Home > Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently 'safe' levels of alcohol during pregnancy? A systematic review and meta-analyses.

Mamluk, Loubaba and Edwards, Hannah B and Savović, Jelena and Leach, Verity and Jones, Timothy and Moore, Theresa H M and Ijaz, Sharea and Lewis, Sarah J and Donovan, Jenny L and Lawlor, Debbie and Smith, George Davey and Fraser, Abigail and Zuccolo, Luisa (2017) Low alcohol consumption and pregnancy and childhood outcomes: time to change guidelines indicating apparently 'safe' levels of alcohol during pregnancy? A systematic review and meta-analyses. BMJ Open , 7 , (7) , e015410.

URL: http://bmjopen.bmj.com/content/7/7/e015410

OBJECTIVES: To determine the effects of low-to-moderate levels of maternal alcohol consumption in pregnancy on pregnancy and longer-term offspring outcomes.

SEARCH STRATEGY: Medline, Embase, Web of Science and Psychinfo from inception to 11 July 2016.

SELECTION CRITERIA: Prospective observational studies, negative control and quasiexperimental studies of pregnant women estimating effects of light drinking in pregnancy (≤32 g/week) versus abstaining. Pregnancy outcomes such as birth weight and features of fetal alcohol syndrome were examined.

DATA COLLECTION AND ANALYSIS: One reviewer extracted data and another checked extracted data. Random effects meta-analyses were performed where applicable, and a narrative summary of findings was carried out otherwise.

MAIN RESULTS: 24 cohort and two quasiexperimental studies were included. With the exception of birth size and gestational age, there was insufficient data to meta-analyse or make robust conclusions. Odds of small for gestational age (SGA) and preterm birth were higher for babies whose mothers consumed up to 32 g/week versus none, but estimates for preterm birth were also compatible with no association: summary OR 1.08, 95% CI (1.02 to 1.14), I(2) 0%, (seven studies, all estimates were adjusted) OR 1.10, 95% CI (0.95 to 1.28), I(2) 60%, (nine studies, includes one unadjusted estimates), respectively. The earliest time points of exposure were used in the analysis.

CONCLUSION: Evidence of the effects of drinking ≤32 g/week in pregnancy is sparse. As there was some evidence that even light prenatal alcohol consumption is associated with being SGA and preterm delivery, guidance could advise abstention as a precautionary principle but should explain the paucity of evidence.


Item Type:Article
Date:August 2017
Page Range:e015410
Publisher:BioMed Central
Volume:7
Number:7
EndNote:View
Accession Number:HRB (Electronic Only)
Subjects:E Concepts in biomedical areas > Pregnancy
G Health and disease > Substance use disorder > Alcohol use
T Demographic characteristics > Pregnant woman
VA Geographic area > International aspects

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