Preconception and Early-Pregnancy Alcohol Consumption in Women and Men, Infertility and Risk for Miscarriage.

Background

Alcohol consumption is common among women and men of reproductive age. The effects of alcohol use in the preconception and early-pregnancy periods on early reproductive outcomes are not well-known.

Methods

In a population-based cohort study from preconception onwards among 3225 women and their partners, we examined the associations of preconception and early-pregnancy alcohol consumption, assessed by questionnaires, with fecundability (per-cycle probability of conceiving), infertility (time to pregnancy >12 months or use of assisted reproductive technology), and miscarriage (pregnancy loss before 22 weeks of gestation).

Results

As compared to no alcohol consumption, preconception intake of <1 glass/week and ≥1 glass/week among women was associated with lower odds of infertility (odds ratio (OR) 0.61, 95% confidence interval (CI) 0.39, 0.94 and OR 0.54, 95% CI 0.35, 0.84, respectively). As compared to no alcohol consumption, early-pregnancy alcohol consumption among women of <1 glass/week and ≥1 glass/week was associated with increased odds of miscarriage (OR 1.99, 95% CI 1.36, 2.92 and OR 2.37, 95%CI 1.58, 3.57). Early-pregnancy binge drinking among women was also associated with increased odds of miscarriage (OR 1.52, 95%CI 1.04, 2.24). Alcohol consumption among men was not associated with infertility or miscarriage risk.

Conclusions

The associations of low-to-moderate preconception alcohol consumption with lower odds of infertility might reflect healthier lifestyles, socioeconomic factors, and residual confounding by health-related abstinence from alcohol, all of which are associated with greater fertility. Therefore, preconception and early-pregnancy counseling should mainly focus on the risk of miscarriage and fetal health outcomes.