Intended for healthcare professionals

Rapid response to:

Head To Head

Should women abstain from alcohol throughout pregnancy?

BMJ 2015; 351 doi: (Published 06 October 2015) Cite this as: BMJ 2015;351:h5232

Rapid Response:

Re: Should women abstain from alcohol throughout pregnancy?

Re: Should women abstain from alcohol throughout pregnancy?

In agreement with the article, lack of evidence is not the same as evidence of absence of risk and, in this case, no evidence of harm does not mean evidence of no harm; subsequently, no amount of alcohol during pregnancy can be considered safe based on research evidence.

However, some aspects are at least as little convincing as the criticized contradictory advice from health agencies. Sometimes less severe disorders of the spectrum can be associated to a distorted functioning in the daily life at less as severe as complete foetal alcohol syndrome (FAS), especially in adopted children who add the deleterious effects of a long stay in foster care centers.

Certainly, the advice about moderate or low alcohol intake in any week of the gestation must be clear and one: we don’t know if this consumption damages the neurodevelopment of the foetus, so any amount of alcohol can be considered secure and we can’t recommend any other advice that complete abstinence. In this sense, we must consider that the main problem about this subject is not the evidence based discourse but the no damage presumption. As health professionals, we must manage the uncertainty and advice from caution, not from presumption, mainly because an affected child could be hardly overcome by parents.


Vall O, Salat-Batlle J, Garcia-Algar O. Alcohol consumption during pregnancy and adverse neurodevelopmental outcomes. J Epidemiol Community Health. 2015;69:927-9.

Garcia-Algar O, Carballo L, Reguart N, Salat-Batlle J. Neurobehavioural Effects of Prenatal Exposure to Alcohol. J Preg Child Health. 2015;2:177.

Competing interests: No competing interests

10 October 2015
Oscar Garcia-Algar
Adriana Bastons, Lourdes-Rita Vega
Grup de Recerca Infancia i Entorn (GRIE), Institut Hospital del Mar d'Investigacions Mediques (IMIM), Barcelona, Spain
Pº Maritimo 25-29, 08003 Barcelona, Spain