Does light drinking in pregnancy have benefits?

NEW YORK (Reuters Health) - Could a glass of wine a day early in pregnancy yield better behaved kids? Maybe, according to results of a new study.

Researchers found that the children of women who were light or moderate drinkers (2 to 6 drinks per week or one per day) early in pregnancy tended to have “more positive” behavior than the children of mothers who did not drink at all early in pregnancy.

“This positive behavior meant that the children of light and moderate drinkers had less emotional and behavioral problems through childhood and adolescence,” Dr. Monique Robinson, from Telethon Institute for Child Health Research in West Perth, Western Australia, told Reuters Health by email.

The new findings, published in the obstetrics and gynecology journal BJOG, are based on 14 years’ worth of data in the Western Australian Pregnancy Cohort (Raine) Study.

The women provided information on their weekly drinking habits during early pregnancy: 59 percent of women reported no drinking; 20 percent reported occasional drinking (up to one standard drink per week); 15 percent reported light drinking (2-6 drinks per week); 3 percent moderate drinking (7-10 per week); and 2 percent reported heavy drinking (11 or more per week).

The behavior of 2,370 children was assessed every 2-3 years between the ages of 2 and 14.

Compared with mothers who did not drink in the first 3 months of pregnancy, those who were light drinkers during this time had better behaved children over 14 years, as indicated by better scores on a standard checklist used by psychologists.

Children of light to moderate drinkers early in pregnancy had a “clinically meaningful” lower risk of internalizing behavior (in which negativity is directed inwards, for example depression) and externalizing behavior (such as aggression), than children of nondrinkers.

As an example, at the age of 14, 127 children of nondrinkers had internalizing problems (14 percent) and 159 (18 percent) had externalizing problems. By comparison, among light drinkers, only 32 children (10 percent) had internalizing problems and 45 (13 percent) had externalizing problems.

Research has shown that moderate drinkers are mentally healthier than both abstainers and addicts, which could help explain these findings, the researchers say. There may biological reasons as well; namely, low doses of alcohol in pregnancy may help calm the mother-to-be, perhaps yielding calming kids.

“Given what we know about the dangers of frequent heavy consumption of alcohol in pregnancy, these results may initially appear surprising,” Robinson admitted. For example, fetal alcohol syndrome is a well-described condition. “However, we need to be cautious about generalizing the effects of a heavy alcohol intake to a light consumption of alcohol -- they are not equal.”

Robinson also noted that some studies have found a light consumption of alcohol in pregnancy to be associated with positive cognitive outcomes for children. “But the light-to-moderate intake results tend to be overshadowed by the focus on harm at the excessive intake end of the scale,” she said.

With about half of all pregnancies in Australia being unplanned (with similar figures for the US and UK), the current findings should be reassuring to women, Robinson said.

“Women may be drinking alcohol in small amounts prior to recognition of the pregnancy and we feel these data highlight that it is unlikely that this has harmed their unborn child’s mental health,” she said.

“Women should not feel guilty or anxious about low-level drinking effects prior to recognition of the pregnancy. However, binge and large alcohol intake should still be avoided as this does have potential for harm,” Robinson emphasized.

Nonetheless, Robinson does not advise women who are pregnant or trying to become pregnant to head to the local pub. She also emphasized that child behavior is “just one of many outcomes that might be assessed with regards to alcohol consumption during pregnancy. While our study found light drinking during pregnancy was not associated with increased risk for the child, national guidelines recommend the safest choice is to avoid alcohol once the pregnancy is known.”

“The best option,” Robinson said, “is for women to ask their obstetric care provider (obstetrician, midwife, family doctor, etc) and work with that person on their decision regarding alcohol.”

SOURCE: BJOG, online May 28, 2010.