Analyzing Questions About Alcohol in Pregnancy Using Web-Based Forum Topics: Qualitative Content Analysis

Abstract

Background: Prenatal alcohol exposure represents a significant public health concern as it may lead to several detrimental outcomes, including fetal alcohol spectrum disorder (FASD). Although UK national guidance recommends abstaining from drinking alcohol in pregnancy, evidence suggests that confusion remains on this topic among members of the public and little is known about what questions people have regarding alcohol in pregnancy.Objective: This study aims to assess what questions and topics are raised concerning alcohol in pregnancy on an online, UKbased parenting forum. A second aim is to explore how, if at all, these correspond to official public health guidelines with respect to two critical events: the implementation of revised UK Chief Medical Officers' (CMO) low-risk drinking guidelines (2016) and the first COVID-19 lockdown (2020).Methods: All social media posts mentioning alcohol in the 'Pregnancy' topic were collected from Mumsnet.com for the period 2002-2022 and analysed using qualitative content analysis. Descriptive statistics were used to characterise the number and proportion of posts for each topic over the whole study time period and for the periods corresponding to the change in CMO guidance and the COVID-19 pandemic.Results: Topics discussed on Mumsnet regarding alcohol in pregnancy remained similar between 2002 and 2022. Key topics included 'Asking for advice on whether it is safe to consume alcohol or on 'safe limits', 'Consumed alcohol before knowing about pregnancy', and 'Research, guidelines, and official information about alcohol in pregnancy'. The relative proportion of each of these topics changed over time. Posts about having consumed alcohol during pregnancy were more common before the introduction of the revised CMOs' guidance than in the later time periods. Conclusions:The findings suggest that mothers and expecting mothers use Mumsnet to seek reassurance and information regarding alcohol in pregnancy from others in similar situations. The results also indicate that there may be less confusion about guidelines and research about alcohol in pregnancy in more recent years.