Nutritional teratogens: a survey of epidemiological literature.

Alcohol seems to be, by far, the most important nutritional teratogen. Assuming an incidence rate of 1.3%o, 240 newborns with fetal alcohol syndrome per year would be expected in the Netherlands alone. Only a minor fraction of this number is diagnosed as such. Even moderate drinking during pregnancy results in developmental disturbances. There is no safe consumption level. Therefore the intake of alcohol during pregnancy should be abandoned completely. There is conflicting evidence on the effects of caffeine with regard to pregnancy outcome. A slight decrease in birthweight among the offspring of women drinking at least 4 cups of coffee per day seems to be the most consistent finding. In view of the many uncertainties on this subject the intake of caffeine-containing foods and drugs should be curtailed as far as possible. There is a lot of circumstantial evidence in favour of the assumption that high-risk mothers do benefit from vitamin supplementation in the periconceptional period. More research however is needed to elucidate the role of vitamins and other nutrients before supplementation can be recommended in practice as a prophylactic measure.