Birth defects and alcohol

DEFINITION: Prenatal alcohol exposure is a leading cause of congenital anomalies and developmental disorders in the United States. Estimates from the US Centers for Disease Control and Prevention (CDC) in 2024 place the number of school-aged children affected by fetal alcohol spectrum disorders (FASDs) at approximately one in twenty.

The Dangers of Drinking for Two

When a pregnant woman drinks alcoholic beverages, the alcohol in her blood crosses the placenta easily and enters the embryo or fetus through the umbilical cord. Children affected by prenatal exposure to alcohol and FASDs may experience lifelong consequences, including intellectual impairment, learning disabilities, and serious behavioral problems.

All drinks containing alcohol can harm a fetus. A standard 12-ounce can of beer (5 percent alcohol by volume) contains the same amount of alcohol as a 5-ounce glass of wine (12 percent alcohol by volume) or a 1.5-ounce shot of 80-proof liquor. In addition, some alcoholic drinks, such as malt beverages, wine coolers, and mixed drinks, often contain more alcohol than a twelve-ounce can of beer. Studies have not conclusively established any known safe amount of alcohol that one can consume while pregnant.

Regular drinking during pregnancy increases the chance of having a miscarriage and increases the risk for growth deficiencies, learning disabilities, and behavioral problems. Congenital anomalies associated with prenatal exposure to alcohol can occur in the first eight weeks of pregnancy, before the person even knows they are pregnant.

Between 2015 and 2017, one in nine pregnant women surveyed reported alcohol use, and about 4 percent reported binge drinking within thirty days of the survey, according to the CDC. These numbers remained steady despite myriad studies showing a negative correlation between drinking alcohol and the health of a child. In 2020, 13.5 percent of pregnant women reported drinking during their pregnancy, and 5.2 percent reported binge drinking.

Fetal Alcohol Syndrome

Fetal alcohol syndrome (FAS) is caused by alcohol consumption during pregnancy and is one of the leading known causes of mental, physical, and congenital abnormalities. It is characterized by abnormal facial features, including small head size, narrow eye slits, abnormalities of the nose and lip areas, growth deficiencies, and problems with the central nervous system.

Children with FAS may have problems with learning, memory, attention span, problem-solving, speech, and hearing. These problems often lead to difficulties in school and getting along with others. FAS is an irreversible condition that affects every aspect of a child’s life and the lives of their family. FAS is preventable if one avoids alcohol during pregnancy.

Fetal Alcohol Effects

In the past, the term "fetal alcohol effects (FAE)" was generally used to describe children who did not have all of the clinical signs of FAS, but who had various problems, including growth deficiency, behavioral problems, or problems with motor and speech skills. FAE has also been used to describe children who have all of the diagnostic features of FAS, but at mild levels. Because experts in the field were unable to agree on a single definition for FAE, the Institute of Medicine (now the National Academy of Medicine) proposed the terms alcohol-related neurodevelopment disorder (ARND) and alcohol-related birth defects (ARBD). ARND describes the functional or mental impairments linked to prenatal alcohol exposure, such as behavioral or cognitive anomalies. These include learning challenges (speech delays, intellectual disabilities, poor memory, or difficulty in school) and behavioral problems (attention problems, hyperactivity, or a lack of reasoning or judgment skills). ARBD describes malformations of the skeletal system and major organ systems. Such malformations may include defects of the heart, kidneys, bones, and auditory system.

The modern medical community refers to instances of FAS as Fetal Alcohol Spectrum Disorders (FASD). This change to identifying FAS as a spectrum disorder indicates the complex range of conditions resulting from the exposure of a fetus to alcohol. FAS is the most severe of FASD, while ARND and ARBD are recognized as lying in other areas of the spectrum. Other FASD conditions include partial fetal alcohol syndrome (pFAS) and neurobehavioral disorder associated with prenatal alcohol exposure (ND-PAE).

Treatment and Prevention

There is no cure for FASDs; they are irreversible, lifelong conditions that affect every aspect of a child’s development. With early identification and diagnosis, a child with FASD can receive services that can help to maximize their potential.

The easiest way to prevent FASD is to abstain from alcohol use during pregnancy. Any amount of alcohol consumed during pregnancy is potentially dangerous to an unborn baby. If a person is drinking during pregnancy, it is never too late to stop, and the sooner, the better. If a person is unable to quit drinking, local social service agencies or health plans for alcohol abuse treatment are available.

However, mothers are not the only ones who can help prevent FASD. Significant others, such as family members, schools, social organizations, and communities, can help prevent FASD through education and intervention. Also, research suggests that long-term alcohol abuse among men may alter sperm cells in ways that introduce defects to the fetus at conception. Continued research will help to clarify this link and improve prevention efforts. 

Bibliography

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"Alcohol during Pregnancy." March of Dimes, July 2023, www.marchofdimes.org/find-support/topics/pregnancy/alcohol-during-pregnancy. Accessed 22 Oct. 2025.

"Data and Statistics on Alcohol and Pregnancy." Centers for Disease Control and Prevention, 8 May 2025, www.cdc.gov/alcohol-pregnancy/data-research/facts-stats. Accessed 22 Oct. 2025.

"Data and Statistics on FASDs." Centers for Disease Control and Prevention, 15 May 2024, www.cdc.gov/fasd/data. Accessed 22 Oct. 2025.

"Fetal Alcohol Spectrum Disorders." National Institute on Alcohol Abuse and Alcoholism (NIAAA), Nov. 2023, www.niaaa.nih.gov/research/fetal-alcohol-spectrum-disorders. Accessed 22 Oct. 2025.

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"Treatment of FASDs." Centers for Disease Control and Prevention, 8 Mar. 2025, www.cdc.gov/fasd/treatment. Accessed 22 Oct. 2025.

"Types of Treatment for FASDs." Centers for Disease Control and Prevention, 8 Mar. 2025, www.cdc.gov/fasd/treatment/types.html. Accessed 22 Oct. 2025.

Zeng, Xingdong, et al. “An Overview of Current Advances in Perinatal Alcohol Exposure and Pathogenesis of Fetal Alcohol Spectrum Disorders.” Journal of Neurodevelopmental Disorders, vol. 16, no. 1, 2024, p. 20, doi:10.1186/s11689-024-09537-w. Accessed 22 Oct. 2025.

Zhou, Qiongjie, et al. "Association of Preconception Paternal Alcohol Consumption with Increased Fetal Birth Defect Risk." JAMA Pediatrics, vol. 175, no. 7, 2021, pp. 742-43, doi:10.1001/jamapediatrics.2021.0291. Accessed 22 Oct. 2025.