MODERATE ALCOHOL-CONSUMPTION DURING PREGNANCY AND THE INCIDENCE OF FETAL MALFORMATIONS - A METAANALYSIS

To determine whether there is an association between moderate alcohol consumption in the first trimester of pregnancy and increased risk of fetal malformations, we conducted a literature search using Medline (1 966-present), PsycLit (1974-1995), and EMBASE (1988-1995). The followi ng inclusion criteria were used to select the studies to be evaluated: 1) pregnant women; 2) moderate alcohol consumption (>2 drinks/week to 2 drinks/day); 3) case-control or cohort studies; 4) presence of an a bstainer group (0 to 2 drinks/wk); 5) outcome measures include major o r minor malformations; 6) papers published in the English language. Th e exclusion criteria were: 1) studies in which moderate alcohol consum ption could not be confirmed; 2) case reports, and editorials. The Met hods section of each study was examined independently by two blinded i nvestigators with a third investigator settling any disagreement. The number of malformations in the abstainer and moderate alcohol consumin g groups in two by two tables. Out of 24 studies which met the inclusi on criteria, only seven had extractable data. The included studies eva luated 130,810 pregnancy outcomes, with 24,007 in the moderate alcohol group and 106,803 in the control group. An overall Mantel-Haenszel od ds ratio showed that the relative risk for fetal malformations was 1.0 1 with 95% confidence limits of 0.94 to 1.08 and a chi-square for homo geneity of 8.26 (p = 0.220). Quality of the studies did not correlate with their showing negative or positive association. Moderate alcohol consumption during the first trimester of pregnancy is not associated with increased risk of fetal malformations. (C) 1998 Elsevier Science Inc.