Low levels of prenatal alcohol exposure can cause fetal damage

Abstract

Sir, In BJOG 114:3, Henderson et al. review studies on the effects of low to moderate prenatal alcohol exposure.1 Their stated goal was to review human studies tallying the following outcomes: ‘miscarriage, stillbirth, intrauterine growth restriction, prematurity, birthweight, small for gestational age at birth and birth defects including fetal alcohol syndrome’. The authors drew the conclusion that there is ‘no convincing evidence of adverse effects of prenatal alcohol exposure at low to moderate levels of exposure’. This broad conclusion is, in our opinion, misleading. First, Henderson et al.1 did not include studies examining cognitive or neurological effects of prenatal alcohol exposure, sequelae believed to be more common than the full fetal alcohol syndrome.2 Second, animal studies have shown that even transient, low levels of alcohol exposure can cause negative neurological effects.3 The only conclusion justified by the current scientific evidence is that pregnant women should be advised against drinking during pregnancy, a position supported by the Health Council of the Netherlands after weighing all the evidence, including animal studies.4 j