Changes in Alcohol Intake During Pregnancy in Spain, 1980 to 2014

Abstract

Background Even small amounts of alcohol consumed during pregnancy can have adverse effects on the embryo and the fetus. We estimated how alcohol intake among pregnant women in Spain changed between 1980 and 2014, and identified factors associated with alcohol use. Methods Data came from the Spanish Collaborative Study of Congenital Malformations (ECEMC). The sample includes ECEMC′s control mothers, 40,268 pregnant women from all regions of Spain. We classified alcohol consumption during pregnancy into 3 categories: no consumption; sporadic consumption of small amounts of alcohol; and regular consumption, or sporadic but in large quantities including drunkenness. Independent variables included sociodemographic factors, planned/unplanned pregnancy, maternal chronic diseases, gestational diabetes, and tobacco and illegal drug use during pregnancy. Trend analyses were performed using data from 1980 to 2014. The multinomial logistic regression models designed to identify associated factors differentiated between 2 periods: 1994 to 2004 and 2005 to 2014. Results Prevalence of alcohol consumption declined from 29.6% (95% CI: 27.1 to 32.2) in 1980 to 5.4% (95% CI: 3.7 to 7.6) in 2014, mostly due to the reduction in regular intake. This decline was especially acute between 1980 and 1994. Sporadic and regular consumption increased among women working outside the home, born outside Spain, those whose pregnancy was unplanned, and those reporting using tobacco or other drugs. Comparing 1994 to 2004 versus 2005 to 2014, a stronger association was observed between regular alcohol consumption and tobacco consumption in the latter period (interaction p = 0.003). Conclusions Alcohol consumption among expectant mothers has declined substantially in the last 35 years. However, it is worth highlighting the significant and substantial associations between alcohol use and consumption of tobacco, which have become stronger in the most recent years.

At a Juncture: Exploring Patterns and Trends in FASD Prevention Research from 2015 – 2021 Using the Four-Part Model of Prevention

“…28 However, it is important to note that there is conflicting evidence regarding the prevalence of alcohol use during preg nancy over time. Some studies have indicated a decrease in alcohol use during pregnancy over time, 29 whereas others have pointed to an increase. 30 From 2015 -2021, there was an increase in the studies focusing on biomarkers and the accuracy of selfreport measures compared to various biological measures of alcohol use (e.g., meconium samples, urine toxicology, blood samples, alcohol metabolite analysis).…”

“…There are a wide range of factors and influ ences that impact women's alcohol use during pregnancy, including pregnancy recognition, 35 knowledge of FASD 36 and/or the impacts of alcohol use during pregnancy, 20,23,[36][37][38] marital status, 22,39 planned pregnancy, 23,24,29.35.37.38.40.41 tobacco 20,26,35,39 and other/polysubstance use during the preconcep tion and pregnancy periods, 24,29,41,42 and preconcep tion alcohol use, including preconception binge drinking. 32,39 Alcohol use in pregnancy was also influenced by adverse childhood experiences, 43,44 trauma, 45,46 residential school histories, 47 and mental health status.…”