Miscarriage risk increases each week alcohol is used in early pregnancy


Date:
August 10, 2020
Source:
Vanderbilt University Medical Center
Summary:
Each week a woman consumes alcohol during the first five to 10
weeks of pregnancy is associated with an incremental 8% increase
in risk of miscarriage, according to a new study.



FULL STORY ==========================================================================
Each week a woman consumes alcohol during the first five to 10 weeks
of pregnancy is associated with an incremental 8% increase in risk of miscarriage, according to a study by Vanderbilt University Medical Center (VUMC) researchers.


==========================================================================
The findings, published in the American Journal of Obstetrics and
Gynecology, examine the timing, amount and type of alcohol use during
pregnancy and how these factors relate to miscarriage risk before 20
weeks' gestation.

Impact of alcohol use rises through the ninth week of pregnancy, and risk accrues regardless of whether a woman reported having fewer than one drink
or more than four drinks each week. Risk is also independent of the type
of alcohol consumed and whether the woman had episodes of binge drinking.

Though most women change their alcohol use after a positive pregnancy
test, consuming alcohol before recognizing a pregnancy is common among
both those with a planned or unintended pregnancy. Half of the 5,353
women included in the analysis reported alcohol use around conception
and during the first weeks of pregnancy.

The median gestational age for stopping alcohol use was 29 days. Although
41% of women who changed their use did so within three days of a positive pregnancy test, those who stopped consumption near their missed period
had a 37% greater risk of miscarriage compared to women who did not
use alcohol.

"Abstaining from alcohol around conception or during pregnancy has
long been advised for many reasons, including preventing fetal alcohol syndrome.

Nonetheless, modest levels of consumption are often seen as likely to
be safe," said Katherine Hartmann, MD, PhD, vice president for Research Integration at VUMC and principal investigator for the Right from the
Start cohort, from which participants were enrolled in the study.



==========================================================================
"For this reason, our findings are alarming. Levels of use that women,
and some care providers, may believe are responsible are harmful, and no
amount can be suggested as safe regarding pregnancy loss." According to
the researchers, one in six recognized pregnancies ends in miscarriage,
which brings great emotional cost and leaves unanswered questions about
why the miscarriage occurred.

Biologically, little is known about how alcohol causes harm during early pregnancy, but it may increase miscarriage risk by modifying hormone
patterns, altering the quality of implantation, increasing oxidative
stress or impairing key pathways.

Because alcohol use is most common in the first weeks -- when the embryo develops most rapidly and lays down the pattern for organ development -
- understanding how timing relates to risk matters.

Risk did not peak in patterns related to alcohol use in specific phases
of embryonic development, and there was no evidence that a cumulative
"dose" of alcohol contributed to level of risk.

The study recruited women planning a pregnancy or in early pregnancy
from eight metropolitan areas in Tennessee, North Carolina and
Texas. Participants were interviewed during the first trimester about
their alcohol use in a four-month window.

"Combining the facts that the cohort is large, comes from diverse
communities, captures data early in pregnancy and applies more advanced analytic techniques than prior studies, we're confident we've raised
important concerns," said Alex Sundermann, MD, PhD, the study's first
author and recent graduate of the Vanderbilt Medical Scientist Training Program.

To avoid increased risk of miscarriage, the researchers emphasize the importance of using home pregnancy tests, which can reliably detect
pregnancy before a missed period, and ceasing alcohol use when planning
a pregnancy or when pregnancy is possible.

This work was supported by the National Institutes of Health (grants
HD043883, HD049675, HD094345, GM07347, TR000445 and TR002243) and the
American Water Works Association Research Foundation. Follow-up is
sustained by a VUMC internal fund.


========================================================================== Story Source: Materials provided by
Vanderbilt_University_Medical_Center. Original written by Kelsey
Herbers. Note: Content may be edited for style and length.


========================================================================== Journal Reference:
1. Alexandra C. Sundermann, Digna R. Velez Edwards, James C. Slaughter,
Pingsheng Wu, Sarah H. Jones, Eric S. Torstenson, Katherine
E. Hartmann.

Week-by-week alcohol consumption in early pregnancy and spontaneous
abortion risk: a prospective cohort study. American Journal of
Obstetrics and Gynecology, 2020; DOI: 10.1016/j.ajog.2020.07.012 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200810102430.htm

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