Alcohol exposure during pregnancy has declined in Finland, but early pregnancy remains a concern
26.10.2026 - Alcohol exposure during pregnancy has decreased substantially in Finland over the past 35 years, according to a new study published in PLOS One. However, the researchers estimate that exposure remains common, with drinking before pregnancy recognition continuing to present a significant challenge for prevention.
The study, published on 21 October, estimates prenatal alcohol exposure and fetal alcohol spectrum disorders (FASD) in Finland between 1990 and 2025. Led by Mirjami Jolma, the research combines Finnish studies on alcohol use during pregnancy, biomarker findings, population statistics and international studies of FASD.
The authors estimate that the proportion of children exposed to any alcohol before birth fell from around 75% in the early 1990s to 32% in the early 2020s. Estimated heavy prenatal alcohol exposure declined more modestly, from approximately 9% to 6%.
These figures are modelled estimates, rather than results from a new nationwide screening study. They include exposure before a woman knows she is pregnant, which helps explain why they are higher than figures based only on reported drinking after pregnancy recognition. Exposure also does not mean that a child will develop FASD.
Drinking before pregnancy recognition
The study identifies an important difference between changes in drinking before and after pregnancy recognition. Self-reported alcohol use during a recognised pregnancy declined following Finland’s recommendation of complete abstinence in 2004. Drinking before pregnancy recognition, however, remained relatively stable.
This matters because alcohol exposure can occur during sensitive stages of development before a pregnancy is recognised. The authors note that no safe amount or timing of alcohol use during pregnancy has been established, and the developing brain remains vulnerable throughout pregnancy.
Heavy episodic drinking is a particular concern. The researchers argue that drinking patterns among women before pregnancy need greater attention, alongside advice and support provided through maternity services. Prevention that begins only after pregnancy recognition will miss some early exposure.
A substantial estimated burden of FASD
FASD describes a range of lifelong effects associated with prenatal alcohol exposure, including difficulties with learning, attention, behaviour and everyday functioning.
The researchers used two approaches to estimate how many children born in Finland could have FASD. One linked international FASD prevalence findings with heavy episodic drinking among women. The other applied a previously established ratio between any prenatal alcohol exposure and FASD.
For 2020 to 2024, the two conservative approaches produced estimates of approximately 1,240 to 2,350 children with FASD born annually. These are model-dependent estimates, not counts of diagnosed children or a confirmed national incidence rate.
The authors highlight a substantial gap between the estimated burden and recorded diagnoses. Limited awareness, stigma and insufficient access to specialist assessment may contribute to missed diagnoses. Children may receive diagnoses addressing individual difficulties without prenatal alcohol exposure being recognised as an underlying cause.
Better evidence and stronger support
The findings carry considerable uncertainty. Finnish data are fragmented, self-reported drinking can be underreported, and applying international FASD findings to Finland requires assumptions. The authors also caution that part of the apparent decline in reported drinking may reflect changes in disclosure rather than behaviour alone.
They call for more population-based research using alcohol exposure biomarkers, alongside studies that actively assess children for FASD instead of relying on existing diagnoses.
At the same time, they argue that gaps in the evidence should not delay prevention or support. Their recommendations include promoting abstinence from the time pregnancy is being planned, adequately resourcing services for pregnant women who need help with alcohol use, and improving multidisciplinary assessment and support for affected individuals and families.
The declining trend is encouraging, but the study underlines the need to address alcohol exposure before pregnancy recognition and to improve recognition of FASD. It also points to a continuing need for support among people already living with its effects, including adults whose condition may never have been diagnosed.
Source: Jolma M, Koivu-Jolma M, Gissler M, Sarajuuri A and Autti-Rämö I. Estimated incidence and number of new cases with prenatal alcohol exposure and fetal alcohol spectrum disorders in Finland 1990–2025. PLOS One, 21 October 2026. Read the study.
