FOR IMMEDIATE RELEASE
Monday, February 21, 2005
Contact: HHS Press Office
U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy
Urges women who are pregnant or who may become pregnant to abstain from alcohol
U.S. Surgeon General Richard H. Carmona today warned pregnant women
and women who may become pregnant to abstain from alcohol consumption
in order to eliminate the chance of giving birth to a baby with any of
the harmful effects of the Fetal Alcohol Spectrum Disorders (FASD).
FASD is the full spectrum of birth defects caused by prenatal alcohol
The spectrum may include mild and subtle changes, such as a slight
learning disability and/or physical abnormality, through full-blown
Fetal Alcohol Syndrome, which can include severe learning disabilities,
growth deficiencies, abnormal facial features, and central nervous
system disorders. This updates a 1981 Surgeon General's Advisory that
suggested that pregnant women limit the amount of alcohol they drink.
"We must prevent all injury and illness that is preventable in
society, and alcohol-related birth defects are completely preventable,"
Dr. Carmona said. "We do not know what, if any, amount of alcohol is
safe. But we do know that the risk of a baby being born with any of the
fetal alcohol spectrum disorders increases with the amount of alcohol a
pregnant woman drinks, as does the likely severity of the condition.
And when a pregnant woman drinks alcohol, so does her baby. Therefore,
it's in the child's best interest for a pregnant woman to simply not
In addition, studies indicate that a baby could be affected by
alcohol consumption within the earliest weeks after conception, even
before a woman knows that she is pregnant. For that reason, the Surgeon
General is recommending that women who may become pregnant also abstain
"Thanks to our ever-increasing body of scientific knowledge we are
now able to identify more and more causes of premature births and birth
defects," Dr. Carmona said. "And we must use this knowledge, not for
knowledge's sake, but for the sake of the health of children
Dr. Carmona made this announcement prior to participating in
BirthDay Live!, a 10-hour live television program on the Discovery
Health Channel that shows childbirths from three locations across the
country. This announcement and participation in the program are both
part of Surgeon General Carmona's "The Year of the Healthy Child"
agenda: a commitment to help improve the holistic health of children
from pre-conception through the teen years. For more information about
"The Year of the Healthy Child," visit www.surgeongeneral.gov.
The Surgeon General's advisory is attached.
Surgeon General's Advisory on Alcohol Use in Pregnancy
Thirty-two years ago, United States researchers first recognized
fetal alcohol syndrome (FAS). FAS is characterized by growth
deficiencies (or decreased growth), abnormal facial features (specific
facial features), and central nervous system (or brain) abnormalities.
FAS falls under the spectrum of adverse outcomes caused by prenatal
alcohol exposure called Fetal Alcohol Spectrum Disorders (FASD). The
discovery of FAS led to considerable public education and awareness
initiatives informing women to limit the amount of alcohol they consume
while pregnant. But since that time, more has been learned about the
effects of alcohol on a fetus. It is now clear that no amount of
alcohol can be considered safe.
I now wish to emphasize to prospective parents, healthcare
practitioners, and all childbearing-aged women, especially those who
are pregnant, the importance of not drinking alcohol if a woman is
pregnant or considering becoming pregnant.
Based on the current, best science available we now know the following:
- Alcohol consumed during pregnancy increases the risk of alcohol
related birth defects, including growth deficiencies, facial
abnormalities, central nervous system impairment, behavioral disorders,
and impaired intellectual development.
- No amount of alcohol consumption can be considered safe during pregnancy.
- Alcohol can damage a fetus at any stage of pregnancy. Damage can
occur in the earliest weeks of pregnancy, even before a woman knows
that she is pregnant.
- The cognitive deficits and behavioral problems resulting from prenatal alcohol exposure are lifelong.
- Alcohol-related birth defects are completely preventable.
For these reasons:
- A pregnant woman should not drink alcohol during pregnancy.
- A pregnant woman who has already consumed alcohol during her pregnancy should stop in order to minimize further risk.
- A woman who is considering becoming pregnant should abstain from alcohol.
- Recognizing that nearly half of all births in the United States are
unplanned, women of child-bearing age should consult their physician
and take steps to reduce the possibility of prenatal alcohol exposure.
- Health professionals should inquire routinely about alcohol
consumption by women of childbearing age, inform them of the risks of
alcohol consumption during pregnancy, and advise them not to drink
alcoholic beverages during pregnancy.
In the United States, FAS is the leading preventable birth defect with
associated mental and behavioral impairment. There are many individuals
exposed to prenatal alcohol who, while not exhibiting all of the
characteristic features of FAS, do manifest lifelong neurocognitive and
behavioral problems arising from this early alcohol exposure. In the
United States, the prevalence of FAS is between 0.5 to 2 cases per
1,000 births. It is estimated that for every child born with FAS, three
additional children are born who may not have the physical
characteristics of FAS but still experience neurobehavioral deficits
resulting from prenatal alcohol exposure that affect learning and
The outcomes attributable to prenatal alcohol exposure for the
children of women whose alcohol consumption averages seven to 14 drinks
per week include deficits in growth, behavior, and neurocognition such
as problems in arithmetic, language and memory; visual-spatial
abilities; attention; and deficits in speed of information processing.
Patterns of exposure known to place a fetus at greatest risk include
binge drinking, defined as having five or more drinks at one time, and
drinking seven or more drinks per week.
Despite public health advisories and subsequent efforts to
disseminate this information, including a Surgeon General's advisory in
1981, recent data indicate that significant numbers of women continue
to drink during pregnancy, many in a high-risk manner that places the
fetus at risk for a broad range of problems arising from prenatal
alcohol exposure including fetal alcohol syndrome. For example, data
suggest that rates of binge drinking and drinking seven or more drinks
per week among both pregnant women and non-pregnant women of
childbearing age have not declined in recent years. Many women who know
they are pregnant report drinking at these levels.
In addition, recent analysis of obstetrical textbooks suggests that
physicians may not be receiving adequate instruction in the dangers of
prenatal alcohol exposure. The American College of Obstetricians and
Gynecologists advises against drinking at all during pregnancy.
Nevertheless, only 24 percent of obstetrical textbooks published since
1990 recommended abstinence during pregnancy, despite 30 years of
research since the first publications proposed a link between alcohol
exposure and birth defects. Scientific evidence amassed in these
decades has fortified the rationale for the original advisory against
alcohol consumption during pregnancy. Continuing research has generated
a wealth of new knowledge on the nature of fetal alcohol-induced
injury, the underlying mechanisms of damage, concurrent risk factors,
and the clinical distinction of alcohol-related deficits from other
Alcohol-related birth defects are completely preventable. A number
of resources are available to assist healthcare and social services
professionals in advising their patients to reduce and refrain from
alcohol in pregnancy. These resources include the National Institute on
Alcohol Abuse and Alcoholism, NIH (www.niaaa.nih.gov), the Centers for Disease Control and Prevention (www.cdc.gov/ncbddd/fas/), and the Substance Abuse and Mental Health Services Administration (www.fascenter.samhsa.gov).
NOTE: All Surgeon General press releases, reports and other materials are available at www.surgeongeneral.gov
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