This article includes contributions from Isabelle Ryan, MD and Beth Schriock, MD
Studies have tied alcohol consumption during pregnancy to increased risk for stillbirth and first trimester miscarriage. Indeed - alcohol abuse by women who are expecting is the number one cause of birth defects, premature births, low birth weight and mental retardation. A shocking 12,000 babies each year are born with Fetal Alcohol Syndrome (FAS) and at least twice that many with the milder Fetal Alcohol Effects (FAE) associated with learning disabilities and lower alcohol intakes.
While the tragedy of FAS is well established, less certain is whether casual consumption of alcohol while trying to conceive either hinders or helps a womans chances. Past published studies have been mixed as to whether there is an association between moderate alcohol consumption and waiting time to pregnancy. One study did show decreased probability of conception in women imbibing 1-5 drinks per week. Another study saw no effect of 7 or more drinks per week in younger woman but women over 30 were more likely to be infertile. None of these studies have stratified the data to see if any type of alcohol might benefit or hinder. Yet a recent study drew a mildly positive correlation between moderate wine drinking and pregnancy.
The study, published in the September Journal of Human Reproduction was conducted at the Danish Epidemiology Science Center in Copenhagen by Mette Juhl, who had already researched the impact of moderate alcohol consumption on conception. Her past survey work concluded that moderate consumption of alcohol (up to 7 glasses per week) does not reduce a womans chances of purposefully getting pregnant.
For this study, the researcher set out to take a closer look at specific types of alcohol consumed by the 29,844 pregnant women who had participated in the first survey. Researchers discovered that wine drinkers had a nearly 30 percent greater chance than nondrinkers of getting pregnant within one year of trying. Woman who exclusively drank wine became pregnant sooner than those that drank only beer or hard liquor (spirits). Interestingly, drinking all three types of alcohol was associated with the shortest time to pregnancy.
Again, the study confirmed that heavy drinking of spirits actually decreases conception chances. Women who drank more than seven shots per week were 240 percent less likely to conceive. However, it is important to note that many of these women also had other risk factors for subfertility (smoking, greater incidence of pelvic infections or abdominal surgeries).
Ms. Juhl is cautious to point out that it may not be wine consumption per se, causing the increase or decrease in pregnancy success, but rather other lifestyle influences that may go along with wine drinking. For instance, some oenophiles enjoy healthier food than nondrinkers and beer or liquor drinkers. They also are more likely to be of average weight, and practice healthier lifestyle habits. The wine drinkers were less likely to smoke; smoking has been shown to prolong time to conception. Other confounding factors such as caffeine consumption, partners age and frequency of intercourse were not evaluated. She cautioned against drinking alcohol specifically to try to conceive, since this benefit was quite mild.
As little as one drink per day in pregnant women has been linked to decreased cognitive performance in their infants. Alcohol can have detrimental effects on the fetus as early as three weeks gestation - before a woman even knows she is pregnant. The "safe" amount of alcohol intake for pregnant women has not been established. Given that wine drinking could just be a proxy for a healthier lifestyle and the known negative effects of alcohol on the fetus, it is premature to encourage the consumption of wine to enhance conception.
For now we at PFC endorse the positions of the Centers of Disease Control ([www.cdc.gov/ncbddd](http://www.cdc.gov/ncbddd)) and the American Academy of Pediatrics ([www.AAP.org](http://www.aap.org/)) advising that women attempting pregnancy should abstain from alcohol.
References:
American Academy of Pediatrics: Preventing Fetal Alcohol Syndrome. [www.aap.org/advocacy/chm98pre.htm](http://www.aap.org/advocacy/chm98pre.htm)
CDC: Alcohol Use and Pregnancy. [www.cdc.gov/ncbddd](http://www.cdc.gov/ncbddd)
National Institute on Alcohol Abuse and Alcoholism: Fetal Alcohol Exposure and the Brain.
Barefoot JC, Gronbaek M, Feaganes JR, McPherson RS, Williams RB, Siegler IC. Alcoholic beverage preference, diet, and health habits in the UNC Alumni Heart Study. American J of Clinical Nutrition 2002;76 (2): 466-472.
Bolumar F, Olsen J, Boldsen J. Smoking reduces fecundity: a European multicenter study on infertility and subfecundity. The European Study Group on Infertility and Subfecundity. Am J Epidemiol. 1996; 143 (6): 578-87.
Bolumar F, Olsen J, Rebagliato M, Bisanti L. Caffeine intake and delayed conception: a European multicenter study on infertility and subfecundity. The European Study Group on Infertility and Subfecundity. Am J Epidemiol. 1997; 145 (4): 324-34.
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Jensen TK, Hjollund NH, Henriksen TB, Scheike T, Kolstad H, Giwercman A, Ernst E, Bonde JP, Skakkebaek NE, Olsen J. Does moderate alcohol consumption affect fertility? Follow up study among couples planning first pregnancy. BMJ. 1998; 317: 505-510.
Juhl M, Andersen AM, Gronbaek M, Olsen J. Moderate alcohol consumption and waiting time to pregnancy. Human Reproduction. 2001; 16 ( 12) 2705-2709.
Juhl M, Olsen J, Andersen AM, Gronbaek M. Intake of wine, beer, and spirits and waiting time to pregnancy. Human Reproduction. 2003; 19 (9): 1967-1971.
Kesmodel U, Wisborg K, Olsen SF, Henriksen TB, Secher NJ. Moderate alcohol intake during pregnancy and the risk of stillbirth and death in the first year of life. Am J Epidemiol. 2002; 155 (4): 305-12.
Kesmodel U, Wisborg K, Olsen SF, Henriksen TB, Secher NJ. Moderate alcohol intake in pregnancy and the risk of spontaneous abortion. Alcohol Alcohol. 2002; 37 (1): 87-92.
Rosenberg A. Brain Damage Caused by Prenatal Alcohol Exposure. Scientific American. July/August 1996; 42-51
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