Low-to-moderate gestational alcohol use and intrauterine growth retardation, low birthweight, and preterm delivery

Ann Epidemiol. 1997 Oct;7(7):498-508. doi: 10.1016/s1047-2797(97)00081-1.


Purpose: Heavy drinking during pregnancy is an established risk factor for fetal alcohol syndrome and other adverse perinatal outcomes. However, there is still debate as to the effects of low-to-moderate drinking during pregnancy.

Methods: This prospective investigation was based on 2714 singleton live births at Yale-New Haven Hospital during 1988-1992. Alcohol drinking during pregnancy was evaluated with respect to intrauterine growth retardation (IUGR), preterm delivery, and low birthweight.

Results: Mild drinking, defined as > 0.10-0.25 oz of absolute alcohol per day, during the first month of pregnancy was associated with a protective effect on IUGR (OR, 0.39; 95% confidence interval (CI), 0.20-0.76). Overall, drinking during month 1 of pregnancy suggested a curvilinear effect on growth retardation, with consumption of > 1.00 oz of absolute alcohol per day showing increased risk. Drinking during month 7 was associated with a uniform increase in the odds of preterm delivery; the ORs were 2.88 (95% CI, 1.64-5.05) for light drinking and 2.96 (95% CI, 1.32-6.67) for mild-to-moderate alcohol consumption.

Conclusions: Differences in the risk estimates for IUGR and preterm delivery may indicate etiological differences that warrant further investigation of these outcomes and critical periods of exposure. Low birthweight is not a useful neonatal outcome for this exposure because it is a heterogeneous mix of preterm delivery and IUGR. Despite the observed protective effects of mild drinking on IUGR, the increased risk of preterm delivery with alcohol use supports a policy of abstinence during pregnancy.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Alcohol Drinking / adverse effects
  • Alcohol Drinking / epidemiology*
  • Cohort Studies
  • Confounding Factors, Epidemiologic
  • Connecticut / epidemiology
  • Female
  • Fetal Growth Retardation / epidemiology*
  • Fetal Growth Retardation / etiology
  • Gestational Age
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Logistic Models
  • Maternal-Fetal Exchange
  • Multivariate Analysis
  • Obstetric Labor, Premature / epidemiology*
  • Obstetric Labor, Premature / etiology
  • Pregnancy
  • Pregnancy Complications / epidemiology*
  • Pregnancy Outcome
  • Prospective Studies
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / epidemiology