Does Light-to-Moderate Alcohol Consumption During Pregnancy Increase the Risk for Renal Anomalies Among Offspring?

Abstract

ABSTRACT. Objective. To determine the association between light-to-moderate prenatal alcohol exposure and congenital renal anomalies.Methods. Data from the population-based Atlanta Birth Defects Case-Control Study were used to examine the association between selected renal anomalies and self-reported maternal alcohol consumption during the period from 1 month before through 3 months after conception. Case infants were ascertained by a populationbased birth defects registry with active case ascertainment; the case group consisted of 158 infants, born during 1968 through 1980 to metropolitan Atlanta residents, in whom these renal anomalies had been diagnosed. Two control groups were used. One had 3029 infants without birth defects, and the other had 4633 infants with birth defects exclusive of the urinary tract who were born during the same period.Results. Overall, there was a moderate association between renal anomalies and moderate prenatal alcohol exposure (odds ratio, 1.5; 95% confidence interval, 1.0 to 2.3). When the renal anomalies were subclassified, moderate prenatal alcohol exposure was significantly associated only with renal agenesis or hypoplasia (odds ratio, 2.5; 95% confidence interval, 1.2 to 5.1), and within this group only infants with bilateral defects and other major anomalies in addition to renal agenesis or hypoplasia had significantly elevated risks. There were no significant associations between reported light consumption and any category of the selected renal anomalies. No conclusions could be reached for reported heavy consumption because of sparse data. Adjustments for potential confounding factors did not alter these results.Conclusion. This study suggests that moderate alcohol consumption during pregnancy may increase a woman's risk of giving birth to a child with renal agenesis or hypoplasia. Pediatrics 1997;99(4). URL: http://www. pediatrics.org/cgi/content/full/99/4/e11; renal anomalies, renal agenesis, prenatal ethanol exposure, multiple congenital anomalies.

Maternal risk factors involved in specific congenital anomalies of the kidney and urinary tract: A case–control study

“…anomalies, but these results may not be generalizable because all cases had multiple birth defects (Li et al, 1996). Periconceptional maternal use of alcohol was associated with renal agenesis only in a previous study investigating different CAKUT phenotypes (Moore et al, 1997). One other study by Parikh et al (2002) showed a nearly statistically significant association between drinking alcohol and renal agenesis, which was not reproduced by others unless exposure was limited to binge drinking in the second month of pregnancy.…”

“…In a few studies, individual phenotypes within the CAKUT spectrum have been investigated and revealed for example increased risks of renal agenesis/hypoplasia for mothers who used alcohol (Moore et al, 1997;Parikh et al, 2002;Slickers et al, 2008). Smoking in early pregnancy was shown to be associated with kidney but not with urinary tract anomalies (K€ all en, 1997;Slickers et al, 2008).…”

Effects of Light Ethanol Consumption During Pregnancy: Increased Frequency of Minor Anomalies in the Newborn and Altered Contractility of Umbilical Cord Artery

“…However, there is no consensus in the literature as to what should be considered light drinking. Suggestions are Ͻ9 mL/d (810 mL/trimester) of ethanol (15) or fewer than three standard drinks per week (25), which would be approximately 6.5 mL/d (585 mL/ trimester) of ethanol, considering a content of 14.7 mL (0.5 fluid oz) of absolute ethanol in a standard drink (26). Taking into consideration these data, we set 700 mL/trimester as the highest limit to be considered a light drinker.…”

Avaliação do Consumo de Bebida Alcoólica Durante a Gravidez

“…No entanto, a exposição é maior para o concepto porque o metabolismo e a eliminação são mais lentos; o líquido amniótico fica impregnado de álcool não-modificado e de acetaldeído, pois não possui a quantidade necessária de enzimas para sua biodegradação 3,4 . Os danos fetais são diferentes, conforme o período gestacional: no primeiro trimestre da gestação, o risco é de anomalias físicas e dismorfismo; no segundo, há risco de abortamento e, no terceiro, pode ocorrer diminuição do crescimento fetal, em especial o perímetro cefálico e o cérebro 5,6 . Em 1988, o Congresso Norte-americano aprovou a lei que obriga a colocação de aviso no rótulo de bebidas alcoólicas com a mensagem "mulheres grávidas não devem consumir álcool".…”