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Is it all right for women to drink small amounts of alcohol in pregnancy? Yes

BMJ 2007; 335 doi: (Published 25 October 2007) Cite this as: BMJ 2007;335:856
  1. Pat O'Brien, obstetric consultant
  1. Institute for Women's Health, University College London Hospitals, London WC1E 6AU
  1. patrick.obrien{at}

    The National Institute for Health and Clinical Excellence draft guidance on drinking during pregnancy has added to confusion about safety. Pat O'Brien believes that telling women to abstain is overly paternalistic on current evidence, but Vivienne Nathanson and colleagues argue that this is the safest message

    Until May of this year, the Department of Health advised pregnant women in England not to drink “more than one to two units of alcohol once or twice a week.” Since then, both the department and the British Medical Association have changed their stance;1 2 pregnant women are now told to avoid alcohol completely. There is no new evidence so why the change?

    Fetal alcohol syndrome is a serious condition and is clearly a consequence of heavy alcohol intake during pregnancy.3 Although rare (128 cases in England in 2002-3), it is the leading cause of non-genetic intellectual disability in the Western world. The incidence of the broader range of fetal alcohol spectrum disorders is more difficult to determine, for various reasons, including difficulty in diagnosis, under-reporting, and confounding.4

    State of evidence

    Nevertheless, there is still no evidence that low to moderate alcohol intake in pregnancy has any long term adverse effects. But don't take my word for it. Last year …

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