Alcohol in pregnancy research presented to All Party Parliamentary Group

Dr Luisa Zuccolo and Dr Loubaba Mamluk presented the widely reported light drinking during pregnancy research to the All Party Parliamentary Group on Foetal Alcohol Spectrum Disorder on 22 November.

The research was a systematic review of the scientific evidence of the effects of light drinking in pregnancy. Light drinking was defined as drinking no more than two units of alcohol a week, no more than twice a week: the level which the previous version of the UK guidelines recommended not to exceed. They examined both short-term effects such as pregnancy complications and delivery outcomes, and long-term effects such as measures of growth and development in the children.

Funded by NIHR CLAHRC West and Bristol University’s MRC Integrative Epidemiology Unit, the review received a lot of media attention. The coverage included some misleading headlines that interpreted lack of evidence for the harm of light drinking alcohol in pregnancy meant it must therefore be ok to drink. Dr Zuccolo and Dr Mamluk were invited to present following the media coverage, and their robust response to correct the misreporting.

The main finding of the review was that there was a lack of evidence on the effects of light drinking in pregnancy. They only found 26 studies looking at this range of alcohol exposure. This is not enough evidence to establish the existence of a safe level, but also not enough to confidently quantify the harms associated with this level of drinking, for all but two of the outcomes examined.

The study provides some support to the recent change in UK guidelines on alcohol consumption during pregnancy, revised down to ‘not drinking at all’ and initially only based on a ‘better safe than sorry’ approach. We now have a bit more evidence tipping the balance even more so in favour of ‘no alcohol is safe’.

The All Party Parliamentary Group on Foetal Alcohol Spectrum Disorder (FASD) is chaired by Bill Esterson MP, and the vice-chair is Fiona Bruce MP. It is regularly attended by MPs and peers, members and trustees of FASD charities, health professionals working in the field and journalists.

Dr Zuccolo was the first of three experts to present, including two academics and a specialist public health midwife, followed by questions. She answered questions from MPs, other panellists and members of the public. Topics ranged from what caused some media outlets to distort the findings, to how association can be distinguished from causation, to the complexity of British society which seems particularly reluctant to forgo alcohol.

Attendees were given the NIHR CLAHRC West BITE which summarised the research findings, as well as a handout on the media coverage and the social media response to it.

Dr Zuccolo said:

“This was a great opportunity to talk to representatives of the FASD charities, including a teenage girl affected by FASD. Everybody we talked to seemed really interested in our study and the science communication aspect of it, and generally appreciative of the work we do as ‘experts producing and interpreting evidence’. I left feeling motivated to continue working in this field, keeping the research relevant to a wide audience, and to engage the public – and MPs – in the research.”

She is writing a blog for the BMJ on some of the lessons learnt from the media experience. The team are conducting more systematic reviews looking at different types of studies which could improve the ability to distinguish association from causation.