Light Drinking and Pregnancy

It's one of those modern taboos: pregnant women must abstain from alcohol. Even a sip of wine in a restaurant can lead to menacing glances from passerby, as they imagine a fetus drunk on Chardonnay. According to a new study, however, the taboo has it backwards: women who drink lightly while pregnant are less likely to have children with behavioral and cognitive problems.

The research, led by a team at the University College of London, analyzed thousands of pregnancies drawn from a large British government survey. As expected, heavy drinking mothers put their offspring at serious risk for a wide variety of mental problems, including hyperactivity and conduct disorders. But avoiding alcohol altogether wasn't ideal, either: the children who performed best on the battery of cognitive tests came from mothers who had 1-2 drinks per week (the light drinking cohort.) While the scientists aren't ready to prescribe alcohol along with prenatal vitamins - the statistical benefit was rather modest, and it's very hard to correct for the influence of socioeconomic status - they do argue that the occasional drink certainly isn't harmful.

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These alcohol related scientific reports that tout the benefits of light alcohol have started to bother me a little. I know the scientists are well meaning but these reports can have unintended consequences. People with alcohol problems will use these reports to further delude themselves into thinking they don't have a drinking problem. "But its HEALTHY to drink it says so right there in the paper!" as they finish their second bottle of wine. Hopefully no problem drinking pregnant woman are reading this article thinking now they can drink a couple of glasses of wine a week which will turn into a couple a day which will turn into more.

Shorter Eric A:

People who do what they want in spite of the evidence will use this study to...do what they want in spite of the evidence.

Dear Eric A.,
Thank you for concern trolling my uterus.
Sincerely,
Breeder Female Who Clearly Cannot Be Trusted To Take Care Of Her Own Body

Eric A:

shame on you for caring about women and their uteruses! how dare you? :p

Joolya:

glad you Can Be Trusted To Take Care Of Your Own Body, but the rate of FA disorders says that many women obviously aren't as empowered as you and your uterus.

but yes, of course (and to paraphrase NJ), people will be people, and stoopid is as stoopid does.

I wish biologists would stop putting out papers concerning a material basis for altruism. I know they're well-meaning, but they can have unintended consequences. People with religious addictions will use these reports to further delude themselves that science and atheism are evil with no basis for morality.

Oh wait. That's completely idiotic. Sorry, carry on everyone.

I wasn't trying to say anyone can't be trusted, I'm sorry if anyone was offended by what I said, and I also don't believe that scientists should NOT put out a report just to try and protect someone, but just to be a little more sensitive to people with a disease. I wasn't saying anyone who reads this is automatically going to have a drinking problem, but the ones that already do could use this information incorrectly.

Eric A, you made a sensible point. People got annoyed. Welcome to the internet...

Now onto the paper, it's observational, so it's hard to know what to make of it. One thing I would say is that people who drink no alcohol at all, are weird. Not in a bad way, but it's unusual in our culture, and there is usually some reason for it - be it medical, religious, or whatever.

As such, there may be many reasons why they differ from people who drink a little alcohol.

As alcohol in low doses is primarily an anxiolytic, it seems like the most reasonable potential explanation for this effect is not that alcohol is doing anything good to the fetus itself, but that it is decreasing the level of the mother's circulating stress hormones. Any information about that in the study, Jonah?

And for the record, Eric A, I wouldn't qualify as offended, so no need for apologies. It's just that the people who would misuse this information are predisposed to be engaging in this behavior anyway, whether or not such information is released. So getting concerned about this report causing harm is just a bit of fuzzy thinking, or as I put it above...

I think your opening phrase summed it beautifully... "It's one of those modern taboos.."

Scott wrote his version of your statement in relation heart disease and the plethora of proof / non-proof experiments.

"It has never been easy in medical history to oppose dogma which has been firmly indoctrinated in the public mind." Alcohol is more endowed than many issues with dogma.

Scott, J. (1989) The diet-heart disease hypothesis: sense and nonsense. In "Fats for the Future." pp 17-40. ed. R.C. Cambie. Ellis Horwood, Chichester.

It's not really a modern taboo among experts. There's been debating the risks of light alcohol consumption for years, and at least in the UK, expert advice is always changing.

It's a bit of an obsession with some sections of the media, more like...

Late to jump on, but Eric A: You do make a sensible point. Dr. Ian Malcolm would be proud. However, I think it's important to understand that science cannot truly be science if it censors itself on the basis of how its discoveries might be treated by individuals or by society as a whole. If science does its job and reports its findings honestly, then other institutions (such as family, school, churches, and other groups) can be urged to do their job in working to create a society within which we have individuals who are capable of making wise decisions utilizing the information at hand.

This is a bit of a hot-button issue for me personally, as I work in science education. I feel that it's important to make a clear distinction about what role and responsibility science has (and does not have) in relationship to the development of society as a whole. Saying that research scientists should concern themselves with how people (with notably poor decision-making skills) factor their findings into their decision making sends us down a slippery slope. The natural end point of this line of thinking is a society in which science is inhibited by a lack of public understanding, and public understanding is in turn inhibited by the general and growing ineffectiveness of science. That's a downward spiral I think we'd all like to avoid.

Shannon Murphy, I completely agree that scientist should not censor themselves for any reason, and people should not try to censor them. My point mainly being that those who report on such findings should be aware of their misuse and maybe they should attempt to emphasize how quickly misuse of such information could become dangerous. For example, it would be better to include in the article how a slight increase in alcohol consumption from the recommended amount, lets say one or two drinks a day, could become very dangerous to an unborn baby. Because of the compression of information necessary to write about in a news article or blog posts these details can sometimes be left out.

Also, I have to nitpick a little on your "poor decision-making skills" factor. Alcoholism is a disease, with a large swath of scientists on the side of it actually possibly being a genetic disease. From everything I have read and experiences, alcoholism is a poor choice similar to getting cancer is a poor choice, aka, its not much of a choice at all.

"For example, it would be better to include in the article how a slight increase in alcohol consumption from the recommended amount, lets say one or two drinks a day, could become very dangerous to an unborn baby."

If they have data showing that, say, four drinks a week is "very dangerous" then they should publish that finding. If they don't have data showing it, then they should certainly not suggest that is the case. As it is, they tell you what they've found, nothing more and nothing less. Doing as you suggest would be dishonest and bad science. Not to mention that the reviewers would be likely to jump all over an unwarranted claim with no support in the data.

Janne, Gah! I never said to just make things up, that would be very irresponsible. But I also think it would be MORE responsible to in this case include the possible negative aspects of going over their "safe" amount of drinking per week, don't you?

"But I also think it would be MORE responsible to in this case include the possible negative aspects of going over their "safe" amount of drinking per week, don't you?"

Only if they have data showing that going over that amount - but less than the known unsafe amount - is actually damaging. Data which they do not have. All they have is that light drinking, 1-2 drinks a week, show no negative effects and a possible positive effect. As far as we know, the limit for safe drinking could be plenty higher than this. Doing what you suggest would indeed be making things up.

Apologies... tangent comment:

Based on some of the comments above, I have a question... are there any new or interesting neurological anecdotes about the whole process of pathologizing (is that a word?) of everything. Essentially, that everything is a "disease" now.

What is the latest on the difference between simple bad judgment/self-destructive behavior... and the whole "I can't help it... I'm sick." issue.

(As if, from the tone of this post, you can't tell where I tend to fall in my opinions. :) )

Janne, once again I agree, of course they should not present information they have not collected. It is entirely their decision to choose which experiments they choose to perform and the conclusions the data supports. And of course there are problems with doing human experiments with larger amounts of alcohol usage for fear of damage. But the scientists could have chosen to produce experiments with larger amounts of alcohol to understand the possible negative effects. Just the fact that they stated an amount of 1-2 drinks per week leads me to think they would not recommend using more than that, although it was never really explicitly stated and the possible harmful effects of using more were left out.

Neil:

I don't know about other neurological disorder but I would be interested in seeing some studies on the possibilities of "pathologizing" as you called it, but again from everything I have read on the subject alcoholism is a real neurological disorder and possibly genetic in nature. I think the reason why people who aren't alcoholics see alcoholism as a "choice" is because for non-alcoholics, drinking alcohol IS a choice. Alcoholics, unfortunately, cannot simply choose not to drink, like most people can.

Actually, the summary of the study does warn against heavy drinking:

"As expected, heavy drinking mothers put their offspring at serious risk for a wide variety of mental problems, including hyperactivity and conduct disorders."

Also, to nitpick something EricA said, alcoholics *can* choose not to drink. Of course, it is far more difficult than it is for non-alcoholics to abstain, but it is entirely possible. Just go to any AA meeting to see the abundance of sober alcoholics. Sure, maybe it's a disease, but if so, then they need to accept and work at getting help and treatment.

Eric A, I appreciate that you are acting out of genuine concern and are not trying to patronize, but how is the difference between 1-2 drinks a week and 7-14 drinks a week a "slight increase"? If a doctor says it's not harmful for me to eat beef once per week, I don't think anyone would call it a "slight increase" if I responded by eating a porterhouse for dinner on a nightly basis.

I can't help but think that only the most self-deluding individuals would take this short and objective article and use it as license to binge, and neither scientists nor writers should dilute their reporting on account of such individuals.

Also, the article did not suggest to me that any doctors are recommending that women drink any alcohol at all; rather, they are merely opining that one to two drinks per week do not appear to be harmful.

In a nutshell, I think you've read something into the article that isn't there - specifically, a mandate for pregnant women to start tossing them back - and overreacted.

I, on the other hand, just like to argue.

Phoebe: Sorry I just can't resist :P but if you go to AA you'll see that recovering alcoholics will say they didn't choose to recover, since its a surrender of self-will that allows the admission of powerlessness necessary to become sober, but I realize thats sort of semantic and it turns out that I, like Ian, also like to argue :)

On a random note, it breaks my heart when I see that a post in a science blog gets a lots of flaming/trolling posts... I'd rather see fewer comments (wich is usually the case)

also, keep the good work, Jonah. Greetings from Chile :-)