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.