Association Between Maternal Alcohol Consumption in Early Pregnancy and Pregnancy Outcomes

McCarthy, Fergus P. PhD, MD; O'Keeffe, Linda M. BSc; Khashan, Ali S. PhD, MSc; North, Robyn A. PhD, MD; Poston, Lucilla PhD; McCowan, Lesley M. E. MD, FRANZCOG; Baker, Philip N. FRCOG, DM; Dekker, Gus A. PhD, MD; Roberts, Claire T. PhD; Walker, James J. MD, FRCOG; Kenny, Louise C. PhD, MD

doi: 10.1097/AOG.0b013e3182a6b226
Original Research
Journal Club

OBJECTIVE: To investigate the association between alcohol consumption and binge drinking before and during early pregnancy and adverse pregnancy outcomes.

METHODS: We used data from 5,628 nulliparous pregnant participants recruited to the Screening for Pregnancy Endpoints (SCOPE) study, a prospective cohort study. Participants were interviewed at 15 weeks of gestation and information on alcohol intake before pregnancy and until the time of interview was obtained using a standardized questionnaire. Alcohol intake was classified as occasional (1–2 units per week), low (3–7 units per week), moderate (8–14 units per week), and heavy (greater than 14 units per week). Binge alcohol consumption was defined as consumption of 6 or more alcohol units in one session.

RESULTS: Of the 5,628 participants, 1,090 (19%) reported occasional alcohol consumption, 1,383 (25%) low alcohol consumption, 625 (11%) moderate alcohol consumption, and 300 (5%) heavy alcohol consumption. Overall, 1,905 (34%) participants reported binge alcohol consumption in the 3 months before pregnancy, and 1,288 (23%) of these participants reported binge alcohol consumption during the first 15 weeks of pregnancy. Participants who consumed occasional to heavy amounts of alcohol in early pregnancy did not have altered odds of a small-for-gestational-age neonate, reduced birth weight, preeclampsia, or spontaneous preterm birth. Similarly, those who binge drank in early pregnancy did not have altered odds of these adverse pregnancy outcomes.

CONCLUSION: Alcohol consumption in early pregnancy was prevalent in this nulliparous cohort. There was no association between alcohol consumption before 15 weeks of gestation and small for gestational age, reduced birth weight, preeclampsia, or spontaneous preterm birth.

LEVEL OF EVIDENCE: II

There is no association between alcohol consumption before 15 weeks of gestation and preeclampsia, spontaneous preterm birth, or having a small-for-gestational-age or reduced birth weight neonate.

Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, and the National Perinatal Epidemiology Centre, Cork University Maternity Hospital, Wilton, Cork, Ireland; the Department of Maternal and Fetal Medicine and the Division of Women’s Health, Women's Health Academic Centre, King's College London and King's Health Partners, London, United Kingdom; the Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, and the National Centre for Growth & Development and Maternal and Fetal Health, Liggins Institute, University of Auckland, Auckland, New Zealand; the Women's and Children's Division, Lyell McEwin Hospital, University of Adelaide, and the School of Paediatrics and Reproductive Health, Robinson Institute, University of Adelaide, Adelaide, South Australia; and the Department of Obstetrics and Gynaecology, St James University Hospital, Leeds, United Kingdom.

Corresponding author: Fergus P. McCarthy, PhD, MD, MSc, The Irish Centre for Fetal and Neonatal Translational Research (INFANT), University College Cork, Cork University Maternity Hospital, Wilton, Cork, Ireland; e-mail: Fergus.mccarthy@ucc.ie.

Funded by New Enterprise Research Fund, Foundation for Research Science and Technology; Health Research Council; Evelyn Bond Fund, Auckland District Health Board Charitable Trust (New Zealand Screening for Pregnancy Endpoints [SCOPE] Study); Premier's Science and Research Fund, South Australian Government (Australian SCOPE Study); Health Research Board (Ireland SCOPE Study); National Health Service NEAT Grant, Manchester Biotechnology and Biological Sciences Research Council, University of Manchester Proof of Concept Funding (University of Manchester, Manchester, United Kingdom); Guy's and St Thomas' Charity (King's College London, London, United Kingdom); and Tommy's Charity (King's College London, London, and University of Manchester, Manchester, United Kingdom).

The authors thank the study participants; Eliza Chan for contributions to the creation of the Screening for Pregnancy Endpoints database; Rennae Taylor, Nicolai Murphy, Annette Briley, and Denise Healy for coordinating the Screening for Pregnancy Endpoints studies in each country; and all other study midwives.

Presented at the Society for Gynecologic Investigation 60th Annual Scientific Meeting, March 20–23, 2013, Orlando, Florida.

Financial Disclosure The authors did not report any potential conflicts of interest.

© 2013 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.