# Knowledge Gaps Regarding Alcohol Consumption During Pregnancy and Its Effect on the Fetus: A Systematic Review Focused on Women

## TL;DR

This review finds that many women believe alcohol during pregnancy is acceptable and lack knowledge about its risks to the fetus.

## Contribution

The study systematically evaluates gaps in women's risk perception and knowledge about alcohol use during pregnancy and its fetal effects.

## Key findings

- Alcohol consumption during pregnancy is perceived as acceptable by many women, depending on factors like quantity and gestational stage.
- Knowledge of FASDs is limited, often restricted to physical malformations, with misconceptions more common among women with prior alcohol use.
- Prevention efforts should target women of childbearing age and their sociocultural environment to reduce gestational alcohol exposure.

## Abstract

Background/objectives: Alcohol use during pregnancy can result in adverse outcomes for the offspring, including Fetal Alcohol Spectrum Disorders (FASD). Psychosocial and contextual factors may influence gestational alcohol intake and women’s risk perception. This systematic review aimed to assess pregnant women’s and women of childbearing age’s perceived risk of alcohol use during pregnancy and to evaluate their knowledge of its potential effects on children. Methods: Following the PRISMA guidelines, a systematic search was conducted in Web of Science, PubMed and PsycArticles databases for studies published up to May 2025. Eligible studies examined gestational alcohol use, risk perception, or knowledge of fetal consequences among pregnant women or women of reproductive age. Methodological quality was assessed with the Critical Appraisal of Qualitative Studies tool from the Centre for Evidence-Based Medicine (CEBM). Results: Twenty-nine studies were included. Reported prevalence of alcohol consumption during pregnancy varied considerably across settings. A substantial proportion of women perceived alcohol use during pregnancy as acceptable, often depending on quantity, frequency, type of beverage, or stage of gestation. Knowledge of FASDs was generally limited and frequently restricted to physical malformations. Misconceptions were more common among women with prior alcohol use. The findings highlight persistent gaps in risk perception and knowledge about FASDs. Conclusions: Prevention strategies should not be limited to pregnant women but should also target women of childbearing age, especially those with active drinking patterns, as well as their immediate sociocultural environment. Strengthening professional training, community-based interventions, and consistent public health messaging are essential to reduce gestational alcohol exposure.