker that there was damage from alcohol."

Rebarber says studies such as Day's underscore the importance of avoiding alcohol during pregnancy.

"Most ob-gyns have a zero tolerance for alcohol during pregnancy," says Rebarber, an assistant professor of obstetrics and gynecology at New York University School of Medicine. "There is no real safe amount to drink during pregnancy because we don't know what the threshold is."

Rebarber adds that doctors don't know precisely why alcohol causes problems during pregnancy.

Some studies show alcohol can have a toxic affect on the placenta, leading to fetal malnutrition. Studies with animals have also shown alcohol can interfere with DNA and protein formation, he says.

Day notes that the women in her study came from stressful environments, with high rates of medical, economic, psychiatric, social and legal problems. These added stressors may have contributed to the continued growth deficits of the alcohol-exposed children, she says.

In a related study from the same journal, researchers found that children whose mothers drank during pregnancy had a harder time relating to their mothers and a harder time coping with the problems of daily life.

However, mothers who gave their children a lot of support were able to counteract the effect of alcohol exposure and help their children develop positive coping skills, according to the study.

Researchers assessed the alcohol consumption of 42 low-income mothers and how they related to their children when they were between the ages of 3 and 5, both in the home and in a laboratory setting.

None of the children had fetal alcohol syndrome.

About 80 percent of the children of moderate to heavy drinkers had insecure attachments to their mother, compared to only 36 percent of the children of abstainers and light drinkers.

"It appears that while prenatal alcohol exposure may be associated with increased risk for the development of a difficult temperament in childhood, if the mother is able to respond to the child in a supportive, nurturing manner, the child may be more able to deal with frustration and stress and may be more likely to develop secure attachment relationships," says lead author Mary J. O'Connor of the University of California, Los Angeles.

What To Do

For more information about alcohol and pregnancy, visit the National Organization on Fetal Alcohol Syndrome. If you're pregnant and need help with an alcohol problem, the National Institute on Alcohol Abuse and Alcoholism has a list of resources and agencies that can assist you.

SOURCES: Nancy Day, M.P.H., professor, psychiatry, pediatrics and epidemiology, University of Pittsburgh School of Medicine; Andrei Rebarber, M.D., assistant professor, obstetrics and gynecology, New York University School of Medicine, New York City; October 2002 Alcoholism: Experimental and Clinical Research
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