Aspiring fathers should avoid alcohol 6 months prior to conception, says ESC study

China: Alcohol should be avoided by aspiring fathers six months before conception, and women should avoid it 1 year before pregnancy and during pregnancy to protect the offspring from developing congenital heart diseases (CHDs), finds a recent study published in the European Journal of Preventive Cardiology.

According to the study, the consumption of alcohol three months before pregnancy by fathers increased the risk of CHD to 44%, whereas drinking by mothers increased the risk by 16% compared to not drinking. Five or more drinking per sitting, called binge drinking, increased the likelihood of these birth defects by 52% for men and 16% for women.

Congenital heart diseases are the most common birth defects, with approximately 1.35 million babies affected every year. These conditions can increase the likelihood of cardiovascular disease later life, even after surgical treatment, and are the main cause of perinatal death. Alcohol is a known teratogen and has been connected with foetal alcohol spectrum disorder (FASD). Around one in four children with FASD have congenital heart disease, indicating that alcohol might also be implicated in these disorders.

Previous studies investigating the link between alcohol and congenital heart disease have focused on prospective mothers, with inconclusive results. This is the first meta-analysis to examine the role of paternal alcohol drinking.

Jiabi Qin, of Xiangya School of Public Health, Central South University, Changsha, China, and colleagues provide updated evidence to assess the association between parental alcohol consumption and the risk of total congenital heart diseases (CHDs) and specific CHD phenotypes in offspring and explore the possible dose-response pattern.

The researchers compiled the best data published between 1991 and 2019, which amounted to 55 studies including 41,747 babies with congenital heart disease and 297,587 without. The analysis showed a nonlinear dose-response relationship between parental alcohol drinking and congenital heart diseases.

Key findings include:

• Overall, both maternal and paternal alcohol exposures were significantly associated with risk of total CHDs in offspring.


• A nonlinear dose-response relationship between parental alcohol exposure and risk of total CHDs was observed.


• With an increase in parental alcohol consumption, the risk of total CHDs in offspring also gradually increases.


• For specific CHD phenotypes, a statistically significant association was found between maternal alcohol consumption and risk of tetralogy of fallot.


• Relevant heterogeneity moderators have been identified by subgroup analysis, and sensitivity analysis yielded consistent results.

‘Binge drinking by would-be parents is high risk and dangerous behaviour that not only may increase the chance of their baby being born with a heart defect, but also greatly damages their own health,’ said Dr Qin.

Dr Qin said the results suggest that when couples are trying for a baby, men should not consume alcohol for at least six months before fertilisation while women should stop alcohol one year before and avoid it while pregnant.

Dr Qin said: ‘We observed a gradually rising risk of congenital heart diseases as parental alcohol consumption increased. The relationship was not statistically significant at the lower quantities.’

Regarding specific defects, the study found that compared to abstinence, maternal drinking was correlated to a 20% greater risk of tetralogy of Fallot, a combination of four abnormalities in the heart’s structure.

The authors noted that this was an observational study and does not prove a causal effect, nor does it prove that paternal drinking is more harmful to the foetal heart than maternal drinking. The data cannot be used to define a cut-off of alcohol consumption that might be considered safe.

Dr Qin said: ‘The underlying mechanisms connecting parental alcohol and congenital heart diseases are uncertain and warrant further research. Although our analysis has limitations – for example the type of alcohol was not recorded – it does indicate that men and women planning a family should give up alcohol.’

The study highlights the necessity of improving health awareness to prevent alcohol exposure during preconception and conception periods.

To read the complete study log on to: https://doi.org/10.1177/2047487319874530