Fewer babies being exposed to alcohol before birth

By Martha Kerr

NEW YORK (Reuters Health) - Fewer infants in the U.S. than a decade earlier received a diagnosis of "alcohol affecting fetus," indicating that they have suffered the effects of alcohol exposure while in the womb.

Investigators say that while this is partly due to a more selective use of the diagnosis, it appears that there is also a true decrease in the number of infants affected by alcohol before birth.

Using two large national hospital databases in the Healthcare Cost and Utilization Project, Dr. James M. Robbins of the University of Arkansas in Little Rock and colleagues studied trends in use of the alcohol affecting fetus diagnosis, trends in self-reported drinking during pregnancy, and maternal diagnoses of alcohol abuse during childbirth for infants born between 1993 and 2002.

Results of the study are published in the Archives of Pediatrics and Adolescent Medicine.

The use of the diagnosis declined from 0.73 per 1,000 per live births in 1993 to 0.17 per 1000 live births in 2002. The number of mothers reporting alcohol use during pregnancy and a diagnosis of maternal alcohol abuse during childbirth also declined during this 10-year period.

"Given these independent sources of information," Robbins commented to Reuters Health, "we suspect that some, perhaps much, of the decline in newborns being recognized as affected by alcohol is real and not simply due to a change" in use of the diagnosis.

It could be that "an increasing reluctance of mothers to admit to drinking during pregnancy could also influence our findings, though we have not been able to find evidence for this hypothesis," Robbins added.

"Because the damaging effects of alcohol on the fetus are not typically observed before the child is 3, 4 or 5 years old, a standardized surveillance program for fetal alcohol spectrum disorder would be required to determine if our results are being realized in improved health of infants and children," Robbins noted. "One model surveillance program in Washington State does show a decrease over time in fetal alcohol syndrome."

SOURCE: Archives of Pediatrics and Adolescent Medicine, December 2006.