The American Academy of Pediatrics announced new recommendations this fall that encourage women who are pregnant to refrain from drinking any alcohol or face a greater prospect of giving birth to a child with mental, behavioral or physical disabilities.
Academy-related researchers reported in last month’s edition of Pediatrics that first-trimester drinking, compared to no drinking, results in 12 times the odds of a mother giving birth to a child with Fetal Alcohol Spectrum Disorder. First- and second-trimester drinking increased the odds 61 times, and women who drink during all trimesters increased the likelihood by a factor of 65.
“The bottom line story is that we don’t really know if there’s a safe level of drinking, so it’s better not to drink at all,” said Rina Das Eiden, a senior research scientist and research associate professor of pediatrics and psychology for the University at Buffalo Research Institute on Addictions. She was not involved in the latest research but specializes in studying the development of children born to parents with tobacco, alcohol and other substance addictions.
Eiden, a native of New Delhi, India, holds a master’s degree in developmental psychology from Purdue University and a doctorate in applied developmental psychology from the University of Maryland. She has worked at the UB institute in Buffalo since 1992. She and her husband, Mark Eiden, a Fort Wayne, Ind., native who she met at Purdue, live in Clarence with their son, Kiran, 17, and a Portuguese water dog, Tessa.
Q. You and Institute Director Kenneth Leonard have been collaborating together since 1996 on a Children of Alcoholic Fathers Study. Can you talk about that?
We recruited 227 families from the community through birth records. Roughly half had an alcoholic father in the household. They all had a child who was a year old at the time. The other half was a control group of non-alcoholic families. And we’ve been following them ever since. … We just finished the high school grade. It’s a really rich data set.
Q. What are some of your key findings?
One really key finding is that when you have an alcoholic parent in the household, the non-alcoholic parent – which in the majority of our study was the mother – can play a very key protective role, and can play that role very early.
Q. Can you talk about some of the similar challenges that children who have parents who abuse substances face across the board?
In terms of maternal substance use during pregnancy, alcohol is the biggest teratogen (agent that can disturb fetal development). One of the diagnostic criteria for Fetal Alcohol Syndrome is cognitive deficiencies, including mental retardation, so alcohol use during pregnancy is the single most preventable cause of mental retardation in our society. Cigarettes, alcohol and cocaine all affect fetal growth. Fetal growth is one of the most common outcomes across all these substances but the others are also behavioral difficulties. Higher rates of behavioral problems are common with alcohol and cigarettes. Cocaine is a very complex issue. In our sample of 200-some mothers, I don’t think we had a single mother who used just cocaine during pregnancy. Cocaine-using women are also more likely to smoke during pregnancy, use alcohol or marijuana.
Q. So which children are at highest risk?
In some sense, it’s hard to rank order these things, they’re all bad, but if you gave me five things and said I could only stop using one thing, I’d tell you to stop using alcohol. The worst outcomes are associated with the most chronic, heavy use.
Q. What happens if a woman is drinking socially before she realizes she is pregnant?
That happens to a lot of women. I would say, it’s OK, but stop as soon as you know. It’s the best you can do at that point. It’s the chronicity that increases risk. Twelve versus 65 in terms of risk is a huge difference, so even if you can stop within the first trimester, the odds of having an alcohol-affected baby are much lower than if you continue even into the second trimester.
Heavy, chronic drinking in the first trimester is very different than social drinking in the first trimester.
Q. So once you become aware you’re pregnant, just stop.
Yes. It’s never too late to quit. It does reduce the risk substantially.
Q. And if you’re planning to get pregnant or thinking about getting pregnant?
Don’t drink. People have been researching this for years; 1973 is when we discovered this syndrome. Nobody has been able to come up with a safe level of drinking. Obviously, less is better than more. Lower duration is better than longer duration.
Q. What would you say to expectant moms who are addicted and worried they might not be able to get through pregnancy?
There is a lot of help.
Pregnant and new mothers and their families concerned about alcohol and substance abuse, recovery and education are encouraged to call the Robert Warner Center at Women & Children’s Hospital at 878-1374, the Buffalo Prenatal-Perinatal Network (parentnetworkwny.org) at 332-4170, the Joan A. Male Family Support Center at 892-2172 or the New York State Smokers’ Quitline (nysmokefree.com) at (886) 697-8487.
On the Web: Read more about Research Institute cigarette and alcohol research at refresh.buffalonews.com