Miscarriage news round-up 11.20.2007

Today's news items:

• Research on alcohol and pregnancy: According to the headline of this article, studies suggest that individual episodes of binge drinking may not lead to an increased risk of miscarriage, pregnancy complications, or birth defects. What the authors of the study (which appears to have been a metaanalysis of the data from prior research, which I assume was descriptive rather than randomized and scientific) actually seem to be saying is that there is insufficient data to say for certain that infrequent binge drinking by pregnant women causes adverse effects. I suspect this is in part due to the nature of any studies like these -- you can't randomly assign people to the group that must binge drink, so you extrapolate from descriptive data, but it's hard to remove all the noise (i.e. all the confounding variables). My read of the bottom line was not that women should feel free to binge drink during pregnancy but rather that a woman should not freak out immediately if she learns she is pregnant shortly after having a wild night. The study was also reported on in the UK, and comments to that article were of the if-you-can't-live-without-alcohol-for-9-months-then-you-shouldn't-be-a-parent variety, which doesn't do much for the woman who finds herself in the "oh crap" position, nor does it assuage her guilt if she subsequently miscarries.

• On a semi-related note: This op-ed considers a proposed Human Life Amendment in Colorado, opining that if, under such an amendment, abortion is murder, miscarriage would be manslaughter (and therefore arguing that the amendment should be rejected, regardless of one's views re abortion). The logic is that manslaughter is the unintentional taking of a life, and, under the amendment, a fertilized egg is a life. If a woman gets pregnant knowing she is at an increased risk of miscarrying (and thereby causing the death of another person) due to, for example, an auto-immune disorder or a history of recurrent miscarriage, and subsequently miscarries, she becomes akin to a person who drives drunk, knowing they are at increased risk of ending the life of another. (The analogy is the op-ed writer's; I would probably have chosen an epileptic whose seizures are incompletely controlled by medication but who drives anyway as the comparator rather than the drunk driver, as the drunk driver chose both to drink and to drive, while the driving epileptic and the pregnant miscarrier made no choice resulting in an increased risk of harm to others from a common activity. Even still, the comparison is rather inapt -- the person who dies at the hands of a driving epiletic who suffers a seizure existed prior to the driver's decision to drive; the person who dies as a result of miscarriage did not exist prior to the parents' decision to conceive him, which is the same behavior that resulted in his death.) It's an interesting (and decidedly disturbing) logic. I initially rejected it as cockamamie, but I'm not really sure it's that farfetched.