Surgeon General's Advisory on Alcohol and Pregnancy 

(Click Here to See Surgeon General's Advisory Issued 2005)

FDA Drug Bulletin, 11(2), 9-10 

July 1981

 The Surgeon General advises women who are pregnant (or considering pregnancy) not to drink alcoholic beverages and to be aware of the alcoholic content of foods and drugs.

A recent report to the President and Congress(1) summarizes current scientific knowledge about health hazards with alcohol consumption, including those during pregnancy. The report concludes that alcohol consumption during pregnancy, especially in the early months, can harm the fetus.

Among the findings of the report are the following:

• Significantly decreased birth weight has been observed among the children of some women who average only one ounce of absolute alcohol (two standard drinks) per day during pregnancy. (2)
• Sizable and significant increases in spontaneous abortions have been observed at reported alcohol consumption levels as low as one ounce of absolute alcohol twice a week. (3,4)
• A woman who consumes alcohol at amounts consistent with a diagnosis of alcoholism risks bearing a child with a specific cluster of severe physical and mental defects known as the fetal alcohol syndrome (FAS) (See September-October 1977 Drug Bulletin). This syndrome of birth defects is frequently associated with mental retardation, and is also characterized by central nervous system disorders, growth deficiencies, a specific cluster of facial abnormalities, and other malformations, particularly skeletal, urogenital, and cardiac. Many of these characteristics are individually subtle but are readily apparent to trained dysmorphologists.
• Even if she does not bear a child with full FAS, a woman who drinks heavily is more likely to bear a child with one or more of the birth defects included in the syndrome. Microcephaly, which is associated with mental impairment, is one of the more common of these defects.

The reported effects on pregnancy outcome appear to be independent of potentially confounding variables including nutrition and smoking.

In addition, it has been demonstrated that alcohol readily enters breast milk and thus is transmitted to the nursing infant. Heavy alcohol consumption is known to decrease the mother's milk.

Research to establish the mechanisms by which alcohol consumption affects fetal and neonatal growth and development is underway.

Health professionals are urged to inquire routinely about alcohol consumption by patients who are pregnant or considering pregnancy. This information should be included in their medical records.

Each patient should be told about the risk of alcohol consumption during pregnancy and advised to not drink alcoholic beverages and to be aware of the alcoholic content of foods and drugs.

Interested practitioners can obtain material about techniques for obtaining accurate drinking information from patients, as well as written material for pregnant patients, by contacting the National Clearinghouse for Alcohol Information (NCALI). (5,6)

References:

1. Report to the President and Congress on Health Hazards Associated with Alcohol and Methods to Inform the General Public of these Hazards. U.S. Department of the Treasury and U.S. Department of Health and Human Services, Nov. 1980. Available for $4.25 from Superintendent of Documents, U.S. Government Printing Office, Washington. D.C. 20402.

2. Little RE. Moderate alcohol use during pregnancy and decreased birth rate. Am J Public Health, 67:1154, 1977.

3. Kline J, Shrout P, Stein Z et al.: Lancet, 2:176, 1980.

4. Harlap S and Shiono PH: Alcohol, smoking and incidence of spontaneous abortions in first and second trimester. Lancet, 2:183, 1980.

5. Sokol RJ and Miller SI: Identifying the alcohol abusing obstetric/gynecologic patient: a pratical approach. In Alcohol Health and Resource World, 4: 36-40, 1980. Available as document RPO 258 from NCALI, P.O. Box 2345, Rockville, MD 20852.

6. Alcohol and Your Unborn Baby, Pub. No. PH-90, NIAAA, 5600 Fishers Lane, Rockville, MD 20857.

2005 Surgeon General Advisory

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