The consumption of alcohol during pregnancy is associated with a variety of unhealthy outcomes, such as spontaneous abortions, birth defects, and developmental disorders. (Floyd et al., 1999; Floyd, Decoufles & Hungerford, 1999) The CDC warns that “no amount of alcohol is known to be safe, and any alcohol use puts a woman at elevated risk for having a FAS (Fetal Alcohol Syndrome ) infant.” (CDC, 12-14-07) Many of these disorders occur early in gestation before the woman is aware that she is pregnant. So it’s important for women to avoid alcohol if there is even a chance that they are pregnant.

Most people are aware that alcohol consumption during pregnancy can lead to pregnancy complications and/or birth defects. But what isn’t so well known is that alcohol consumption during pregnancy has also been linked to brain and behavioral changes that are much more subtle and which don’t show up until much farther down the road. As Cohen (2010, p. 31) says, “Physicians and researchers now recognize a whole range of conditions, known as fetal alcohol spectrum disorders, that can occur in children who are exposed to alcohol in-utero. The effects may include physical, mental, behavioral, and learning disabilities with possible lifelong implications.”

How many women drink during pregnancy?
It’s hard to pinpoint just how prevalent drinking is during pregnancy, since surveys rely on women to self-report such things, and this would be one of those behaviors that is notorious for being under-reported. In 1995, 16.3% of pregnant women reported drinking during the previous month, a 31.4% rise from 1991 when 12.4% of pregnant women reported such drinking. (Califano et al., 1999, p. 17)

More recent surveys have found a promising drop in such behavior. In 2009 it was reported that 19% of expectant mothers drank in the first trimester, 7.8% in the second, and 6.2% in the third. Prevalence rates for binge drinking during pregnancy were 1%; and rates of alcohol abuse problems overall during pregnancy were 6.2% suggesting that those women still drinking in the third trimester were probably also those who had a substance abuse problem. (Berman, 6-1-2009)

Fetal Alcohol Syndrome
The most serious of these adverse effects is fetal alcohol syndrome, or FAS for short. It causes impaired growth and mental retardation in the developing infant. (AAP, 2000; Sokol, Delaney-Black & Norstrom, 2003) It’s caused by frequent alcohol use during pregnancy. Fetal alcohol syndrome now appears to be the number one cause of mental retardation among children in America. (Jensen, 2006) The costs related to lost productivity alone among PAS adults runs about $1 billion each year in the U.S. Health care associated costs are another $2 billion annually. (Califano et al., 1999, p. 23)

The brain problems associated with PAS are manifold,” writes Cohen. “The damage that alcohol causes to the developing brain results in a constellation of mental and behavioral characteristics that go well beyond what is seen in ADHD. Some children have a generalized cognitive impairment, or mental retardation. Others are not mentally retarded but still have significant learning disorders and other developmental issues, including motor delays, problems with social skills, memory deficits, language problems, and difficulties with the complex set of mental skills – including planning, flexibility, and decision making – that are known as ‘executive functioning. ‘” (Cohen, 2010, p. 31)

Fetal alcohol exposure & child behavioral problems
Even smaller amounts of alcohol that do not produce anything on the scale of PAS can potentially result in child behavioral changes later on. Similar to nicotine, alcohol consumption during pregnancy has been linked to an increased risk of things like aggression and ADHD-type behavior. (Cohen, 2010)

Drinking during pregnancy and the elevated risk of substance abuse in children
Prenatal exposure to alcohol has also been shown to increase the risk of future alcohol problems as that child grows older. “Exposure to three or more glasses consumed as infrequently as a few times a month is associated with double the risk of both early- and late-onset alcohol disorders in youth,” write Alati et. al. (2006). It’s suspected that this early exposure impacts the brain’s natural reward circuitry as it develops, predisposing a child towards substance abuse problems in the future.

Maternal substance use in-utero & its effects on fetal brain development
A recent study by Jerold Chun and his colleagues at the Scripps Research Institute in La Jolla, California, suggests that alcohol and drug use during pregnancy may actually cause chromosomes to go missing from their child’s brain cells, causing them to die or function improperly. When Chun’s team injected pregnant mice with alcohol or amphetamines when the embryos were 13.5 days old (equivalent to the second trimester in humans) and then later performed an autopsy, they discovered that around half to two-thirds of the youngsters’ brain cells had the wrong number of chromosomes. (Saey, 2011) This suggests potentially profound, life-altering cognitive impairment for the children of mothers who used substances during pregnancy.

Drinking during pregnancy & fetal death
Drinking during pregnancy also endangers the life of the baby. While the infant death rate is 8.6 per 1,000 among women who do not drink during pregnancy, it is 23.5 per 1,000 births among those who average 2 or more drinks per day. (Jersild, 2001, p. 25; CDC, National Center for Health Statistics, Linked Birth/Infant Death Data Set, 1991) To put this number in perspective, maternal drinking kills more children every year than the number of kids murdered by all other means.