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Cited by 555Prenatal Substance Exposure EffectsAlcohol Consumption and Health EffectsMaternal and Neonatal Healthcare

Dose–response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)—a systematic review and meta‐analyses

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Patra, J, Bakker, R, Irving, H, Jaddoe, VWV, Malini, S, Rehm, J·2011·BJOG: An International Journal of Obstetrics & Gynaecology
DOI 10.1111/j.1471-0528.2011.03050.xPMC PMC3394156
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Abstract

Please cite this paper as: Patra J, Bakker R, Irving H, Jaddoe V, Malini S, Rehm J. Dose–response relationship between alcohol consumption before and during pregnancy and the risks of low birthweight, preterm birth and small for gestational age (SGA)—a systematic review and meta‐analyses. BJOG2011;118:1411–1421. Background Descriptions of the effects of moderate alcohol consumption during pregnancy on adverse pregnancy outcomes have been inconsistent. Objective To review systematically and perform meta‐analyses on the effect of maternal alcohol exposure on the risk of low birthweight, preterm birth and small for gestational age (SGA). Search strategy Using Medical Subject Headings, a literature search of MEDLINE, EMBASE, CINAHL, CABS, WHOlist, SIGLE, ETOH, and Web of Science between 1 January 1980 and 1 August 2009 was performed followed by manual searches. Selection criteria Case–control or cohort studies were assessed for quality (STROBE), 36 available studies were included. Data collection and analysis Two reviewers independently extracted the information on low birthweight, preterm birth and SGA using a standardised protocol. Meta‐analyses on dose–response relationships were performed using linear as well as first‐order and second‐order fractional polynomial regressions to estimate best fitting curves to the data. Main results Compared with abstainers, the overall dose–response relationships for low birthweight and SGA showed no effect up to 10 g pure alcohol/day (an average of about 1 drink/day) and preterm birth showed no effect up to 18 g pure alcohol/day (an average of 1.5 drinks/day); thereafter, the relationship showed a monotonically increasing risk for increasing maternal alcohol consumption. Moderate consumption during pre‐pregnancy was associated with reduced risks for all outcomes. Conclusions Dose–response relationship indicates that heavy alcohol consumption during pregnancy increases the risks of all three outcomes whereas light to moderate alcohol consumption shows no effect. Preventive measures during antenatal consultations should be initiated.

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  • The healthy drinker effect explains the paradox: women with poor obstetric prognosis, socio-economic status or well-being are more likely to abstain from drinking alcohol.

    “The possible explanation provided for this paradox is the “healthy drinker effect”, in which women with poor obstetric prognosis, socio-economic status or well-being are more likely to abstain from drinking alcohol [50, 51].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [51]

    The Discussion section (‘Maternal alcohol consumption and low birth weight, preterm birth and SGA’; page unavailable) reports the healthy-drinkers effect as a possible explanation: women with poorer obstetric history or prognosis may be more likely to abstain during pregnancy. It does not extend that explanation to women with poorer socio-economic status or well-being. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Light alcohol consumption may possibly have a mildly protective effect on low birth weight and preterm birth.

    “Several previous studies indicated that (heavy) alcohol consumption during pregnancy increases the risk of low birth weight and preterm birth, while light alcohol consumption may possibly have a mildly protective effect on these outcomes [50, 51].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [51]

  • Heavy alcohol consumption during pregnancy increases the risk of low birth weight and preterm birth.

    “Several previous studies indicated that (heavy) alcohol consumption during pregnancy increases the risk of low birth weight and preterm birth, while light alcohol consumption may possibly have a mildly protective effect on these outcomes [50, 51].”

    From Associations between periconceptional lifestyle behaviours and adverse pregnancy outcomes (2021) · cites this paper as [51]

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Cited by

Sorted by citations

Authors
Patra, J., Bakker, R., Irving, H., Jaddoe, V., Malini, S., & Rehm, J.
Affiliations
  • Centre for Addiction and Mental Health (CA)
  • Erasmus MC (NL)
  • Maharaja Krishna Chandra Gajapati Medical College and Hospital (IN)
Corresponding author
Patra, J
ORCID
Venue
BJOG: An International Journal of Obstetrics & Gynaecology
Publisher
Wiley
Published
2011-07-06
Volume
118
Issue
12
Pages
1411-1421
ISSN
  • 0306-5456 (ISSN-L)
  • 1470-0328
  • 1471-0528
DOI
10.1111/j.1471-0528.2011.03050.x
PMC
PMC3394156
OpenAlex
W2150870806
Cited by
555
References
6
Citations by year
2026: 19 · 2025: 21 · 2024: 32 · 2023: 47 · 2022: 47 · 2021: 59 · 2020: 23 · 2019: 38 · 2018: 36 · 2017: 42 · 2016: 59 · 2015: 45 · 2014: 40 · 2013: 26 · 2012: 16
FWCI
4.10
Type
journal article
Language
en
Open access
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • BJOG An International Journal of Obstetrics & Gynaecology (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • PubMed Central (acceptedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Funders
  • National Institute on Alcohol Abuse and Alcoholism (HHSN267200700041C)
  • National Institute of Diabetes and Digestive and Kidney Diseases (HHSN267200700041C)
Topics
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
  • Health Sciences › Health Professions › General Health Professions › Maternal and Neonatal Healthcare
Keywords
maternal alcohol consumption, prenatal alcohol exposure, low birth weight, preterm birth, small for gestational age, dose-response relationship, fetal growth restriction
MeSH terms
Alcohol Drinking, Dose-Response Relationship, Drug, Female, Humans, Infant, Low Birth Weight, Infant, Newborn, Infant, Small for Gestational Age, Pregnancy, Regression Analysis, Risk, Risk Factors, Premature Birth

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