Could 'Moderate' Drinking Be Safe During Pregnancy?

British study finds no problems with balance in kids, but some experts have concerns about the findings

By Alan Mozes

HealthDay Reporter

TUESDAY, June 18 (HealthDay News) -- Children of women who drink moderate amounts of alcohol while pregnant don't appear to have any neurodevelopmental problems when it comes to balance, a new British study suggests.

Researchers assessed the long-term health impact of drinking while pregnant by testing roughly 7,000 10-year-olds on their balancing abilities, a method that offers a reliable reflection of fetal neurodevelopment. For the study, "moderate" alcohol consumption was defined as between three to seven glasses of alcohol a week.

The research team cautioned, however, that other variables, such as maternal wealth and education, might have influenced the findings.

The bottom line, according to study co-author John Mcleod, is that "[there's] certainly no evidence that moderate alcohol use by pregnant mums is good for their kids, and [there are] reasons to be cautious about other messages around 'benefits' of moderate alcohol use by pregnant mums. But equally, [there's] no strong evidence for important harmful effects."

Macleod, chair of clinical epidemiology and primary care with the School of Social and Community Medicine at the University of Bristol, and his colleagues discuss their findings in the June 17 online edition of BMJ Open.

The research comes on the heels of another British study, released in April, which reported no connection between "light" drinking (one to two drinks per week) during pregnancy and increased risk for mental defects among children at the age of 7.

For the new study, the researchers focused on 6,915 children from southwest England who had participated in the larger Avon Longitudinal Study of Parents and Children.

The team first analyzed maternal drinking habits self-reported at both the 18-week mark of pregnancy and then again when the children were 4 years old.

The vast majority of mothers -- 70 percent -- said they drank no alcohol during pregnancy, while 25 percent said they had consumed drinks in the range of "low" (one to two per week) to "moderate" amounts on a weekly basis. Among such drinkers, one in seven had actually engaged in "binge drinking," meaning at least four glasses of alcohol at a sitting.

By the time their children were 4 years of age, 50 percent of the mothers said they consumed three to seven glasses of alcohol weekly. The research team noted that those who drank moderately were older, more affluent and better educated.

At the age of 10, the children underwent two balance tests, which included walking across a balance beam (to assess so-called "dynamic balance"); standing heel-to-toe on a beam with eyes open and closed (to assess "static balance"); and standing on just one leg, eyes open and closed.

The result: moderate maternal (and paternal) drinking while pregnant, and maternal drinking after delivery appeared to be associated with better overall balance, particularly in terms of static balance.

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Even in Young Adults, Binge Drinking May Harm Circulation

By Serena Gordon
HealthDay Reporter

TUESDAY, April 23 (HealthDay News) -- When college-aged adults binge drink it may hinder the function of their blood vessels, a small new study finds, possibly setting the stage for later heart disease.

"Consequences of binge drinking may extend beyond just a bad hangover, and may actually interfere with the current and future cardiovascular health of young adults," said Shane Phillips, senior study author and an associate professor and associate head of the department of physical therapy at the University of Illinois at Chicago.

Results of the study were published online April 23 in the Journal of the American College of Cardiology.

More than half of college-student drinkers engage in regular binge-drinking episodes, according to study background information. A binge-drinking episode is generally defined as consuming more than four to five alcoholic drinks in a two-hour period.

Studies on middle-aged and older people have linked binge drinking to a higher risk of cardiovascular disease, such as stroke, sudden cardiac death and heart attack. Other studies have found that binge drinking can lead to hardening of the arteries, which may be what contributes to the increased risk of cardiovascular disease, according to the report.

To see the effects of binge drinking on the blood vessels and circulatory system in young people, the researchers recruited 36 urban college students between the ages of 18 and 25. About half the group participated in binge drinking, and the rest were abstainers -- they didn't drink alcohol at all. None of the study volunteers smoked cigarettes.

The researchers found that the binge drinkers showed signs of changes that could affect their cardiovascular health.

"Repeated episodes of binge drinking in young, healthy adults was associated with changes in the function of the circulation that impacts blood flow. Specifically, there was evidence that two main cells types -- endothelium and smooth muscle -- that work to control blood flow in the circulation were not functioning normally," Phillips said.

"These vascular changes may be a precursor for the initiation and progression of atherosclerosis [hardening of the arteries] and increased vulnerability to cardiovascular disease," he added.

While the study found an association between binge drinking in young adults and possible increased risk of future heart disease, it did not establish a cause-and-effect relationship.

The author of an accompanying journal editorial explained the study findings further.

"The researchers saw a signal for vasoconstriction [when blood vessels constrict] in the binge drinkers even after they stopped binge drinking, and were measured three to four days after binge drinking," said Dr. Robert Vogel, a clinical professor of medicine at the University of Colorado, Denver.

"Alcohol is a very complex drug. Your blood pressure goes down while you have alcohol in your system, but your blood pressure goes up the day after drinking. We don't understand exactly why that is, but alcohol is often forgotten when doctors are assessing for [high blood pressure]," Vogel said.

Dr. Suzanne Steinbaum, a preventive cardiologist at Lenox Hill Hospital in New York City, said, "Binge drinking is a true public health problem on college campuses. Even in these young people, binge drinking was associated with changes to the lining of the arteries associated with heart disease," she noted.

"Perhaps when discussing binge drinking on college campuses, providing this information on the ramifications of this unhealthy behavior on arterial health can help in managing this destructive behavioral choice," she suggested.

For his part, Dr. Scott Krakower, an addiction specialist at North Shore-LIJ Health System in Mineola, N.Y., said he wasn't surprised that there's a potential link between college-age binge drinking and cardiovascular disease. The challenge is getting students to do something about it.

"Most college students do not realize the psychological and medical implications binge drinking can have, and often believe that they are invincible," Krakower said.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Shane Phillips, P.T., Ph.D., associate professor, and associate head, department of physical therapy, University of Illinois at Chicago; Robert Vogel, M.D., clinical professor of medicine, University of Colorado, Denver; Scott Krakower, D.O., addiction specialist, North Shore-LIJ Health System, Mineola, N.Y.; Suzanne Steinbaum, M.D., preventive cardiologist, Lenox Hill Hospital, New York City; April 23, 2013, Journal of the American College of Cardiology, online

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Rheumatoid Arthritis, Smoking, and Drinking Alcohol

The potential risks smoking and drinking pose to people with rheumatoid arthritis.By Stephanie Schupska
WebMD Feature

You already know that smoking is bad for you and that it's unhealthy to drink too much alcohol.

But do you know how tobacco and alcohol relate to rheumatoid arthritis -- your odds of developing RA, or, if you already have RA, your odds of making it worse?

Joint Stiffness and Rheumatoid Arthritis

Joint stiffness is a hallmark of rheumatoid arthritis (RA), a chronic disease that affects 1.3 million adult Americans. Resulting from an abnormal response of the immune system, rheumatoid arthritis inflames the soft tissue that lines the surface of joints (called the synovium). It is a systemic disease that not only makes joints stiff and painful, but can also affect other parts of your body, such as internal organs. By noting symptoms such as joint stiffness and seeking early treatment, you can...

Read the Joint Stiffness and Rheumatoid Arthritis article > >

Here's what the research shows.

Smoking may make people more likely to get RA. And, depending on their genes, it may make their RA worse. On top of that, smoking mixed with RA can lead to even greater problems, like heart disease.

“Very clear studies indicate that tobacco is highly associated [with] and probably causal in rheumatoid arthritis and is causal in the worst form of the disease,” says Susan Goodman, MD, an assistant attending rheumatologist and internist at the Hospital for Special Surgery and assistant professor of medicine at Weill Cornell Medical College.

Your genes may also matter. A Swedish study, published in December 2010, shows that the odds of developing RA was related not just to how much a person smokes, but also to their genetic makeup. People with a certain gene variation, called HLA-DRB1, who smoke are much more likely to get rheumatoid arthritis than someone who doesn’t smoke -- and to have severe RA.

“It turns out that people who smoke who bear this genetic factor are much more likely to develop rheumatoid arthritis and do develop more severe disease," Goodman says.

Smoking can also make dealing with the disease more difficult.

“In a lot of the studies on the course of rheumatoid arthritis, patients who smoke do less well, and they’re less likely to achieve remission,” Goodman says. “They’re more likely to have a worse outcome. Smoking gives them a worse prognosis.”

Smoking can increase painful rheumatoid nodules, which form in the joints, she says. It can also lead to heart disease, which -- even on its own -- is a big problem in people with RA. And smoking makes it worse.

“In the last 10 years, there have been studies that show the leading cause of death in patients with RA is cardiovascular disease,” says Walter Moore, MD, senior associate dean for graduate medical education and veteran affairs at Georgia Health Sciences University and chief of rheumatology at Charlie Norwood Department of Veterans Affairs Medical Center. “And smoking itself is clearly associated as a risk factor for cardiovascular disease.”

Stroke is another concern for RA patients.

“RA is an illness like diabetes. In and of itself, it’s a risk factor for heart attack and stroke,” says Andrew Ruthberg, MD, an assistant professor of medicine and an attending physician at Rush University Medical Center and director of Rush Rheumatoid Arthritis Clinic. “And those two things conspire to raise your risk for those other problems to a higher level.”

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Pre-College Parental Chat May Reduce Freshman Drinking

Title: Pre-College Parental Chat May Reduce Freshman Drinking
Category: Health News
Created: 3/29/2013 12:35:00 PM
Last Editorial Review: 4/1/2013 12:00:00 AM

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Mother's Drinking Increases Risk of Infant's Death: Study

By Kathleen Doheny

HealthDay Reporter

TUESDAY, Feb. 26 (HealthDay News) -- Children of women who are diagnosed with an alcohol disorder during pregnancy or within a year after giving birth have a three-fold higher risk of dying from SIDS -- sudden infant death syndrome -- compared to babies whose mothers do not have alcohol issues, according to a new Australian study.

In the study, a mother's problem drinking was implicated in about one out of every six SIDS deaths, according to the researchers. Alcohol abuse by the mothers was also linked with about 3 percent of the deaths caused by something other than SIDS, the researchers found.

"Maternal alcohol-use disorder is a significant risk factor for SIDS and infant mortality excluding SIDS," wrote researcher Colleen O'Leary, of Curtin University in Perth, and colleagues.

The study was published online Feb. 25 and in the March print issue of the journal Pediatrics

SIDS is defined as the sudden death of an infant less than 1 year old that can't be explained after thoroughly investigating, according to the U.S. Centers for Disease Control and Prevention.

Overall, SIDS deaths have dropped by more than half since 1990, the CDC noted. Even so, it is still the leading cause of death among U.S. babies aged 1 month to 1 year.

In 2009, about 2,200 U.S. children died from SIDS. The rate is still disproportionately high among some groups, including American Indians, Alaskan natives and blacks, the Australian researchers said.

Australia has a higher-than-average infant death rate, with more than four of every 1,000 live births affected, according to study background information.

Experts have known that certain risk factors increase the chances of SIDS, including bed sharing, maternal smoking and putting a baby to sleep on their stomach. Prevention guidelines recommend positioning babies on their backs.

More recently, researchers have focused on alcohol.

The new study findings did not surprise David P. Phillips, a professor of sociology at the University of California, San Diego, who also has reported a link between parental alcohol intake and SIDS deaths. As alcohol consumption rises -- such as on New Year's and weekends -- so do the number of SIDS deaths, he found.

"We know that when people are under the influence of alcohol, they perform tasks much more poorly, including parenting," he said.

For the new study, the Australian researchers evaluated nearly 78,000 live births from 1983 to 2005. They found nearly 22,000 of the mothers had an alcohol diagnosis such as acute alcohol intoxication or dependence. About 56,000 did not.

In all, more than 300 children died from SIDS and nearly 600 others died of other causes.

Although the study found an association between infant death and maternal drinking, it didn't establish a cause-and-effect relationship. The researchers can't explain exactly why alcohol abuse and SIDS are linked. They speculate that the alcohol has a bad effect on the development of the brainstem during pregnancy.

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