I've noticed that most health recommendations like these do not have any evidence associated with them, or a description of the actual risks. It seems that the doctors and health officials who write them have the evidence, but don't believe that the public needs to see it and rather should just go with whatever they say.
Having recently become pregnant, a lot of the guidance for expectant mothers echos these blanket recommendations (sushi, deli meats, hot baths etc).
On the topic of alcohol, FASD is a massive concern, but it's known that it's correlated to how much you drink and how frequently you drink (enjoying a glass of wine once a month is very different than binge drinking multiple times throughout your pregnancy).
The thing is, researchers aren't getting pregnant women different levels of hammered, and then assessing how their babies turn out (unethical much), so they're left to infer based on reported behaviors. Hence the unreliability of the data, and the "no amount is proven safe" mantra. Maybe it's the same with this recommendation?
The other thing not factored into inferred results is other associated behaviors. I'd bet that statistically, women that are binge drinking through pregnancy are more likely to also be taking hard drugs than their non-binge drinking counterparts. So is alcohol fully to blame here?
I'm not here advocating for pregnant women and drinking. But it'd be nice to have the data and evidence behind these risks, so that people can be empowered to make their own decisions.
I've seen so many women on forums stressing over a glass of wine they had at christmas, or the time they ate a cold cut without realizing. Needless stress that could be minimized if pregnant people weren't advised as if they're children.
The "no amount proven safe" mantra is refuted by epidemiological studies on the subject. There's no evidence that modern drinking is something to worry about.
It's well known that pregnant women become more risk avarse, and humans being bad at risk assessment in general they tend to channel those worries in relatively unproductive ways.
E.g. worry about obscure food safety issues, as opposed to something like traffic risk, or just focusing on staying generally healthy and anxiety free.
Epidemiological studies might not be very strong evidence though, since moderate alcohol consumption is likely correlated with class. And inversely correlated with the use of more dangerous drugs.
Lacking clear research (in this case, we lack intoxicated pregnant people to study, as you say), I tend to rely more on expert judgment to sort out the facts, bringing to bear their knowledge of physiology, anatomy, chemistry, and disease; their long experience with many thousands of actual people, etc. I have none of that. If I break my arm, that's my only experience with it.
That’s because you’re reading a mass media report on the recommendation. It takes less than a minute of earnest effort to find the actual studies or briefs and scroll down to the sources.
For the claim "Alcohol consumption increases the risk of CVD", they cite the following paper, which actually shows statistically significant reductions in CVD from 75 to 150 g/wk.
