What are the risks of drinking small quantities of alcohol while pregnant?

What are the risks of drinking small quantities of alcohol while pregnant?
Sep 14, 2022

Q: I’ve heard that in the past, pregnant women commonly drank small amounts of alcohol, especially wine. My mother even admits to drinking wine while she was pregnant with me! What are the risks of drinking small quantities of alcohol while pregnant?—Nikki, Dayton, Ohio

A: Ethanol (otherwise known as ethyl alcohol, or simply “alcohol”) is toxic to most forms of life. While alcohol, and especially wine, may have some health benefits when consumed in moderation by adults, it’s worth remembering that at a basic level, alcohol is a toxin. As such, its consumption can carry risks.

Alcohol poses a special threat to developing children, especially when they are in the womb. It’s true that in the past, it was sometimes considered acceptable for pregnant women to drink alcohol. If pregnant women did drink, wine may have been preferred over hard liquor due to its lower alcohol content. Even today, the question isn’t always as clear-cut as those ubiquitous Surgeon General’s Warnings seem to indicate.

That said, health professionals almost universally warn against consuming any alcohol at any stage of pregnancy, and even when trying to conceive or when conception may be possible. Dr. Jae Kim, director of the division of neonatology and co-director of the Perinatal Institute at Cincinnati Children’s Hospital, told Wine Spectator, “There is no amount of alcohol that is considered safe to drink during pregnancy.”

Dr. Kim acknowledges that “it used to be thought that a small amount may be OK if taken at [certain] times during pregnancy.” However, “we know now that alcohol is absorbed quickly, crosses the placenta and is taken up by the fetus.” In the womb, alcohol has the potential to affect all of a fetus’ growing organs, and its damage to the developing brain can be particularly severe.

Though alcohol’s effects on fetal development haven’t changed, our understanding of them has. Dr. Kim says that “fetal alcohol syndrome is now understood to be a larger spectrum,” called fetal alcohol spectrum disorder (FASD). “We recognize now that there are many infants born with more subtle clinical signs of FASD that may be detected over time. Most toxicologists are very concerned that [in the past], we grossly underdiagnosed the effects of alcohol during pregnancy.”

Alcohol is most damaging in the first eight weeks of gestation, when organs are still forming. That period is also when a woman is least likely to know she is pregnant; therefore, women may be wise to consider abstaining from alcohol entirely when trying to conceive, or whenever conception is possible. And even though alcohol’s effects are likely to be most acute in the early stage of pregnancy, Dr. Kim emphasizes that “even in the last few weeks of pregnancy, the brain is undergoing tremendous growth and brain development.” As always, talk to your doctor about how alcohol can fit into a healthy lifestyle, especially if you are or may become pregnant.—Kenny Martin

Q & A health womens-health

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