Alcohol during pregnancy: only the ‘zero-drink’ option provides 100 per cent protection for the baby

Whilst awareness of the risks associated with alcohol consumption during pregnancy is growing, the pitfall of ‘social drinking’ remains whilst prevention of the full spectrum of risks, including foetal alcohol syndrome, can only be fully effective if expectant mothers, supported by their partners and those around them, choose to abstain completely from even the occasional drink during pregnancy. This precaution, according to experts, should be extended to the breastfeeding period because ethanol passes into breast milk.

The International Day for Foetal Alcohol Syndrome and Related Disorders, which is observed on 9 September, provides an opportunity to relaunch a comprehensive prevention programme. The Ministry of Health has dedicated the campaign ‘Zero alcohol during pregnancy’, which is being shared on its Instagram and YouTube channels and on those of the National Institute of Health, with contributions also from the Italian Society of Gynaecology and Obstetrics (SIGO).

Alcohol consumption during childbearing years is harmful not only to the health of the drinker but also to that of the foetus – as the Ministry points out – if a couple planning a pregnancy or who are expecting a baby do not abstain from alcohol. Alcohol metabolites, in fact, cross the placental barrier and cause permanent damage to the exposed foetus; these effects are categorised under the Fetal Alcohol Spectrum Disorders (FASD), the most severe clinical manifestation of which is Foetal Alcohol Syndrome (FAS). FASD manifestations include craniofacial abnormalities and growth retardation, as well as neurodevelopmental disorders, which lead to behavioural and neurocognitive disabilities.

Studies at European level show that around 10 per cent of women in the general population consume alcohol during pregnancy, which is a key risk factor. The Italian National Institute of Health points out that young women are increasingly aware of the risks associated with alcohol consumption during pregnancy and, in most cases, say they avoid it. However, as the report notes, there appears to be a discrepancy between what is reported and what the data show: the habit of drinking occasionally, particularly when socialising, remains underestimated. This is revealed by an analysis of maternal and infant biological samples carried out by the ISS’s National Centre for Addiction and Doping between January 2024 and July 2026 as part of the project ‘Maternal and Child Health: training of social and healthcare workers and the empowerment of young women (aged 18–24) on the risks associated with alcohol consumption during pregnancy’. “The message is clear: zero alcohol during pregnancy,” emphasises Simona Pichini, director of the Centre. Promoting this awareness means taking action before conception, during pregnancy and, more generally, raising awareness of the risks associated with alcohol consumption during pregnancy. Abstinence is not just a matter for the woman alone but involves her partner and those close to the couple.”

As part of the project, 83 hair samples from pregnant women aged between 18 and 24 and 147 samples of neonatal meconium were analysed. The analyses sought traces of ethyl glucuronide (EtG), a marker used to assess alcohol exposure, alongside screening for other psychoactive substances. The most significant finding concerned the maternal samples. Only two samples showed EtG levels close to the threshold indicated in the scientific literature as a reference for chronic alcohol consumption. However, in 34 cases – accounting for 41 per cent of the sample – the hair analyses revealed a profile consistent with that defined in the literature as a ‘social drinker’. This finding is particularly significant because, during the interviews, the women had stated that they did not consume alcohol, were teetotallers, or had stopped drinking during pregnancy. However, this finding does not mean that 41 per cent of pregnant women are chronic alcohol consumers, nor does it, on its own, allow us to establish the quantity and frequency of consumption throughout the entire pregnancy. This is a preliminary finding that will need to be investigated further, including through a scientific publication. “The finding is interesting and will be explored in greater depth in a scientific publication,” points out Adele Minutillo, of the National Centre for Addiction and Doping.