A few days ago, the European Journal of Preventive Cardiology published a very surprising study result:
Fathers who drink alcohol during the first trimester of pregnancy are 44% more likely to give birth to babies with congenital heart disease compared to non-drinkers.
If the prospective father is an alcoholic, the offspring are 52% more likely to have congenital heart disease.
After reading this message, was the expectant father who was drinking so much that he dropped his lamb skewers in shock?
As an obstetrician and gynecologist, I felt as if I were seeing countless anxious expectant mothers screaming through the screen—
"What?! We had a beer together last month, and I found out I'm pregnant today! What do we do?! Can we keep the baby?! Will I get heart disease? Is it treatable?!"
So, how should we understand the issue of preparing for pregnancy and drinking alcohol?
Let's first understand what "drinking alcohol" and "hyperdating" mean, and what "prenatal alcohol exposure" means.
Actually, I don't need to say it, everyone knows that there's a difference between taking a sip of beer at a dinner party and chugging half a jin of baijiu (a strong Chinese liquor) to win over a client.
So how do we define "a lot" and "a little" when it comes to drinking?
One standard glass (containing 10 g of alcohol) is defined as: 360 mL (12 oz) of beer or low-alcohol beverage, 150 mL (5 oz) of wine, or 45 mL (1.5 oz) of spirits, such as 1 tael of baijiu.
Generally speaking, heavy drinking is defined as drinking ≥14 standard drinks per week, which means drinking at least one large bottle of beer or two ounces of liquor every day.
Moderate drinking is defined as 3-13 standard drinks per week, while moderate drinking is defined as 2 standard drinks per week, which is equivalent to one bottle of beer or two glasses of wine per week.
How much did you drink?
Current guidelines only provide the concept of prenatal alcohol exposure for expectant mothers, namely:
Drinking ≥6 standard drinks per week for ≥2 weeks = 6 cans of beer per week for 2 weeks
Each instance of drinking alcohol is ≥3 standard cups, and this occurs ≥2 times = 3 liang (150ml) of baijiu (Chinese liquor) per meal, and this occurs more than twice.
Blood, breath, or urine alcohol tests confirm intoxication
After reading the above classifications, expectant parents probably already have a good idea of their own drinking level.
So, how much does your drinking style affect your ability to conceive and your baby's development?
Unfortunately, there are currently no definitive standards regarding safe alcohol intake levels before and during pregnancy.
It is generally believed that moderate alcohol consumption before pregnancy has almost no adverse effects.
But here, Dr. Mou wants to tell a short story first.
When Dr. Mou was a visiting scholar in the United States, the hospital she visited was a public hospital, so many of her patients were working-class people from the lower rungs of society.
One expectant mother, who was an alcoholic, had participated in many support groups before and during her pregnancy with her first child, but she was still unable to break her alcohol addiction.
However, the eldest brother was unharmed.
When I was pregnant with my second child, I naturally had a sense of confidence that "historical experience tells me everything will be fine," but during the ultrasound screening for fetal abnormalities, a heart defect was discovered in the fetus.
She asked the doctor with surprise and fear: "Does it have anything to do with my drinking?"
The doctor said: Drinking alcohol is indeed a high-risk factor.
The expectant mother wept bitterly and blamed herself in the examination room.
Is drinking alcohol the only cause of heart defects in fetuses? Not necessarily.
But I think, why burden yourself with such a heavy bag of guilt for the rest of your life?
How should we understand this story? Read on~
Although there is no definitive data, our understanding of the risk of birth defects in fetuses after drinking alcohol should include these two levels.
Alcohol can still be blamed for causing birth defects.
First, alcohol is a teratogen and it is known to have adverse effects on fertility, including:
Excessive alcohol consumption by the male partner before conception can lead to gonadal dysfunction, including decreased testosterone production, impotence, and reduced sperm production.
Excessive alcohol consumption by the woman before pregnancy can lead to delayed conception.
Drinking alcohol during pregnancy may lead to fetal alcohol spectrum disorders, which involve facial features, structural defects, growth retardation, and central nervous system damage. The incidence rate is 0.7%, and about 5% in pregnant women who are exposed to alcohol before delivery.
In essence, it's about expressing a consensus:
From the time you start trying to conceive, both men and women should avoid drinking alcohol as much as possible, and expectant mothers should be especially careful not to consume alcohol during pregnancy.
However, the overall incidence is low.
Secondly, while the incidence of adverse events does increase when alcohol is consumed, it is not a certainty and the probability remains low.
For example, this newly published article points out:
Fathers who drink alcohol during the first trimester of pregnancy are 44% more likely to give birth to babies with congenital heart disease compared to non-drinkers.
If the prospective father is an alcoholic, the offspring are 52% more likely to have congenital heart disease.
Behind this alarming figure, the incidence of congenital heart disease is only 0.4%-1.2%.
In other words, among the children of expectant fathers who drink alcohol, multiplying by 144%, the probability becomes 0.57%-1.72%.
If you only look at these two sets of absolute numbers, you might think there is no significant difference.
This doesn't mean drinking alcohol is harmless, it just means it's not as serious as you might think.
Therefore, the message conveyed by this relationship should be: avoid contact with alcohol as much as possible, but even if you do drink it, don't give up on the baby easily.
In other words, situations like "I ate a chocolate with liqueur filling" or "we had barbecue and drank half a glass of beer" do not need to cause excessive anxiety.
But if someone becomes an alcoholic like the mother in the previous story, they should be careful.
For expectant fathers who have been exposed to large amounts of alcohol during the preconception period, or expectant mothers who have been exposed to large amounts of alcohol without their knowledge during early pregnancy, they should have a thorough and comprehensive discussion with their doctor about the risks of the disease and pay attention to subsequent prenatal checkups.
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