Elsevier

Annals of Epidemiology

Volume 17, Issue 10, October 2007, Pages 834-840
Annals of Epidemiology

Moderate Alcohol Consumption During Pregnancy and the Risk of Low Birth Weight and Preterm Birth. The Generation R Study

https://doi.org/10.1016/j.annepidem.2007.04.001Get rights and content

Purpose

To examine the associations of alcohol consumption in different periods of pregnancy with the risks of low birth weight and preterm birth.

Methods

This study was based on 7141 subjects participating in a population-based prospective cohort study from early pregnancy. Alcohol consumption was assessed in early, mid, and late pregnancy. Birth outcomes were birth weight in grams, low birth weight (<2500 g), small size for gestational age at birth (< −2 standard deviation scores) and preterm birth (gestational age <37 weeks).

Results

Overall, alcohol consumption during pregnancy was not associated with adverse birth outcomes. However, dose-response analyses showed tendencies toward adverse effects of average consumption of 1 or more alcoholic drinks per day in early pregnancy on birth weight (difference −129 g [95% confidence interval (CI): −271, 12]), low birth weight (adjusted odds ratio [aOR] 4.81 [95% CI: 1.10, 21.08]), small size for gestational age at birth (aOR 1.45 [95% CI: 0.33, 6.44]) and preterm birth (aOR 2.51 [95% CI: 0.92, 6.81]). Similar effects were found in late pregnancy.

Conclusion

Average consumption of one or more but not less than one alcoholic drink per day in early or late pregnancy seems to be associated with adverse birth outcomes in the offspring.

Introduction

Excessive alcohol consumption during pregnancy is associated with various pregnancy complications, including low birth weight, preterm birth, congenital anomalies, fetal alcohol syndrome, and perinatal death 1, 2, 3. Excessive maternal alcohol consumption during pregnancy is also associated with adverse postnatal behavioral development (4).

The effect of excessive alcohol consumption during pregnancy on prenatal growth and development cannot easily be extrapolated to lower levels of alcohol consumption. Previous studies examining the effect of low or moderate alcohol consumption during pregnancy (<1 alcoholic drink per day on average) on birth outcomes showed inconsistent results. Several studies found adverse effects, whereas others did not find any effect or even reported beneficial effects on weight and gestational age at birth 5, 6, 7, 8, 9. These inconsistent results may be due to differences in study design and in timing and methods of assessment of alcohol consumption. Several studies used only dichotomized outcomes including low birth weight (generally defined as <2500 g) and preterm birth 7, 10. However, alcohol consumption may affect the entire birth weight range, not only the risk of low birth weight. Most studies did not examine the effects of alcohol consumption in different periods of pregnancy. This may be important for identifying specific critical periods for exposure to alcohol during fetal life.

In a population-based cohort study among pregnant women and their children, we examined the associations of moderate maternal alcohol consumption in different periods of pregnancy with birth weight as continuous measure, and the risks of low birth weight, small size for gestational age at birth, and preterm birth in the offspring.

Section snippets

Design

This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life until young adulthood. This study is designed to identify early environmental and genetic determinants of growth, development and health in fetal life, childhood, and adulthood and has been described in detail elsewhere 11, 12. Briefly, the cohort includes 9778 mothers and their children of different ethnicities living in Rotterdam, The Netherlands. Enrollment was aimed at early

Results

Characteristics of the mothers are presented in Table 1. Of all mothers, 51% (n = 3618) used alcoholic drinks in early pregnancy and 37% (n = 2663) continued to use alcoholic drinks after pregnancy was known. In the total group, the age of mothers ranged from 15.3 to 43.3 years, with a mean age of 29.8 years. The percentage of mothers with a higher educational level was highest among those who continued to use alcoholic drinks after pregnancy was known. In the total cohort, the largest ethnic

Discussion

This population-based prospective cohort study suggested that average maternal alcohol consumption of less than one drink per day was not associated with adverse effects on weight and gestational age at birth. Tendencies toward adverse effects were found for alcohol consumption of one or more drinks per day on average in early and late pregnancy.

References (24)

  • F. Parazzini et al.

    Moderate alcohol drinking and risk of preterm birth

    Eur J Clin Nutr

    (2003)
  • N. Whitehead et al.

    Patterns of alcohol use before and during pregnancy and the risk of small-for-gestational-age birth

    Am J Epidemiol

    (2003)
  • Cited by (90)

    • Screening for fetal growth restriction and placental insufficiency

      2018, Seminars in Fetal and Neonatal Medicine
    • A placenta clinic approach to the diagnosis and management of fetal growth restriction

      2018, American Journal of Obstetrics and Gynecology
      Citation Excerpt :

      Obtaining a travel history (to Zika virus–affected areas) is also relevant to the evaluation of a suspected FGR pregnancy.11 Maternal substance use of alcohol, marijuana, cocaine, and cigarette smoking all increase the risk of low birthweight (<2500 g) or SGA deliveries (Table 2).12-15 Finally, the results of any additional pregnancy tests, such as invasive microarray genetic data, fetal anatomical assessment, and previous pregnancy reports (especially for placental pathology), are reviewed.

    View all citing articles on Scopus
    View full text