Advice to avoid alcohol for first three months of pregnancy
Publication Date:26/03/2008
Pregnant women should not drink alcohol during the first three months of pregnancy because this may increase the risk of miscarriage, according to new guidelines.
What do we know already?
The National Institute for Health and Clinical Excellence (NICE) advises doctors about what medical care people should receive on the NHS. NICE first gave advice about routine care for pregnant women in 2003. Now it has updated its advice to take account of the latest medical research.
The guidelines, about the care of healthy pregnant women, include advice about alcohol intake, nutritional supplements, including vitamin D, and tests for conditions that might affect the baby, such as Down's syndrome.
What do the new guidelines say?
The guidelines advise against drinking any alcohol during the first three months of pregnancy because this may increase the risk of miscarriage. If a woman does choose to drink alcohol while pregnant she should drink no more than 2 units of alcohol once or twice a week, and should not get drunk. One small glass of wine is about 1.5 units.
NICE point outs that there is little evidence to show that drinking at low levels during pregnancy can be harmful. Some studies show a link between alcohol and an increased risk of miscarriage, but these studies may not be reliable. However, NICE says, researchers do not know if there is a 'safe' level of alcohol in pregnancy.
Here are the other main changes in the new guidelines, in addition to the new advice on alcohol:
- Women should be advised to make sure they get enough vitamin D during pregnancy and when they are breastfeeding. In practice, for most women, this means taking a supplement of 10 micrograms of vitamin D every day.
- Women should be offered a test for Down's syndrome after 11 weeks and before 14 weeks of their pregnancy, using the 'combined test'. This involves an ultrasound scan and a blood test.
- Women should also be offered screening for blood disorders, such as sickle cell anaemia, before 10 weeks if possible.
- Women should be checked to see if they are at risk of getting diabetes during their pregnancy. This is called gestational diabetes. Women at higher risk of this condition include women who are obese, women who've had gestational diabetes before, who've had a large baby before (more than 4.5 kilograms) or who have a family history of diabetes. Women from certain ethnic backgrounds are also at increased risk.
Where do the guidelines come from?
The guidelines were published by the National Institute for Health and Clinical Excellence. They were put together by a group called the National Collaborating Centre for Women's and Children's Health, which included obstetricians, midwives and patient representatives.
What does this mean for me?
If you are pregnant or planning a pregnancy you might find these guidelines helpful. They set out the type of care you can expect during your pregnancy, including the number of antenatal appointments, screening tests you may be offered, and things you can do to give yourself the best chance of a healthy pregnancy.
What should I do now?
You can read the guidelines on the NICE website (http://www.nice.org.uk/cg62). There's a version for patients, called 'Understanding NICE guidelines'. If you want to take vitamin D supplements, ask your midwife or GP about Healthy Start multivitamins, which include the right dose of vitamin D as well as other supplements like folic acid.
From:
National Institute for Health and Clinical Excellence. Antenatal care: routine care for the healthy pregnant woman. NICE clinical guideline 62. March 2008. Available at http://www.nice.org.uk/cg62.
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