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Why in this advise :

The risk of harm to the baby is likely to be low if a woman has drunk only small amounts of alcohol before she knew she was pregnant or during pregnancy

They use "has drunk", but not "had drunk".

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  • Because any such drinking is explicitly specified as occurring before she knew, I think most native speakers would think it was at least a bit "odd" if you didn't use Past Perfect had drunk in this exact context. But that wouldn't apply if instead it had been phrased as, for example, before realising... (in which case Present Perfect would be fine to my ear). Commented Sep 12, 2017 at 16:31

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The medical writer is giving general advice, meant to apply to any pregnant mother, past or future. It's similar to how English uses the simple present when offering instructions:

To start the car, first turn the key
The car is likely to start if you have kept it in good condition.

We know that this meant to be general advice because the writer says "a woman" and not "the woman"* or "Mrs. Baker".

On top of this, the context indicates that this is a current case, because of the use of the present tense:

the risk to the baby is likely to be low

If this was a past case, the writer would have instead said:

the risk to the baby was likely to have been low.

With a current case, the mother may continue to drink alcohol in the future, so it's an ongoing condition, and the present perfect is appropriate. However, if the writer wants to make it clear that the mother definitely will not drink again while pregnant, the past perfect might be appropriate:

The risk to the baby is likely to be low because Mrs. Baker had drunk only small amounts before she knew she was pregnant.

Again, this would have to be a known person, otherwise the writer could not say for certain that she had stopped drinking.

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  • Dear Andrew, thanks but I really don't get it! I would have perfectly understood "has drunk" if the question had been much shorter with period before the word "before". But in this sentence the process of drinking had occurred before she knew, not before she know she is pregnant. Help me to understand ((
    – Koss M
    Commented Sep 13, 2017 at 8:16
  • If we are talking about a specific person with a known medical history, we could use the past perfect because we are certain what happened and what is likely to happen "She had drunk alcohol before she knew she was pregnant, but she stopped". However in a general case, we use the present perfect to indicate a potential condition "If the patient has drunk small amounts of alcohol before knowing she is pregnant, the baby should be fine"
    – Andrew
    Commented Sep 13, 2017 at 14:10

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