In the past week, two different studies came out about prenatal alcohol exposure (PAE). One, the Annenberg Public Policy Center (APPC), surveyed more than 1,600 adults in the United States regarding maternal health (eurekalert). The other, published in the Alcohol: Clinical and Experimental Research (Hoboken), surveyed more than 1,500 women in the United Kingdom, then had them read a leaflet, “Alcohol and Pregnancy,” that was developed by the Royal College of Obstetricians and Gynaecologists (Keating, Brown, et al). (The leaflet is linked below, RCOG.)
Two studies in two different countries about the same overall subject: PAE.
In the UK, 85 percent of the women surveyed “were aware of fetal alcohol spectrum disorders (FASD) and the guidance on alcohol use during pregnancy, although only 40 percent felt the guidance was widely known” (medbound).
Meanwhile, in the US, 65 percent of those surveyed supported the message from the Centers for Disease Control and Prevention (CDC), that “it’s more accurate to say that someone who wants to get pregnant should stop drinking both before and during pregnancy” (eurekalert).
While there’s a 20 percent difference between surveys in the US and the UK, there’s a problem with the language: the UK survey talks about alcohol use DURING pregnancy, but the US study asks about alcohol use BEFORE and DURING pregnancy. And the US study does show that 84 percent of those surveyed “know that it’s false to claim that drinking wine or beer while pregnant is safe” (eurekalert), so it seems that the numbers are about the same: 84 percent of people in the US know that any amount of alcohol DURING pregnancy is bad. For the record, the base of the drink doesn’t matter; what matters is the alcohol in the drink, and most of the time, if the drink is properly poured, the amount of pure alcohol in wine, beer, or liquor is the same, about .6 ounces.
Quite worrisome, though, is that the US survey found that almost a quarter of those surveyed think the message that “someone seeking to get pregnant should stop drinking as soon as they learn they’re pregnant” is more accurate (eurekalert).
This is really bad news when you understand that “Among all pregnancies reported [from data in the US], gestational age at time of pregnancy awareness was 5.5 weeks (standard error = 0.04) and the prevalence of late pregnancy awareness was 23% (standard error = 1 %)” (pmc). Those first five weeks are when the central nervous system, the heart, arms, legs, ears, and eyes are developing, and so alcohol consumption during these first 5.5 weeks makes the baby more vulnerable to defects in these areas.
And that’s not even considering the 23 percent who have LATE pregnancy awareness.
There’s more bad news from the US. Women of childbearing age are the ones who are “significantly less likely to say that someone who wants to get pregnant should stop drinking alcohol before and during pregnancy (58% vs. 66%). In addition, the proportion of women 18-49 years old who think, incorrectly, that it’s more accurate to say drinking should stop as soon as they learn they are pregnant increased significantly to 25% from 17% in 2024 (eurekalert).
More education is warranted, but we have to ensure that we are delivering the right message. While the leaflet from the Royal College of Obstetricians and Gynaecologists does say “The safest approach is not to drink alcohol at all if you are pregnant, if you think you could become pregnant or if you are breastfeeding,” it also says, “Although the risk of harm to the baby is low with small amounts of alcohol before becoming aware of the pregnancy, there is no ‘safe’ level of alcohol to drink when you are pregnant”(RCOG). What is a small amount of alcohol? I can almost guarantee that my small amount and your small amount are not the same amounts. And, the rest of the four-page document talks only about the dangers of drinking DURING pregnancy.
While technically accurate, the danger is also women drinking when they don’t even know they’re pregnant, thus the CDC’s message is clearly the right one: “There is no known safe amount of alcohol use during pregnancy or while trying to get pregnant” (CDC).
References
https://www.cdc.gov/maternal-infant-health/pregnancy-substance-abuse/index.html
https://www.eurekalert.org/news-releases/1092803
Keating O, Brown RH, McDougall S, Kuenssberg R, O’Rourke S. Knowledge as prevention: A cost-effective intervention to reduce prenatal alcohol exposure. Alcohol Clin Exp Res (Hoboken). 2025 Aug 1. doi: 10.1111/acer.70089. Epub ahead of print. PMID: 40748351.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5269518/
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