Intended for healthcare professionals

Rapid response to:

Editorials

Low level alcohol consumption and the fetus

BMJ 2005; 330 doi: https://doi.org/10.1136/bmj.330.7488.375 (Published 17 February 2005) Cite this as: BMJ 2005;330:375

Rapid Response:

Australian authorities do not recommend abstinence from alcohol for pregnant women

Dear Sir,

The claim 1 that Australia authorities have “adopted the abstinence
message” for pregnant women considering drinking alcohol is incorrect. In
fact the most recent Australian guidelines recommend 2 that “pregnant
women may consider not drinking at all; most importantly, should never
become intoxicated; if they choose to drink, over a week, should have less
than 7 standard drinks, AND, on any one day, no more than 2 standard
drinks (spread over at least two hours); [and] should note that the risk
is highest in the earlier stages of pregnancy, including the time from
conception to the first missed period”.

As a commentary accompanying this guidelines noted “The first weeks
after conception are probably the most critical in relation to alcohol,
and the woman is usually unaware of the pregnancy at this stage. The
guideline is therefore important not only for women who are pregnant, but
for those who may soon become pregnant”.

Many women experience considerable anxiety during pregnancy. Almost
all pregnant women try to do the best they can for their unborn child.
Although alcohol is the most common teratogen, is it worth risking
increasing the anxiety of pregnant women when the actual benefit of this
advice is unknown? If the prevalence of fetal alcohol syndrome is to be
reduced substantially, and if it is accepted that the first few weeks of
pregnancy are particularly important, then all pregnant women and all
women who might soon become pregnant will have to be persuaded to avoid
immoderate alcohol consumption. This is far more achievable than trying to
persuade this large population from drinking any alcohol.

Yours sincerely,

Dr. Alex Wodak,

References:

1 Mukherjee RAS, Hollins S, Abou-Saleh MT, Turk J. Low level alcohol
consumption and the fetus. BMJ 2005;330:375-376 (19 February),
doi:10.1136/bmj.330.7488.375

2 National Health and Medical Research Council. Australian Alcohol
Guidelines: Health Risks and Benefits. 2001
http://www7.health.gov.au/nhmrc/publications/pdf/ds9.pdf

Competing interests:
Member of committee which prepared: National Health and Medical Research Council. Australian Alcohol Guidelines: Health Risks and Benefits. 2001

Competing interests: No competing interests

09 March 2005
Alex D Wodak
Director, Alcohol and Drug Service
St. Vincent's Hospital, Darlinghurst, NSW, 2010, Australia