Risk for congenital anomalies associated with different sporadic and daily doses of alcohol consumption during pregnancy: a case-control study.
BACKGROUND
The classic clinical criteria for the diagnosis of fetal alcohol syndrome (FAS) include a "characteristic" facial appearance, pre- and postnatal growth deficiency, microcephaly, mental retardation, and occasional major malformations. However, diagnostic constraints, especially in the newborn period, lead to an underestimate of their prevalence. We report an epidemiological study of the potential risk of congenital defects in the offspring of mothers who ingested different sporadic and daily amounts of alcohol during pregnancy.


METHODS
The study was based on the data from the ECEMC hospital-based case-control study and surveillance system, with a methodology aimed not only at the surveillance of congenital anomalies, but also at investigating their characteristics, clustering, and causes. For the purposes of this study, we considered as exposed those infants whose mothers reported the ingestion of any amount of alcohol during gestation (4705 mothers of cases and 4329 mothers of controls), and classified them into five groups according to their levels of alcohol consumption. Two groups consisted of mothers who consumed increasing sporadic levels and the other three consisted of mothers who consumed increasing daily levels of alcohol.


RESULTS
Our study showed that even low sporadic doses of alcohol consumption during pregnancy may increase the risk of congenital anomalies in the offspring and that this risk increases with increasing levels of alcohol exposure.


CONCLUSIONS
The results of our study suggest that it is necessary to generalize the preventive norm and recommend complete abstinence from alcohol during gestation. Birth Defects Research (Part A), 2004.
Martínez-Frías
Maria Luisa
ML
Estudio Colaborativo Español de Malformaciones Congénitas (ECEMC) del Centro de Investigación sobre Anomalías Congénitas (CIAC), Instituto de Salud Carlos III, Madrid, Spain. mlmartinez.frias@isciii.es
Bermejo
Eva
E
Rodríguez-Pinilla
Elvira
E
Frías
Jaime Luis
JL
D000014:Abnormalities, Drug-Induced / Q000209:etiology* / Q000503:physiopathology; D000428:Alcohol Drinking / Q000009:adverse effects*; D016022:Case-Control Studies; D004305:Dose-Response Relationship, Drug; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D008431:Maternal-Fetal Exchange; D011247:Pregnancy; D018570:Risk Assessment