Infrequent prenatal exposure to acute doses of alcohol in Inuit communities of Canada: A public health concern?

Exposure to an average absolute alcohol per day (AA) during pregnancy of ≥ 0.5 oz (the equivalent of 1 standard drink) has been shown to affect multiple facets of child development. Below this threshold, very few developmental outcomes have been found to be associated with prenatal exposure to alcohol. However, data from both experimental animal and human prospective cohort studies suggest that binge drinking (≥ 5 standard drinks on a single occasion) is more damaging to the foetus than chronic exposure.  The objectives of this study were to determine the prevalence of binge drinking during pregnancy in a sample of Inuit women in Arctic Québec and whether this pattern of consumption is associated with poorer infant developmental outcome. Maternal interviews were conducted during mid-pregnancy and at 1 month postpartum to document prenatal alcohol use and potential confounding variables. Prenatal growth was assessed at delivery. Infants were tested on visual acuity and cognitive development at 6 and 11 months. Among the 216 women for whom alcohol use was documented, 61% reported alcohol consumption during pregnancy. Average AA/day among women reporting alcohol use was low (Mean = 0.1; S.D. = 0.2), but 36% reported drinking ≥ 5 standard drinks of alcoholic beverages on at least one occasion during pregnancy. After controlling for potential confounding variables, results of multiple linear regressions suggest that binge drinking at least once during pregnancy is associated with reduced weight and head circumference at birth and with reduced visual acuity at 6 months postpartum. These results suggest that in the Inuit communities of Arctic Québec, even among women who consume low-to-moderate average levels of alcohol during pregnancy, binge drinking is an important public health issue, especially given the high prevalence of a binge consumption pattern in this population.