Open Access Research article

Preterm birth and small for gestational age in relation to alcohol consumption during pregnancy: stronger associations among vulnerable women? results from two large Western-European studies

Manuela Pfinder123*, Anton E Kunst2, Reinhold Feldmann3, Manon van Eijsden45 and Tanja G M Vrijkotte2

Author Affiliations

1 Bielefeld Graduate School in History and Sociology, Faculty of Sociology, Bielefeld University, PO Box 100131, 33501 Bielefeld, Germany

2 Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

3 FAS Ambulance, Polyclinic for Children’s and Youth Medicine, University Hospital Munster, Albert-Schweitzer-Straße 33, 48129 Munster, Germany

4 Department of Epidemiology, Documentation and Health Promotion, Public Health Service of Amsterdam (GGD), Nieuwe Achtergracht 100, 1018 WT Amsterdam, PO Box 22001000 CE, Amsterdam, The Netherlands

5 Department of Health Sciences, VU University, De Boelelaan 1085, 1081 HV, Amsterdam,The Netherlands

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BMC Pregnancy and Childbirth 2013, 13:49  doi:10.1186/1471-2393-13-49

Published: 22 February 2013



Inconsistent data on the association between prenatal alcohol exposure and a range of pregnancy outcomes, such as preterm birth (PTB) and small for gestational age (SGA) raise new questions. This study aimed to assess whether the association between low-moderate prenatal alcohol exposure and PTB and SGA differs according to maternal education, maternal mental distress or maternal smoking.


The Amsterdam Born Children and their Development (ABCD) Study (N = 5,238) and the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) (N = 16,301) are both large studies. Women provide information on alcohol intake in early pregnancy, 3 months postpartum and up to 17 years retrospectively. Multivariate logistic regression analyses and stratified regression analyses were performed to examine the association between prenatal alcohol exposure and PTB and SGA, respectively.


No association was found between any level of prenatal alcohol exposure (non-daily, daily, non-abstaining) and SGA. The offspring of daily drinkers and non-abstainers had a lower risk of PTB [ABCD: odds ratio (OR) 0.31, 95% confidence interval (CI) 0.13, 0.77; KiGGS: OR 0.75, 95% CI 0.57, 0.99]. Interactions with maternal education, maternal distress or maternal smoking were not significant.


Although these results should be interpreted with caution, both studies showed no adverse effects of low-moderate prenatal alcohol exposure on PTB and SGA, not even in the offspring of women who were disadvantaged in terms of low education, high levels of distress, or smoking during pregnancy.

Prenatal alcohol exposure; Pregnancy outcomes; Maternal education; Distress; Smoking