Alcohol and pregnancy. An epidemiologic perspective.

This article considers maternal use of alcohol during pregnancy, from an epidemiologic perspective. In general, maternal use of alcohol during pregnancy has been associated with a number of effects in offspring including fetal alcohol syndrome, a reduction in birth weight, effects on behavior, and other late effects. It is apparent from the existing literature that the epidemiologic dimensions of these effects are poorly defined and hampered by methodologic problems. Assessment of both outcome and exposure can be difficult, and there is great potential for uncontrolled confounding. Additionally, it is unclear whether the apparent teratogenicity of alcohol results from direct, acute effects of alcohol on the developing fetus, or results from chronic effects of excessive alcohol intake in the mother. This article concludes with recommendations for further research, which may help clarify the complexity of effects associated with maternal use of alcohol during pregnancy.