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Pregnancy and intoxicants

Published 7 April 2010.

Only about one in every ten women of childbearing age declare themselves to be completely teetotal. It is quite likely that a pregnant woman who does not yet know she is pregnant has used alcohol. What does this mean for her unborn child?

Alcohol can harm the foetus at any stage of pregnancy. In early pregnancy, drinking to get drunk can cause severe, life-threatening defects to the foetus (e.g. heart defects). Alcohol consumption can also lead to minor, cosmetic deformations, such as abnormal facial features, ears, fingers, etc. Long-term exposure to alcohol during pregnancy leads to permanent growth problems, meaning that the child will never reach the height expected according to its parents. Children are often underweight, with girls’ weight returning to normal around puberty, but severely damaged boys remain underweight even into adulthood. Cranium growth may be slow, even after birth, as a sign of permanent damage to the development of brain tissue. Exposure to alcohol causes developmental problems in the sensory central nervous system, ranging from slight learning difficulties to severe mental retardation. The most significant damage caused by alcohol where children’s future is concerned is disorders of the central nervous system, with the degree of damage affected by the amounts of alcohol consumed as well as the duration of alcohol consumption during pregnancy.

There has been a great deal of research into the mechanism by which alcohol causes foetal damage and the long-term prognosis for newborns with birth defects. It is impossible to set a safe limit for consumption of intoxicants, but the following rules can be set out on the basis of this research:

1. If you are planning to get pregnant or if it is possible that you may become pregnant, avoid drinking to get drunk.

  • the foetus’ organs begin to form during the first 10 weeks of pregnancy, when you may not know you are pregnant. The risk of organ defects increases significantly if the mother has been drunk during the first weeks of pregnancy. 

2. When you find out you are pregnant, don’t drink any more alcohol. It has been shown that the risk of damage to the foetus increases if you drink just 1 unit of alcohol (e.g. a 120 ml glass of wine) per day.

  • It has been shown that drinking to get drunk is particularly hazardous to the development of the foetus. 5 bottles of beer in one day will damage the foetus more than one bottle consumed per day over 5 days
  • It has not been shown that just one random unit of alcohol during pregnancy would affect the child’s development after it is born.
  • If you feel that you cannot reduce/stop your consumption of alcohol, seek help. Every day you go without alcohol improves the prognosis for your unborn child. Many maternity hospitals treat substance abuse problems in pregnant women, often in consultation with substance abuse specialists.

Pregnancy and tranquillisers

Using tranquillisers or depressants (such as benzodiazepines) together with alcohol can increase the risk of damage to your foetus. If you are trying to reduce your alcohol consumption because you are pregnant or planning to get pregnant, do not shift your dependency to tranquillisers. Instead, recognise and admit your dependency on intoxicants and seek help from the maternity clinic.

Pregnancy and drugs

The risks of damage to your foetus caused by drugs are associated mainly with deformations (particularly with amphetamines), sudden miscarriage (especially with heroin) and problems caused by premature birth. Long-term, sustained exposure to drugs during pregnancy leads to serious withdrawal symptoms in the foetus which can even lead to death of the newborn if left untreated. The baby may require several days or even weeks of withdrawal care. Intravenous drug use is also associated with the risk of infection in the mother, particularly hepatitis but also HIV can be transferred to the foetus in the womb or during childbirth.

Newborn babies exposed to intoxicants during pregnancy

A newborn baby that is born following prolonged exposure to intoxicants is always difficult to look after. These children may exhibit withdrawal symptoms for several days or weeks. In addition, it will be difficult to settle the child into a routine – they will wake easily and often, feed poorly and often, and are difficult to calm down. It is important that such children are not sent home too soon, because they will quickly exhaust their mothers. It is understandable that if a mother has not received treatment for her substance dependency, she will not be able to cope with looking after the baby on her own at home – there is a clear risk that the child’s care will be neglected. In order to avoid this, it is crucial that the expectant mother acknowledges her situation. Then an individual support network can be created for her before she and her baby are released from the maternity hospital.

Fear and guilt

Many mothers worry about their use of intoxicants during the time they did not realise they were pregnant. Even consumption of a small amount of alcohol during pregnancy can cause feelings of fear and guilt. You should not be left to worry about these things alone. Think about your own situation in the light of this article and Addictionlink’s article on pregnancy.

Share your worry with someone. You can also talk about it at the maternity clinic, and the psychologist at the maternity clinic or health centre is also available. Unnecessary guilt and fear reduce your ability to enjoy your pregnancy, and can have a detrimental effect on the development of your positive image of your developing baby. Don’t let this unique time of your life be spoiled by worrying unnecessarily. It’s important that everyone who hopes to become a parent things about what is best for their unborn child even before becoming pregnant, so that it will be easier to live with the past in the future.

Ilona Autti-Rämö
Specialist in paediatric neurology,
Research Professor