Child, Youth and Women's Health Service

Official Launch of the "Pregnancy and Alcohol Don't Mix" Promotional Campaign

Tuesday 22nd February 2005

PROF ERIC HAAN
HEAD, DEPARTMENT OF GENETIC MEDICINE, CYWHS

Alcohol and pregnancy really don't mix!

The consequences of drinking in pregnancy can include miscarriage, premature birth, low birth weight, increased risk of sudden infant death syndrome and fetal alcohol syndrome.

Fetal alcohol syndrome is arguably the leading cause of preventable disability in childhood. With a frequency of 1 to 2 per 1000 births, it is as common as spina bifida and Down syndrome, yet the public is barely aware of it. It is even more common, 10 times more common, in disadvantaged groups. Its effects are life long and there is no cure, yet it is potentially 100% preventable.

Alcohol can damage a developing baby in several ways, resulting in fetal alcohol syndrome. It can affect brain development, causing intellectual disability, mental health problems problems and disordered behaviour. It can affect growth, both before and after birth. It can cause birth defects, such as heart malformations and cleft palate. And, finally it can produce characteristic changes in a child's facial appearance.

A child with fetal alcohol syndrome can have a normal IQ score, but when detailed psychological testing is done, will show a characteristic pattern of disability, with difficulties in planning and organisation, lack of insight, difficulties understanding cause and effect relationships and an inability to generalise on the basis of experience.

Statistics about the downstream effects of fetal alcohol syndrome are sobering! 50% of affected children are in foster care, 60% will have disrupted schooling, 80% will be unemployed, 90% will have mental health problems, 60% will get into trouble with the law, 30% will have alcohol or other drug dependency – only 10% will live and work independently.

Fetal alcohol syndrome is only the tip of the iceberg. For every child diagnosed with fetal alcohol syndrome there are 3 - 5 who were damaged by alcohol in pregnancy, but not severely enough to be diagnosed with the syndrome. These are children with alcohol-related neurodevelopmental disorders and alcohol-related birth defects that are often not recognised as being the result of exposure to alcohol in pregnancy.

When a pregnant woman drinks alcohol, so does her unborn baby. It is clear that relatively small amounts of alcohol in pregnancy can harm the developing baby and that a safe amount of alcohol in pregnancy has not been established. Both regular drinking throughout pregnancy and binge drinking can cause the disorder and there is no time in pregnancy when it is safe to drink alcohol.

Drinking alcohol is a feature of our culture and has become a significant part of the culture of young people. 1 in 8 young women binge drink and binge drinking accounts for about a fifth of all drinking episodes. When you combine that with the fact that 50% of pregnancies are unplanned, fetal alcohol syndrome is an accident waiting to happen! Then when a pregnancy occurs, data from overseas shows that about 1 in 8 women continue to drink and 1 in 30 binge drink.

The arguments for educating the public about the risks of drinking in pregnancy are overwhelming and research overseas has shown that prevention efforts can work. But who will do the educating? Recent studies have identified substantial gaps in health professionals' knowledge about Australian guidelines about alcohol and pregnancy – for example, no more than half of health professionals routinely ask about alcohol use in pregnancy and only a quarter provide information about the consequences of alcohol use in pregnancy. Providing advice has been difficult because existing guidelines about alcohol in pregnancy are complex, even for health professionals. For the public, they are both hard to understand and hard to put into practice.

There is a need for a clear message to women of childbearing age, and if we are to approach alcohol in the same way as we approach other potentially harmful things in pregnancy, such as X-rays, the message must be that no alcohol in pregnancy is the only safe choice. The "Pregnancy and Alcohol Don't Mix" campaign provides that message.