What were you drinking seventeen years ago?
Corresponding Author:
Lynn Gretkowski, MD
Stanford University
Adjunct Clinical Instructor
Palo Alto Foundation Medical Group
CEO and Co-Founder Winedoctors, LLC
701 E. El Camino Real
Mountainview, CA 94028
Telephone: 650.269.3381
Fax No: 650.851.2631
Mary T. Jacobson, MD, MSc
Stanford University
Department of Obstetrics and Gynecology
Clinical Assistant Professor
CBO and Co-Founder Winedoctors, LLC
Reference:
Re: PEDIATRICS Vol. 122 No. 6 December 2008, pp.e1225-e1230
(doi:10.1542/peds.2008-1380)
Sources of Financial Assistance: None.
Conflict of Interest: We are founders of Winedoctors.com, dedicated
to transparency and accuracy of information as it relates to moderate wine
consumption. We are also wine makers.
To Whom It May Concern:
Re: PEDIATRICS Vol. 122 No. 6 December 2008, pp.e1225-e1230
(doi:10.1542/peds.2008-1380)
“Strengthening the Case: Prenatal Alcohol Exposure Is Associated
With Increased Risk for Conduct Disorder”/”What were you Drinking 17 Years
ago?”
To the Editor:
We are not often moved to respond, but when a scientific publication
paints itself as “strengthening the case”, implying a movement or ordered
momentum with an inherently bias looking to provide evidence based on a
belief, rather than sound science, we sat down at our desks. As
scientists we are bound to present evidence, but based on adherence to the
scientific method. Research tells us that 20% of critical details of a
recognized event are irretrievable after one year from its occurrence and
50% are irretrievable after 5 years.
Admittedly, studies of parous women and alcohol consumption are
ethically challenged, and as a result, from which it is difficult to
extract data. Rare reports have been published with tracking alcohol
consumption prospectively in pregnant women. The original documentation
of “Fetal Alcohol Syndrome” was indeed a case report of 3 pregnant native
American women with no prenatal care, one of whom had diptheria, and all
of whom were alcoholic, and generalized for generations of gravidas. This
was our first retrospective confound. These were unique cases of extreme
consumption.
We take issue with the following: The study starts with a homogenous
98% Caucasian population. Twin pregnancies have an inherent risk profile
distinct from singleton pregnancies regardless of gestational age at
delivery. IVF pregnancies carry their unique risk profile, not including
Twin-twin transfusion syndrome, intrauterine growth restriction and
discordant growth and different from spontaneous twins. Remarks regarding
management issues that preceded twin deliveries, as well as mode of
delivery were not included. There was no mention of the type of alcohol,
wine versus beer versus spirits and whether binge drinking was observed.
No mention is made of studies that show a higher rate of mental illness in
parents of twins versus singletons.
We do not advocate the routine consumption of alcohol in pregnancy,
but “Strengthening the Case” is a strong statement. Where were you 17
years ago?
1 Bradburn N, Rips L, Shevell S. Answering autobiographical
questions: The impact of memory and inference on surveys. Science, New
Series 1987; 236(4798):157-161.
2 Jones, KL and Smith David W; “Recognition of the Fetal Alcohol Syndrome
in Early Infancy”: The Lancet: Nov 3, 1973 (999-1001).
3 Kallio, U; Parents of twins report more mental health symptoms than
parents of singletons. European Society for Human Reproduction and
Embryology, 7 Jul 2008.
Mary Jacobson, MD, MSc
Assistant Professor
Department of Obstetrics and Gynecology
Stanford University
Lynn Gretkowski, MD
Clinical Adjunct Faculty
Department of Obstetrics and Gynecology
Stanford University
Conflict of Interest:
We are founders of Winedoctors LLC, dedicated to transparency and accuracy of information as it relates to moderate wine consumption. We are also winemakers.
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