The Center for Disease Control and Prevention (CDC) reports that three out of four women consume alcoholic beverages while trying to get pregnant. Here’s what you need to know about the recommendations for alcohol use during preconception.
Early Pregnancy and Drinking
What if alcohol was consumed before you knew you were pregnant? Remember that once you get a positive pregnancy test result back, you’re already considered (at least) four weeks pregnant. The embryo, which will hopefully develop into a healthy baby, has already existed for two or more weeks. If you drank alcohol during preconception or are currently trying to conceive and have not yet stopped drinking, you may have the following questions:
Could drinking while trying to conceive cause harm to a fetus? Does drinking lower fertility and make it harder to get pregnant? Will drinking in early pregnancy increase the risk of miscarriage?
The short answer is that the research is mixed—and some of the evidence conflicts with the position that top health organizations have taken on the matter.
What the Experts Say
Contrary to some of the research detailed below, the Centers for Disease Control and Prevention (CDC) and the American College of Obstetrics and Gynecologists (ACOG) recommend that you completely avoid consuming alcohol during pregnancy as well as while you are trying to get pregnant.
What the Research Says
Contrary to recommendations by health organizations, some research suggests that drinking during preconception may be safe. For instance, a large study of over 5,600 women examined the association between drinking alcohol prior to and up to 15 weeks of the pregnancy. Of the study participants, 25% reported drinking between three and seven alcoholic drinks per week in the months before and during early pregnancy. The study found no association between drinking alcohol prior to 15 weeks of pregnancy and low birth weight, slow intrauterine growth, preeclampsia, or preterm birth. Though this study did not show a negative correlation between low-level drinking during early pregnancy and negative birth outcomes, the findings did not report on early miscarriage rates or cognitive and behavioral issues following childbirth. It’s important to note that 15 weeks, which was the time period of this study, is beyond the first four weeks. Overall, there is a lack of research on drinking only during the first four weeks. That said, the maternal-fetal blood flow in the early weeks is pretty insignificant, so if someone didn’t know they were pregnant and was drinking at a low to moderate level, there isn’t a grave concern.
Possible Fetal Risks
As previously stated, guidelines from top medical organizations including the ACOG consistently recommend that women abstain from alcohol during pregnancy. Research shows that drinking during pregnancy poses a number of health risks to a fetus including:
Congenital abnormalities (including facial deformities) Developmental delays and long-term cognitive disabilities Fetal alcohol spectrum disorder (FASD) Low birth weight Preterm delivery Stillbirth (in severe cases)
Many individual variables must be taken into account when assessing risk. These include maternal alcohol metabolic clearance rate, fetal developmental sensitivity based on gestational age, various genetic components, binge drinking behavior versus casual drinking habits, and the use of other substances in conjunction with alcohol.
Is Occasional Drinking Safe?
Confusion surrounding low to moderate alcohol consumption during preconception may have arisen from several studies showing that low-level drinking did not increase the risk of preterm delivery or a low-birth-weight baby. Some of these findings have circulated in the media, leaving many pregnant people to ask whether it is really necessary to completely abstain from alcohol during early pregnancy. One problem with the research is that not all possible cognitive and psychological impacts of alcohol on a developing fetus have been examined. Even if a baby is born at a healthy weight, research shows they may still experience lifelong learning challenges if they were exposed to alcohol during the first trimester. If you are going to drink on occasion while trying to conceive, you may want to:
Avoid all alcoholic drinks within one month of a fertility treatment cycle. Avoid drinking during your two-week wait (the period after ovulation and before your period starts).
Can Drinking Affect Fertility?
If you’re wondering whether a few occasional drinks will have an adverse effect on your fertility, the evidence is still unclear. Some studies have found that drinking a moderate amount of alcohol daily can significantly increase the risk of infertility. For example, a 2017 study showed that women who drank less than one serving of alcohol per day had a lower risk of infertility compared to women who consumed more alcohol. Conversely, a study published in Fertility and Sterility in 2017 showed that low-level red wine consumption—less than five 6-ounce servings per month—was associated with increased ovarian reserve among women with regular menstrual cycles who were not yet pregnant. Researchers linked the boost in women’s fertility to the anti-inflammatory properties of resveratrol, a naturally occurring polyphenol found in red wine. In this particular study, no subject drank more than 15 glasses of wine in a month. With regards to fertility, most practitioners indicate that when it comes to food, alcohol, and caffeine consumption, moderation is key. So, having an occasional glass of wine with dinner, for example, is not something most doctors advise their patients against. But of course, they don’t recommend drinking more and never recommend binge-drinking (having many alcoholic beverages in rapid succession). That said, people with health conditions such as polycystic ovarian syndrome (PCOS), the leading cause of anovulation, may want to avoid alcohol entirely to increase their chances of getting pregnant. People who are diagnosed with PCOS are usually advised by their healthcare provider to make certain lifestyle modifications that include avoiding alcohol in order to successfully ovulate and conceive.
Drinking and Miscarriage
Evidence as to whether drinking increases your risk of early miscarriage is also inconclusive. Some research says there’s no increased risk, but other studies suggest that drinking can lead to miscarriage—especially if alcohol consumption exceeds three or more drinks per day. A large study of almost 18,000 women looked at drinking habits and miscarriage risk. The researchers found that drinking before becoming pregnant was not associated with an increased risk of miscarriage for women who did not have a history of pregnancy loss. Another study found that the risk for miscarriage did not increase for women until they exceeded two drinks per day prior to getting pregnant. However, a 2014 study showed that while drinking fewer than four drinks per week during early pregnancy did not have an effect on pregnancy loss, women who drank just four (or more) drinks per week were much more likely to have a miscarriage.
Alcohol Use and IVF
Research on alcohol consumption among in vitro fertilization (IVF) patients reveals statistically different results than that of women who are able to conceive naturally. For instance, a 2011 study published in Obstetrics & Gynecology followed 2,545 couples to determine whether alcohol consumption at the start of an IVF cycle had an effect on the live birth rate. The findings showed that women who drank at least four drinks per week had a 16% less chance of carrying a healthy child to term compared with those who drank fewer than four drinks per week, which is still less than one drink a day. As alcohol consumption increased at the initiation of an IVF cycle, so did the chances of pregnancy loss. In addition, a 2017 study of 2,908 couples showed that the risk of IVF failure almost tripled when women drank just one serving of alcohol a month before treatment. That risk quadrupled if the drink was consumed within a week of treatment.
Impact of Male Drinking
Male drinking also plays a role in a female IVF patient’s ability to conceive. Men who drank within a week to a month of treatment negatively impacted the couple’s IVF success rates. Additionally, drinking one week before sperm collection for IVF treatment was associated with an increased miscarriage risk by up to 38 times.
Should You Talk to Your Doctor?
The CDC advises healthcare providers to recommend to their patients who are trying to get pregnant to stop drinking. For women with normal reproductive cycles, low-level drinking while you’re trying to conceive might not be harmful, according to some of the research. But the results are still inconclusive, with evidence on both sides showing the potential for risks and positive outcomes. Although the CDC and ACOG recommend completely abstaining from alcohol while you’re trying to conceive, your healthcare provider may have their own opinion and recommendations on the matter. If you’re still left wondering whether the occasional glass of wine or beer during preconception matters, talk to your doctor or OB/GYN. Additionally, both the CDC and ACOG recommend routine screening for alcohol use and misuse, as well as educational counseling during pre-conceptual visits with physicians.
A Word From Verywell
It’s well-known that drinking during pregnancy can harm an unborn child. While research may one day support claims that the occasional drink is harmless during very early pregnancy, you may want to stay on the safe side and abstain for now. There is not enough evidence (as it is difficult to ethically study this issue without posing harm to babies) to say for certain that any amount of alcohol is safe for consumption if you might be pregnant. As you consider whether or not to drink during preconception, keep in mind the recommendations from health organizations like the CDC and ACOG. No amount of alcohol is considered safe at any stage of pregnancy—even if it’s just a glass of wine, a beer, or a shot of vodka, or a mixed drink. For many experts (and future parents), the health of your baby is too important to take the risk.
