Moderate Alcohol Consumption During Pregnancy and the Risk of Low Birth Weight and Preterm Birth. The Generation R Study
Introduction
Excessive alcohol consumption during pregnancy is associated with various pregnancy complications, including low birth weight, preterm birth, congenital anomalies, fetal alcohol syndrome, and perinatal death 1, 2, 3. Excessive maternal alcohol consumption during pregnancy is also associated with adverse postnatal behavioral development (4).
The effect of excessive alcohol consumption during pregnancy on prenatal growth and development cannot easily be extrapolated to lower levels of alcohol consumption. Previous studies examining the effect of low or moderate alcohol consumption during pregnancy (<1 alcoholic drink per day on average) on birth outcomes showed inconsistent results. Several studies found adverse effects, whereas others did not find any effect or even reported beneficial effects on weight and gestational age at birth 5, 6, 7, 8, 9. These inconsistent results may be due to differences in study design and in timing and methods of assessment of alcohol consumption. Several studies used only dichotomized outcomes including low birth weight (generally defined as <2500 g) and preterm birth 7, 10. However, alcohol consumption may affect the entire birth weight range, not only the risk of low birth weight. Most studies did not examine the effects of alcohol consumption in different periods of pregnancy. This may be important for identifying specific critical periods for exposure to alcohol during fetal life.
In a population-based cohort study among pregnant women and their children, we examined the associations of moderate maternal alcohol consumption in different periods of pregnancy with birth weight as continuous measure, and the risks of low birth weight, small size for gestational age at birth, and preterm birth in the offspring.
Section snippets
Design
This study was embedded in the Generation R Study, a population-based prospective cohort study from fetal life until young adulthood. This study is designed to identify early environmental and genetic determinants of growth, development and health in fetal life, childhood, and adulthood and has been described in detail elsewhere 11, 12. Briefly, the cohort includes 9778 mothers and their children of different ethnicities living in Rotterdam, The Netherlands. Enrollment was aimed at early
Results
Characteristics of the mothers are presented in Table 1. Of all mothers, 51% (n = 3618) used alcoholic drinks in early pregnancy and 37% (n = 2663) continued to use alcoholic drinks after pregnancy was known. In the total group, the age of mothers ranged from 15.3 to 43.3 years, with a mean age of 29.8 years. The percentage of mothers with a higher educational level was highest among those who continued to use alcoholic drinks after pregnancy was known. In the total cohort, the largest ethnic
Discussion
This population-based prospective cohort study suggested that average maternal alcohol consumption of less than one drink per day was not associated with adverse effects on weight and gestational age at birth. Tendencies toward adverse effects were found for alcohol consumption of one or more drinks per day on average in early and late pregnancy.
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