Abstract
BackgroundConsensus has not been reached on safe alcohol consumption recommendations during pregnancy. The National Institutes for Care and Health Excellence (NICE) in the UK suggest that one to two drinks not more than twice per week is safe. However, the speech and language effects of even low levels of alcohol use among offspring are unknown. The aim of this study was to review systematically the evidence on studies of the effect of low to moderate levels of alcohol consumption during pregnancy (up to 70 grams of alcohol per week) compared to abstinence on speech and language outcomes in children.MethodsUsing medical subject headings, PubMed, Web of knowledge, Scopus, Embase, Cinahl and the Cochrane Library were searched from their inception up to March 2012. Case control and cohort studies were included. Two assessors independently reviewed titles, abstracts and full articles, extracted data and assessed quality.ResultsA total of 1,397 titles and abstracts were reviewed of which 51 full texts were retrieved. Three cohort studies totaling 10,642 women met the inclusion criteria. All three studies, (United States (2) and Australia (1)) indicated that language was not impaired as a result of low to moderate alcohol consumption during pregnancy. Two studies were judged to be of low quality based on a six-item bias classification tool. Due to heterogeneity, results could not be meta-analyzed.ConclusionStudies included in this review do not provide sufficient evidence to confirm or refute an association between low to moderate alcohol use during pregnancy and speech and language outcomes in children. High quality, population based studies are required to establish the safety of low to moderate levels of alcohol use such as those set out by the NICE guidelines in the UK.
Highlights
Consensus has not been reached on safe alcohol consumption recommendations during pregnancy
Magnetic resonance imaging (MRI) studies have shown that prenatal alcohol exposure can impact on many areas of the brain involved in speech and language development, including the corpus collosum [22]
Covariates were not adjusted for and the results reported did not show any dose–response relationship between lower levels of language development and mean number of drinks per day
Summary
Consensus has not been reached on safe alcohol consumption recommendations during pregnancy. The speech and language effects of even low levels of alcohol use among offspring are unknown. The aim of this study was to review systematically the evidence on studies of the effect of low to moderate levels of alcohol consumption during pregnancy (up to 70 grams of alcohol per week) compared to abstinence on speech and language outcomes in children. While the impact of alcohol consumption during pregnancy on birth outcomes [9], mental development [10] and neuropsychological outcomes [11] is well investigated, the effect of alcohol consumption during pregnancy on speech and language development especially at lower or moderate levels is unknown [12]. Evidence suggests that low to moderate alcohol use in pregnancy can still produce functional damage to the brain leading to adverse cognitive and neurological development without obviously affecting other systems such as growth [12]. Magnetic resonance imaging (MRI) studies have shown that prenatal alcohol exposure can impact on many areas of the brain involved in speech and language development, including the corpus collosum [22]
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