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Asking Questions about Alcohol in Pregnancy (AQUA)

Research project

About the AQUA study

Women are told not to drink during pregnancy to protect their babies. But can the occasional glass of wine hurt? And what if a woman has already had a drink before knowing she is pregnant? The Institute is seeking to answer these questions through the AQUA study.

Currently we don't know how much alcohol pregnant women can safely drink without harming the developing baby, so avoiding alcohol entirely is the best option. The lack of knowledge in this area has the potential to cause anxiety for women who drink even small amounts of alcohol before realising they are pregnant. This also creates problems for doctors and midwives about how to best advise women.

Through their involvement in this research project, participants are helping researchers find out whether low or moderate alcohol drinking during pregnancy adversely affects early childhood health and development. In the future this information may be useful for women planning to get pregnant, pregnant women, and the health professionals who provide maternity care.

Aims of AQUA

The research aims to collect detailed information about alcohol consumption in pregnancy from a large group of pregnant women and to assess the effect of different doses of alcohol and other associated influences on the unborn child.

The specific aims of this project are to find out whether:

  • Low to moderate quantities of alcohol at various stages of pregnancy are associated with problems in the health and development of young children and;
  • Maternal DNA variations, specific dietary factors or other environmental influences can affect the impact of low to moderate quantities of alcohol in pregnancy.

Who are our research participants?

Our participants are women who attended an antenatal clinic in 2011 or 2012 at the Mercy Hospital for Women, Royal Women's Hospital, Monash Medical Centre, Dandenong Hospital, Casey Hospital or Box Hill Hospital, who were at the time of enrolment:

  • less than 19 weeks pregnant with a single baby
  • at least 16 years of age
  • able to speak, read and write in English*
  • able to provide informed consent

* We were not funded to translate our questionnaires into other languages.

What does the AQUA study involve?

Stage 1: Pregnancy to 24 months

AQUA researchers have collected detailed information about alcohol consumption during pregnancy from nearly 1,600 pregnant women to assess the impact of different amounts of alcohol on the unborn child. This has been compiled through three questionnaires, one in each trimester of pregnancy. The team has also collected information on factors that might influence the effects of alcohol such as diet, medication and body size.

Women participating in the AQUA study also completed a questionnaire about the health and development of their baby, when their baby was one and two years old.

Some participants were also invited to have a 3D photo of their baby's face and head taken at one year and a developmental assessment at two years of age. 

Stage 2: Early School Year's Follow-up (AQUA at 6)

A second stage of the study took place between July 2018 and April 2021 and involved follow-up of the study children as they entered school-age (see AQUA at 6).


  • The preliminary work for this project was funded by VicHealth and the Commonwealth Department of Health & Ageing. 
  • Stage 1 of AQUA was funded by a project grant from the National Health & Medical Research Council from 2011 to 2014.
  • Stage 2 of AQUA was funded by a project grant from the National Health & Medical Research Council from 2018 to 2021.
  • The collection of biosamples at birth was supported by the McCusker Charitable Foundation.
  • Aspects of the epigenetic work were funded by the Jack Brockhoff Foundation, and Financial Markets for Children. 
  • The project also received funding from the Murdoch Children's Research Institute. 
  • Additional funding for the AQUA at 6 data linkage to the Australian Early Development Census has been partly funded by the Gourlay Charitable Trust. 


Findings are still being published. Please check the Study updates and Publications tabs.