Pregnant for the Holidays: To Toast or Not to Toast?

by Dr. Michele Brown, OB/GYN

Is drinking during pregnancy risky for your baby? You are all dressed up and ready to leave for the annual holiday party at your office, at your neighbor’s home, or maybe with family. The holidays are so special, festive and romantic, but this year there is a heightened sense of excitement are pregnant.

With the holidays rapidly approaching, the age old question raises itself along with the clink of glasses -- can I join in the festivities with family and friends by having an alcoholic drink to celebrate. Maybe just one?

Alcohol and Pregnancy

The general rule has always been to avoid alcohol in pregnancy. The prevalence of alcohol use in pregnancy is estimated to be roughly 12.2% with 1.9% reporting binge drinking. Women have been shown to have a tendency to underestimate their alcohol consumption during pregnancy which often underestimates the fetal exposure also. Factors associated with alcohol use in pregnancy include education level, income level, temptation to drink in social situations, previous drinking history prior to the pregnancy and history of drinking at initiation of prenatal care.

High levels of chronic heavy prenatal alcohol consumption or frequent heavy intermittent use is a known cause of birth defects commonly referred to as Fetal Alcohol Syndrome. Among the characteristics of this condition are:

  • Cognitive developmental delays
  • Fetal growth retardation
  • Facial anomalies
  • Neurobehavioral deficits including learning disabilities, speech and language problems, hyperactivity and attention deficits.
  • High risk of preterm birth and small of gestational age babies

Moderate levels of alcohol consumption (1–2 drinks per day) during pregnancy can be associated with milder but clinically significant outcomes such as childhood cognitive, learning, attentional, and behavioral problems. Prenatal alcohol consumption, even at levels of less than one drink per day, may adversely affect fetal growth and development.

Is There a Safe Level of Drinking During Pregnancy?

The question always arises -- is there a safe level of drinking during pregnancy? It has been clearly found that heavy drinking harms a child's health and development but the role of light drinking has been far more controversial.

This issue is also relevant since in most industrialized countries, women of childbearing age drink alcohol and often this happens in the first trimester prior to pregnancy being recognized.

The mechanism of how alcohol acts as a toxin varies from direct alcohol toxicity, to placental dysfunction, fetal hypoxia, acetaldehyde toxicity, and nutritional deficits. The area of the brain that is commonly affected by alcohol is the hippocampus and development of the cerebral cortex.

What determines toxicity is the concentration of alcohol used, the pattern and quantity consumed and the stage of development of the fetus.

Research on Light Drinking During Pregnancy

newborn sleepingSome studies that have reported an association between very low levels of prenatal alcohol exposure and fetal growth, but the the association has not been consistent. Each study has looked at a single area of development. Although that outcome may not be affected by light drinking, light drinking may affect your baby in other ways.

Here are some recent studies and findings:


I know I'm not drinking. I'm 7 months pregnant and I have not had one sip of wine or any alcoholic beverage. If I went this long I can make it through the holidays without alcohol. Think about it, would you pour wine in your baby's bottle? Probably not. I'm sure a pregnant woman somewhere is going to have their one glass of wine this year but it seems unnecessary to me.