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James L. Mills, MD, MS; Barry I. Graubard, MA; George G. Rhoads, MD, MPH
National Institute of Child Health and Human Development Bethesda, Md

JAMA. 1985;253(24):3551.

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In Reply.—

We appreciate the thoughtful comments of Dr Rosett, Ms Weiner, and Dr Roehm.

The problem of underreporting of alcohol use is well known to clinician and researcher alike. We thought it sufficient to note that, since the risks of drinking during pregnancy were not widely appreciated in the 1970s, women in our study would have been less likely to underestimate intake than in more recent studies. What is needed is a biochemical measure of alcohol ingestion (like cotinine for smoking) to eliminate the problems of self-reporting.

We disagree with Dr Rosett's conclusion that since our study found lower drinking rates than some others, women reporting light or moderate intake could be assumed to be heavy drinkers underestimating their consumption and, therefore, that the association we found between moderate drinking and reduced birth weight was an artifact. Reported drinking rates vary considerably, probably because of differences in study design . . . [Full Text PDF of this Article]

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