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August 6, 2019 Carolyn

How Common Is Drinking During Pregnancy?

If you've read our blog "Why It's Never Okay to Drink Alcohol while Pregnant, Seriously" you know that no level of alcohol is safe to consume during pregnancy. After knowing about how even small amounts of alcohol can negatively impact the health of an unborn child, you would think that drinking during pregnancy is a thing of the past. But it's not!

Drinking during pregnancy

How common is drinking during pregnancy around the world?

According to a new scientific review (4), drinking during pregnancy is probably more common than you think. Researchers analyzed 34,580 original quantitative studies on the prevalence of alcohol use and cases of fetal alcohol syndrome (FAS). The researchers narrowed it down to 390 studies that address their research question “How common is drinking during pregnancy? and what are the consequences?”.

Alcohol Consumption During Pregnancy Around the World

Scientists estimate that 9.8% of women consume alcohol during pregnancy around the world! A shocking number considering we have been told our whole lives that drinking during pregnancy is bad. 9.8% translates into almost 1 in every 10 pregnant women are drinking alcohol at least once during their pregnancy. If you remember, alcohol is a teratogen and can easily be transferred to a growing fetus from the mother through the placenta. When you drink alcohol it’s not only you drinking, it’s also your growing child and the effects are devastating. Below is a visual model of the percent of people consuming alcohol during pregnancy and giving birth to a child with Fetal Alcohol Syndrome (FAS) around the world; the darker the color, the higher percentage of people born with FAS.  Drinking during pregnancy

(Global prevalence of FAS per 10,000 people in 2012 (4))

Top 5 Countries That Consume Alcohol During Pregnancy (2017)

  1. Ireland (60.4%)
  2. Belarus (46.6%)
  3. Denmark (45.8%)
  4. United Kingdom (41.3%)
  5. Russia (36.5%)

Prevalence of Fetal Alcohol Syndrome (FAS) Around the World

In 2017 approximately 119,000 children were born with FAS. Almost 1 in every 10 pregnant women around is drinking alcohol during pregnancy — producing about 1 in every 67 pregnant women (14.6 out of 10,000) to give birth to a child with FAS.

Top 5 Countries With The Highest Rates Of Fetal Alcohol Syndrome (FAS) (2017)

  1. South Africa (585 / 10,000 births)
  2. Croatia (115.2 / 10,000 births)
  3. Ireland (89.7 / 10,000 births)
  4. Italy (82.1 / 10,000 births)
  5. Belarus (69.1 / 10,000 births)
Researchers split up alcohol consumption during pregnancy and FAS frequencies into the World Health Organization (WHO) organizational areas, to give a strong overview of where drinking during pregnancy and FAS are occurring around the world.
Region Alcohol use during pregnancy (%) Fetal alcohol syndrome per 10,000 births
Africa 8.5% - 11.8% (10.0%) 8.9 - 21.5 (14.8)
Americas 9.4% - 12.6% (11.2%) 11.0 - 24.0 (16.6)
Eastern-Mediterranean 0.1% - 0.9% (0.2%) 0.2 - 0.9 (0.2)
European 21.6% - 29.6% (25.2%) 24.7 - 54.2 (37.4)
South-East Asia 0.9% - 5.1% (1.8%) 1.3 - 8.1 (2.7)
Western Pacific 4.5% - 11.6% (8.6%) 7.7 - 19.4 (12.7)
Worldwide 8.9% - 11.1% (9.8%) 9.4 - 23.3 (14.6)
When looking at what areas of the world are drinking the most during pregnancy and countries with high rates of FAS, you can see that culture is a dominant factor in determining the rate of alcohol use during pregnancy and FAS. Economic status of different regions around the world is also playing a role in the rates of alcohol use during pregnancy and FAS rates.

Preventing Fetal Alcohol Syndrome - Short and Long Term Strategies

Unfortunately, drinking any amount of alcohol during pregnancy puts your child at risk for FAS. In a 2015 study done in Sweden (5), researchers asked non-pregnant women about their opinions on alcohol use during pregnancy. They found that the majority of women thought drinking small amounts of alcohol during pregnancy would be harmless, but the reality is that even a small amount of alcohol during pregnancy can lead to devastating consequences for a child growing in the womb. Education is a big factor in reducing the occurrence of FAS and alcohol use during pregnancy around the world. Sweden is a highly educated country with a lot of resources available to its average citizen, yet the majority of women living in Sweden thought having a small drink during pregnancy is fine. Governments, NGOs, and media teams should focus more on getting the message out to the general public, especially in regions of the world that have higher rates of alcohol use during pregnancy (i.e North America, Europe, Australia, Uk, Russia). Through better education, women will be able to make better judgments on the risks of alcohol use during pregnancy, reduce social pressure to drink alcohol, and mitigate the desire to drink alcohol if a woman is pregnant or suspects she may be pregnant. Some researchers are suggesting we go even further as a society to prevent alcohol use during pregnancy by introducing new regulations on alcohol such as training for medical professionals, price manipulation, taxation, restrictions on times liquor stores are allowed to operate, and increased restrictions on the advertising and promotions of alcohol (1).  In countries with higher rates of FAS, such as South Africa where 585 out of every 10,000 children are born with FAS, temporary government regulation and involvement may be more cost-effective for the country compared to relying mostly on the private sector.

Economic Impact of FAS on the Global Economy

It is shocking to see the high rates of alcohol use during pregnancy and FAS that are occurring globally. The impact of FAS not only significantly lowers the quality of life of people who have it, but also puts a large burden on the global economy. The economic and societal impact of FAS is difficult to measure, but there are two studies which have attempted to measure its impact in the United States and Canada. In 1998, FAS cost the American government over 4 billion USD in health care costs, and the average cost of a child born with FAS to the American healthcare system over their lifetime was estimated to be 2 million USD (2).  In 2013 a Canadian study estimated that over the course of a person's life with FAS, the economic burden placed upon the Canadian economy is approximately 1.8 billion USD (3). Three primary factors contribute to the high economic cost of FAS:
  1. Productivity loss from morbidity and premature death (Highest cost)
  2. Incarceration and rehabilitation
  3. Healthcare (Lowest)
Unless measures are taken to lower the rates of drinking during pregnancy, the economic impact of FAS in North America, Europe and the rest of the world is likely to become more burdensome to the global economy as the cost of healthcare rises. That being said, the majority of births over the next several decades are going to be in Africa and Asia. Although these regions have lower rates of FAS than Western nations, it is difficult to see the impact of FAS on the global economy decrease in the coming decades due to the sheer growth in population size. It is important for organizations and governments around the world to get the message out that drinking during pregnancy is not ok.

Final Thoughts

Each of us needs to help others avoid drinking during their pregnancy. We can do this by spreading the message on social media and in conversations we have with friends, family, and colleagues, of how consuming any amount of alcohol during pregnancy can lead to devastating lifelong consequences for the child. If you know anyone who is currently pregnant or trying to become pregnant, send them this article and our other article “Why It’s Never Okay to Drink Alcohol While Pregnant, Seriously”. The combination of knowing the harmful effects of alcohol on a pregnancy and knowing how common drinking is during pregnancy will help support better decision making.

Here is a quick summary of important information for you to remember:

  • Alcohol is a teratogen (agent that causes malformation of an embryo) that can easily pass from a mother to her child through the placenta
  • Almost 1 in 10 pregnant women  (9.8%) around the world consume alcohol at least once during their pregnancy
  • 1 in 67 births is to a child who will suffer from FAS throughout his/her life  
  • In 2017 approximately 119,000 children were born with FAS
  • FAS causes a significant burden on the global economy
  • Share this article with at least one person who you think will benefit from this information
 

References

  1. Elliott, E. J. (2015). Fetal alcohol spectrum disorders in Australia—the future is prevention. Public Health Res Pract, 25(2), e2521516.
  2. Lupton, C., Burd, L., & Harwood, R. (2004, May). Cost of fetal alcohol spectrum disorders. In American Journal of Medical Genetics Part C: Seminars in Medical Genetics (Vol. 127, No. 1, pp. 42-50). Wiley Subscription Services, Inc., A Wiley Company.
  3. Popova, S., Lange, S., Burd, L., & Rehm, J. (2015). The economic burden of fetal alcohol spectrum disorder in Canada in 2013. Alcohol and Alcoholism, 51(3), 367-375.
  4. Popova, S., Lange, S., Probst, C., Gmel, G., & Rehm, J. (2017). Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. The Lancet Global Health, 5(3), e290-e299.
  5. Skagerström, J., Häggström-Nordin, E., & Alehagen, S. (2015). The voice of non-pregnant women on alcohol consumption during pregnancy: a focus group study among women in Sweden. BMC public health, 15(1), 1193.
 
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