Is low dose alcohol exposure during pregnancy harmful?

The issue

Statistics show that social drinking among western women during pregnancy is relatively common. There is consensus among researchers that heavy drinking during pregnancy has damaging effects on the central nervous system of the fetus, such as neurological anomalies, delayed mental development and later behavioural problems. However, little is known about the impact of low to moderate alcohol consumption (1–4 glasses of alcohol per week) during pregnancy on children’s later cognitive and socioemotional development. Official recommendations regarding alcohol intake by pregnant women differ between countries.


The age span of children in this review was between 3 and 16 years. A total of six studies fulfilled the quality requirements and were included. The studies yielded mixed results. Half of the studies found a significant association between prenatal alcohol exposure and cognitive and socioemotional deficits. When their material was divided into three age groups (3–5 years, 6–12 years and 13–16 years), the results showed that the association is most prominent in children aged 3–5 years. Children exposed to prenatal alcohol experience significantly more mental health problems, including hyperactivity/inattention, and behavioural, emotional and peer relationship problems, as well as being less attentive and experiencing shorter “longest attention episodes”. However, the other half of the studies, mainly on older children, did not demonstrate such an association.

Policy considerations

The findings have established that small to moderate doses of alcohol during pregnancy may have an impact on children’s cognitive and socioemotional development. To be safe and avoid potential damage to children’s health, care professionals are recommended to advise women to abstain from alcohol consumption during or when planning pregnancy.

Type of evidence

This systematic review included and summarized the effects of low to moderate alcohol consumption during pregnancy from six studies. The studies were performed in Australia, Denmark, England, Finland and the United States of America.

The views expressed in this summary are based on a publication of a HEN Network member agency and do not necessarily represent the decisions or stated policy of WHO/Europe.