In reply: Morley and colleagues and Miers raise a number of interesting discussion points. As we reported in our policy review, the Canadian, United Kingdom and Australian guidelines have similar intent but differ in emphasis.1 Health Canada’s policy position is that, although abstinence is the prudent choice, fetal risk is relative to the amount of alcohol consumed and is minimal with low levels of maternal alcohol intake. Australian policy addresses the same issues, with less emphasis on abstinence and more on avoiding intoxication and ensuring low-level alcohol consumption. Since our review was published, UK guidelines have been reframed to emphasise abstinence, but their message has not changed — they now place more weight on avoiding alcohol during pregnancy.2
The full article is accessible to AMA members and paid subscribers. Login to read more or purchase a subscription now.
Please note: institutional and Research4Life access to the MJA is now provided through Wiley Online Library.
- 1 Department of Population Sciences, Telethon Institute for Child Health Research, Perth, WA.
- 2 Centre for Child Health Research, University of Western Australia, Perth, WA.
- 3 Mental Health Research and Outcomes, Central Northern Adelaide Health Service, Glenside Campus, Adelaide, SA.
- 4 Discipline of Paediatrics and Child Health, and Australian Paediatric Surveillance Unit, University of Sydney, Children's Hospital at Westmead, Sydney, NSW.
- 1. O'Leary CM, Heuzenroeder L, Elliott EJ, Bower C. A review of policies on alcohol use during pregnancy in Australia and other English-speaking countries, 2006. Med J Aust 2007; 186: 466-471. <MJA full text>
- 2. UK Department of Health. Alcohol advice to pregnant women. http://www.dh.gov.uk/ (accessed May 2007).
- 3. Payne J, Elliott E, D’Antoine H, et al. Health professionals’ knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy. Aust N Z J Public Health 2005; 29: 558-564.
- 4. Colvin L, Payne J, Parsons D, et al. Alcohol consumption during pregnancy in non-Indigenous west Australian women. Alcohol Clin Exp Res 2007; 31: 276-284.
- 5. Henderson J, Gray R, Brocklehurst P. Systematic review of effects of low–moderate prenatal alcohol exposure on pregnancy outcome. BJOG 2007; 114: 243-252.
- 6. Testa M, Quigley BM, Eiden RD. The effects of prenatal alcohol exposure on infant mental development: a meta-analytical review. Alcohol Alcohol 2003; 38: 295-304.