Systematic review of the fetal effects of prenatal binge-drinking

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Abstract
Objective: The effects of binge-drinking during pregnancy on the fetus and child have been an increasing concern for clinicians and policy-makers. This study reviews the available evidence from human observational studies. Design: Systematic review of observational studies. Population: Pregnant women or women who are trying to become pregnant. Methods: A computerised search strategy was run in Medline, Embase, Cinahl and PsychInfo for the years 1970–2005. Titles and abstracts were read by two researchers for eligibility. Eligible papers were then obtained and read in full by two researchers to decide on inclusion. The papers were assessed for quality using the Newcastle–Ottawa Quality Assessment Scales and data were extracted. Main outcome measures: Adverse outcomes considered in this study included miscarriage; stillbirth; intrauterine growth restriction; prematurity; birth-weight; small for gestational age at birth; and birth defects, including fetal alcohol syndrome and neurodevelopmental effects. Results: The search resulted in 3630 titles and abstracts, which were narrowed down to 14 relevant papers. There were no consistently significant effects of alcohol on any of the outcomes considered. There was a possible effect on neurodevelopment. Many of the reported studies had methodological weaknesses despite being assessed as having reasonable quality. Conclusions: This systematic review found no convincing evidence of adverse effects of prenatal binge-drinking, except possibly on neurodevelopmental outcomes.