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July 1, 2010

Don't drink or smoke while pregnant

Reuel S. Amdur

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Zoe Williams, a pregnant columnist who writes for Great Britain's Guardian newspaper, has gone ballistic. No one is going to tell her not to take the occasional drink.

“To think this government has the brass neck to lecture women about their gestational behaviour.  It is an outrage against women; against the relationship between the state and the individual and, without wishing to be too mawkish, against babies.” 

Well, without going into a philosophical dialogue about the relationship between a woman and the state, Dr. Roy Peters of the Queen’s University Psychology Department laid out the evidence. 

Mother Nature is not an equal opportunity employer.

When he began to speak in a federal auditorium in Ottawa, about the relationship between drinking and smoking during pregnancy and their effects in early school years, we quickly learned that it was to be an earth-shaking presentation.  5.5 on the Richter scale and we were out of the building and on our way home.  Fortunately, the organizers of the event supplied loads of written information covering his proposed talk.

The information reported data gathered from a demonstration program, Better Beginnings, Better Futures. 

The program served young disadvantaged mothers and their children in eight locations across Ontario. 

The researchers looked at data around maternal tobacco and alcohol use during and after pregnancy and child behavior and scholastic achievement.  Children’s functioning was reported at 33 months, 48 months, and eight years. 

Results were quite clear regarding drinking during pregnancy. 

As compared to children whose mothers did not imbibe while pregnant, these children did less well in school performance and had more behavioral problems, both acting out and withdrawal and depression. 

The problems were more serious for heavy as opposed to moderate drinking.

A greater impact also occurred where a mother both drank and smoked.

When the researchers looked at the results for smoking but not drinking, they could not find a statistically significant effect. 

However, second-hand smoke after birth was associated with withdrawn and depressed kinds of behavior. 

Measuring the impact of prenatal smoking was difficult because it was not simple to distinguish the impact of prenatal and postnatal smoking, while postnatal drinking, in contrast, was not implicated in behavioral and scholastic difficulties. 

The impact of drinking during nursing does not appear to have been considered.  In reports from other sources, smoking has been associated with low birth weight, birth defects, and sudden infant death syndrome.

A study by Indiana University professor Brian D’Onofrio found that the behavioral problems exhibited by children increased with the number of days that the mother drank while pregnant, and Dr. John Olney, of the Washington School of Medicine in St. Louis, found that even two drinks during a pregnancy could kill some brain cells and cause permanent damage.

According to Dr. Russell Kirby, professor of Maternal and Child Health at the University of Alabama, “Alcohol exposure in the first three months is more apt to have effects on the embryo.  Most basic structures of the body are basically formed in the ten to 12 weeks of pregnancy.” 

Unfortunately, at that stage a woman may not be aware she is pregnant.  And, he added, “Drinking in the last few months of pregnancy is associated with a retardation of growth, resulting in a baby smaller than normal at delivery.”  There is also greater risk of microcephaly and mental deficiency.

Drinking while pregnant can result in a child with fetal alcohol spectrum disorder (FASD). 

The extreme form is fetal alcohol syndrome  (FAS).  FAS is characterized by abnormal facial features, deficiency in growth, and problems of the central nervous system.

FASD applies as well when a person has some but not all of the FAS characteristics.  Those with FASD may have problems with vision or hearing, behavior, defects of hands, feet, heart, and other organs, learning problems, and psychiatric problems. 

FASD is the number one cause of mental deficiency, though not all people with FASD are mentally deficient.  FASD occurs in one per cent of Canadian births and is more common than birth with HIV, muscular dystrophy, spina bifida, and Down syndrome combined. 

The condition is extremely costly.  It entails specialized teaching methods, and those with the condition often have serious problems functioning in society.  They tend to be easily led.  Incarceration, unwanted pregnancy, inability to keep a job, and mental illness are common. 

The message for women: Drinking while pregnant is a bad idea.  Proceed with caution if you are able to become pregnant and may be pregnant without knowing.  Smoking can also be harmful.  Better safe than sorry.

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