Low prenatal alcohol exposure and pregnancy and childhood outcomes

NIHR CLAHRC West and the MRC Integrative Epidemiology Unit are completing an extensive systematic review and a series of meta-analyses of the published evidence on the effects of low-to-moderate maternal alcohol consumption during pregnancy, on pregnancy, delivery and perinatal outcomes, as well as Foetal Alcohol Syndrome (FAS) features (read the full protocol).

This work is of great public health importance and extremely topical, following the recent publication of new alcohol guidelines by the Department of Health. For pregnant women, or those planning a pregnancy, the guidelines now say the safest approach is to drink no alcohol at all to keep risks to the foetus to a minimum.

The new guidelines are said to be largely based on the precautionary principle – assuming potential harm to the foetus when in reality there is still some uncertainty around the effect of drinking small amounts of alcohol. Therefore, our comprehensive and updated review, which uniquely includes more robust evidence from natural experiments as well as dozens of more conventional epidemiological studies and focuses just on very low levels of alcohol drinking, could help answer just that question.

In early 2014, researchers at the CLAHRC West and MRC Integrative Epidemiology Unit felt there was enough new evidence on the effects of exposure to low-to-moderate prenatal alcohol consumption to justify revisiting the literature, and potentially warrant a change to the existing guidelines, which then advised against exceeding 1-2 UK units twice a week.

The project is near completion and we are preparing a manuscript for submission to a medical journal, as well as a lay summary review for PolicyBristol and a response to the open consultation process following publication of the new guidelines.

This work is jointly funded by CLAHRC West and the MRC Integrative Epidemiology Unit at the University of Bristol, and is the first project funded within their knowledge transfer program.