PREG­NANT PAUSE ON AL­CO­HOL

The ad­vice from ex­perts is clear: there’s no “safe” level of al­co­hol con­sump­tion in preg­nancy. But that mes­sage be­comes im­pacted by a lot of hu­man fac­tors

Sunday Territorian - - SUNDAY - WITH FIONA BAKER

More and more is be­ing un­der­stood about foetal al­co­hol spec­trum dis­or­der ( FASD), an um­brella term for a range of phys­i­cal, de­vel­op­men­tal and neu­ro­log­i­cal dis­abil­i­ties re­sult­ing from al­co­hol con­sump­tion in preg­nancy.

Health ex­perts be­lieve it’s far more wide­spread than pre­vi­ously be­lieved. In the US, FASD is the most com­mon cause of de­vel­op­men­tal de­lay and is es­ti­mated to af­fect be­tween 2 and 7 per cent of all births.

This isn’t a con­di­tion that’s only found in dis­ad­van­taged pock­ets of the com­mu­nity, be­cause drink­ing isn’t con­fined to so­cioe­co­nomic groups, ex­plains El­iz­a­beth El­liott, a pro­fes­sor of pae­di­atrics and child health at the Univer­sity of Syd­ney.

“What we do know is that women who don’t drink any al­co­hol dur­ing preg­nancy face no risks of [this kind of] dam­age to their foe­tus,” she says. “Fre­quent, high in­takes of al­co­hol, and par­tic­u­larly binge drink­ing, in­creases the risk.

“What we don’t know is the risk to an in­di­vid­ual preg­nancy. Each preg­nancy is dif­fer­ent and ev­ery woman’s body re­sponds dif­fer­ently to al­co­hol con­sump­tion be­cause of a range of fac­tors such as age, body com­po­si­tion, ge­net­ics and prior dis­ease.”

So, she strongly ad­vises that ex­pect­ing and try­ing-to-con­ceive women ap­ply the pre­cau­tion­ary prin­ci­ple as rec­om­mended in Aus­tralia’s na­tional al­co­hol guide­lines that “not drink­ing al­co­hol is the safest op­tion”.

How­ever, that’s where some of these hu­man fac­tors come in.

UN­PLANNED PREG­NAN­CIES

De­spite liv­ing in an age of highly ac­ces­si­ble con­tra­cep­tion, al­most 50 per cent of preg­nan­cies in Aus­tralia are un­planned. Add to that an­other con­tem­po­rary is­sue of the sharp in­crease in young women binge drink­ing, and the mes­sage of hav­ing an al­co­hol-free preg­nancy be­comes blurred.

A new study from New­cas­tle Univer­sity has re­vealed that eight in 10 ex­pec­tant mums drink al­co­hol in preg­nancy – 64 per cent higher than found in other Aus­tralian stud­ies.

This fol­lows sur­vey re­sults re­leased last year by the Foun­da­tion for Al­co­hol Re­search & Ed­u­ca­tion which found that 47 per cent of Aus­tralian women in­ter­viewed con­sumed al­co­hol while preg­nant be­fore know­ing they’d con­ceived – and al­most 20 per cent drank al­co­hol af­ter con­fir­ma­tion of their preg­nancy.

The most com­pa­ra­ble fig­ures for how much mums are drink­ing come from the US, where al­most 1.5 per cent of women re­ported binge drink­ing while preg­nant.

El­liott un­der­stands the panic women can feel if they con­tin­ued drink­ing at high lev­els while un­know­ingly preg­nant: “We know birth de­fects can re­sult from first trimester al­co­hol ex­po­sure – al­though the foe­tus is vul­ner­a­ble through­out the preg­nancy.

“The best ad­vice we can pro­vide is that the woman talks about her al­co­hol con­sump­tion with her health provider. In most cases we’ll be able to pro­vide re­as­sur­ance that ev­ery­thing should be fine but if there are con­cerns, at least we can be pre­pared for that.”

Mean­while, El­liott’s ad­vice for women who are plan­ning to get preg­nant is “stop drink­ing now”.

She de­scribes preven­tion as the only op­tion. This should in­volve pub­lic ed­u­ca­tion strate­gies such as la­belling of al­co­holic drinks. Cur­rently, la­belling of the harms of al­co­hol in preg­nancy is vol­un­tary, but El­liott would like to see it man­dated and en­forced.

“The im­pact of FASD on a fam­ily is dev­as­tat­ing and it’s more com­mon than we think,” she says. “Strate­gies which fo­cus on preven­tion are vi­tal.”

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