Maternal Age and Trajectories of Risky Alcohol Use: A Prospective Study

Abstract

Background No prospective study of maternal alcohol use has focused on age at transition to motherhood as a predictor of trajectories of risky drinking. The goal of this study was to examine the impact of maternal age at first birth on trajectories of alcohol use beyond recommended levels over a 17-year span. Methods Pregnant women (N = 456) were recruited at an urban prenatal clinic. The women (13–42 years old; 64% African-American, 36% White) were interviewed about alcohol use during pregnancy and at 6, 10, 14, and 16 years postpartum. Growth mixture modeling (GMM) was used to identify trajectories of risky drinking. Maternal age at first birth was then regressed onto trajectory class membership. Results The GMM on maternal alcohol use identified 3 groups of mothers as a function of alcohol use before, during and after the pregnancy. The majority of mothers (66%) were identified as having low risk trajectories of alcohol use over the 17-year span. However, two groups were in the higher risk categories, with 23% identified as being in a long-term high risk trajectory, and 11% in a short-term high risk trajectory group. Maternal age at first birth predicted membership in a high-risk group: younger mothers were more likely to be classified into a long-term high risk alcohol use group. Conclusions Younger mothers were more likely to engage in risky drinking early in pregnancy, continuing 6 to 14 years postpartum. These results can help physicians target mothers who are likely to exceed current NIAAA guidelines of abstinence during pregnancy, and no more than 7 drinks per week in the postpartum.

Commentary on De Genna et al. (2017): Why Should We Be Concerned About Adolescent Mothers and Their Risks for Long‐Term Risky Alcohol Consumption Over the Life Course?

“…Despite convincing evidence of this decline in consumption in pregnancy, we know relatively little about the long‐term consequences of this reduction in alcohol use or how maternal age at first birth may be related to subsequent alcohol use trajectories. The study results reported by De Genna and colleagues () contribute to our understanding of a number of key areas. The study sample involves a cohort of women who were 12 to 18 years of age, as well as 2 older mother cohorts.…”

“…Previous studies have focused on older mothers and the increased risks of maternal age at time of delivery, with women 30 years or older more likely to be in higher trajectory of alcohol consumption in comparison with younger mothers; older drinking women tend to have children with more severe alcohol‐related problems (Chiodo et al., ; Jacobson et al., , ; Liu et al., ; May, ). By contrast, De Genna and colleagues' () paper appears to be among the first to examine maternal age at transition to motherhood with a focus on age variations in drinking trajectories, particularly younger mothers.…”

“…The findings reported by De Genna and colleagues () raise the need to leverage the reduction in alcohol consumption that occurs in pregnancy, and to develop policies to maintain this reduction in alcohol consumption. On this latter point, we note a persistent demand for more and better detoxification services in society in general.…”

“…The gap in drinking between male and female teenage drinkers has narrowed (Jang et al., ); in some cases, females have been reported more likely than their counterparts to start drinking before 18 (Cheng et al., ). The paper by De Genna and colleagues () raised the need for effective prevention and intervention programs for underage drinking, particularly addressing drinking by teenage girls.…”

“…Arguably, detoxification is the first step in interrupting a high level of substance use. The paper by De Genna and colleagues () provides another way of looking at the short‐ and long‐term consequences of a natural experimental form of detoxification. For women, a pregnancy is often associated with a decision to quit or reduce levels of alcohol consumption.…”