“Did you ever drink more?” A detailed description of pregnant women’s drinking patterns

Abstract

BackgroundThis paper presents drinking patterns in a prospective study of a population-based cohort of 1570 pregnant women using a combination of dose and timing to give best estimates of prenatal alcohol exposure (PAE). Novel assessments include women’s special occasion drinking and alcohol use prior to pregnancy recognition.MethodsInformation on up to nine types of alcoholic drink, with separate frequencies and volumes, including drinking on special occasions outside a ‘usual’ pattern, was collected for the periconceptional period and at four pregnancy time points. Weekly total and maximum alcohol consumption on any one occasion was calculated and categorised. Drinking patterns are described in the context of predictive maternal characteristics.Results41.3 % of women did not drink during pregnancy, 27 % drank in first trimester only; most of whom stopped once they realised they were pregnant (87 %). When compared to women who abstained from alcohol when pregnant, those who drank in the first trimester only were more likely to have an unplanned pregnancy and not feel the effects of alcohol quickly. Almost a third of women continued to drink alcohol at some level throughout pregnancy (27 %), around half of whom never drank more than at low or moderate levels. When compared with abstainers and to women who only drank in trimester one, those who drank throughout pregnancy tended to be in their early to mid-thirties, smoke, have a higher income and educational attainment.Overall, almost one in five women (18.5 %) binge drank prior to pregnancy recognition, a third of whom were identified with a question about ‘special occasion’ drinking. Women whose age at first intoxication was less than 18 years (the legal drinking age in Australia), were significantly more likely to drink in pregnancy and at binge levels prior to pregnancy recognition.ConclusionsWe have identified characteristics of pregnant women who either abstain, drink until pregnancy awareness or drink throughout pregnancy. These may assist in targeting strategies to enhance adherence to an abstinence policy and ultimately allow for appropriate follow-up and interpretation of adverse child outcomes. Our methodology also produced important information to reduce misclassification of occasional binge drinking episodes and ensure clearly defined comparison groups.

The Effects of Maternal Periconceptional Ethanol Exposure on the Development of the Pre-Implantation Embryo, Placenta, and the Influence of the Uterine Environment

“…A more recent study from Australia of 1570 participants showed that these rates have risen to 39% (Muggli et al, 2016). This same study also analysed the period prior to pregnancy recognition, in which 12% of women admitted to binge drinking regularly, with an additional 6% admitting to binge drinking on one occasion (Muggli et al, 2016). In total over the periconception period, 27% of women drank alcohol, with 87% ceasing alcohol consumption after pregnancy recognition (Muggli et al, 2016).…”

“…A population study from Australia showed that approximately 14% of women drank more than 5 standard drinks in 1 day of the 3 months prior to pregnancy (Colvin et al, 2007). A more recent study from Australia of 1570 participants showed that these rates have risen to 39% (Muggli et al, 2016). This same study also analysed the period prior to pregnancy recognition, in which 12% of women admitted to binge drinking regularly, with an additional 6% admitting to binge drinking on one occasion (Muggli et al, 2016).…”

“…Alcohol consumption is more prevalent in the United States where a recent study showed that nearly 75% of women who were planning a pregnancy drank alcohol (Green et al, 2016). Current demographic analysis suggests that women who drink moderate-high levels during pregnancy are primarily from high income households with tertiary education (Muggli et al, 2016, Jansen et al, 2009). …”

“…This same study also analysed the period prior to pregnancy recognition, in which 12% of women admitted to binge drinking regularly, with an additional 6% admitting to binge drinking on one occasion (Muggli et al, 2016). In total over the periconception period, 27% of women drank alcohol, with 87% ceasing alcohol consumption after pregnancy recognition (Muggli et al, 2016). This cessation after pregnancy recognition is a common finding (Parackal et al, 2013, Alvik et al, 2006, and is likely to be contributed by unplanned pregnancies, which are approximately 50% (Colvin et al, 2007, Finer andZolna, 2016).…”

“…A poor maternal environment as a result of poor nutrition (Grieger et al, 2014), smoking (Homish et al, 2012), and alcohol exposure (Muggli et al, 2016), are likely perturbations during this period as many women are unaware of being pregnant. One major contributing factor to this is unplanned pregnancies, which accounts for approximately 50% of pregnancies in Australia and America (Colvin et al, 2007, Finer andZolna, 2016).…”