British Pregnancy Advisory Service comment on BMJ Open study examining prevalence of alcohol use in pregnancy
This research looked at alcohol use among nearly 18,000 pregnant women in the UK, Ireland, Australia and New Zealand. In particular, it examined findings from the Screening for Pregnancy Endpoints (SCOPE) study, which recruited nearly 6,000 pregnant women from these countries, to enable international cross-cohort comparisons.
Around 75% of pregnant women in the UK reported drinking some alcohol in pregnancy, lower than in Ireland (86%) and higher than in Australia and New Zealand (40% and 56% respectively). However, overall levels of consumption across pregnancy were low, and dropped dramatically as pregnancy progressed.
While nearly a third (32%) of pregnant women in the UK reported an episode of binge drinking (6 or more units on one occasion) in the first trimester, this had dropped to less than 1% in the second trimester. This likely reflects the fact that many pregnancies are unplanned, and many women will have an episode of binge drinking before they recognise they are pregnant, when they reduce their intake sharply. Just over a third of UK women (34%) drank any alcohol in the second trimester, and of these the overwhelming majority (96%) drank just 1-2 units per week. Current NICE guidance says women who choose to can drink 1-2 units, once or twice a week, because there is no evidence of harm at these low levels.
Clare Murphy, Director of External Affairs at the British Pregnancy Advisory Service, said:
“This analysis suggests women in the UK reduce their alcohol consumption dramatically when they find out they are pregnant. By the second trimester, many women are not drinking at all. Among those who are consuming some alcohol, nearly all are doing so at very low levels where there is no evidence of harm.
“Although the authors describe these findings as raising significant public health concerns, the majority of women in the UK are drinking well within the existing recommendations in the second trimester. The prevalence of unplanned pregnancy in this country means many women may have an episode of binge drinking before they realise they are pregnant, but the monumental drop in reported binges by the second trimester suggests women alter their behaviour very quickly. Bpas regularly sees women so concerned about the damage caused by an episode of binge drinking before they recognised they were pregnant they consider ending what would otherwise be a wanted pregnancy. We would like to see greater reassurance to these women that they are extremely unlikely to have caused their baby harm.
“It is concerning that the authors of this paper are calling for biological tests so that pregnant women’s alcohol intake can be measured. The implication is that women’s own reports of their alcohol use cannot be trusted. We would be extremely wary of any measures which sought to further police pregnant women’s behaviour, and undermined the important relationship between a pregnant woman and her healthcare provider.”
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