Predictors of antenatal alcohol use among Australian women: a prospective cohort study

Anderson, Adrianne; Hure, Alexis; Forder, Peta; Powers, J; Kay‐Lambkin, Frances; Loxton, DJ

doi:10.1111/1471-0528.12356

Cited by 37 publications

(61 citation statements)

References 39 publications

(77 reference statements)

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“…It is important that midwives do not assume pregnant women know about the risks and know not to drink alcohol during pregnancy [64,83,84]. Women are reported to reduce or stop consuming alcohol following knowledge of pregnancy [55,85], yet some Australian studies have shown that many women, including those with risky and binge drinking patterns, continue to drink alcohol during pregnancy [58,59,86]. Asking about alcohol consumption in pregnancy, as nearly all midwives in this study reported doing, is the important first step in assessing and recording the level of risk.…”

Section: Discussionmentioning

confidence: 99%

“…This may in part be attributed to the previous Australian Alcohol Guideline [88] promulgated in 2001 which stated “… the risk is highest in the earlier stages of pregnancy … .” In line with this we found that 12.1% (n = 20) of midwives’ general advice to pregnant women about alcohol consumption included “alcohol is harmful in the first trimester”. Maternal age and higher levels of pre-pregnancy intake are predictors of alcohol use in pregnancy [59,68]. Women are giving birth at a later age and many have established their alcohol consumption patterns for many years before their first pregnancy and may find it difficult to stop or reduce their alcohol consumption [68].…”

Section: Discussionmentioning

confidence: 99%

“…Of young women in the study aged 25 and under, 90% stopped consuming alcohol once they became aware of pregnancy, whereas only 50% of women aged 36 and older did so [57]. Other Australian research has reported that many women, including those with risky and binge drinking patterns continue to drink alcohol during pregnancy [58,59]. …”

Section: Introductionmentioning

confidence: 99%

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Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder

Payne

Watkins

Jones

et al. 2014

BMC Pregnancy Childbirth

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BackgroundMidwives are an influential profession and a key group in informing women about alcohol consumption in pregnancy and its consequences. There are no current quantitative Australian data on midwives’ knowledge, attitudes and practice in relation to alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorder. We aimed to reduce this knowledge gap by understanding midwives’ perceptions of their practice in addressing alcohol consumption during pregnancy.MethodsThis cross-sectional study was conducted at 19 maternity sites across the seven health regions of country Western Australia. A questionnaire was designed following review of the literature and other relevant surveys. Midwifery managers of the maternity sites distributed questionnaires to all midwives working in their line of management. A total of 334 midwives were invited to participate in the research and (n = 245, 73.4%) of these were eligible.ResultsThe response fraction was (n = 166, 67.8%). Nearly all (n = 151, 93.2%) midwives asked pregnant women about their alcohol consumption during pregnancy and (n = 164, 99.4%) offered advice about alcohol consumption in accordance with the Australian Alcohol Guideline, which states “For women who are pregnant or planning a pregnancy, not drinking is the safest option”. Nearly two thirds (n = 104, 64.2%) of the midwives informed pregnant women about the effects of alcohol consumption in pregnancy, they did not always use the recommended AUDIT screening tool (n = 66, 47.5%) to assess alcohol consumption during pregnancy, nor conduct brief intervention when indicated (n = 107, 70.4%). Most midwives endorsed professional development about screening tools (n = 145, 93.5%), brief intervention (n = 144, 92.9%), and alcohol consumption during pregnancy and FASD (n = 144, 92.9%).ConclusionNearly all midwives in this study asked and advised about alcohol consumption in pregnancy and around two thirds provided information about the effects of alcohol in pregnancy. Our findings support the need for further professional development for midwives on screening and brief intervention. Policy should support midwives’ practice to screen for alcohol consumption in pregnancy and offer brief intervention when indicated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder

Payne

Watkins

Jones

et al. 2014

BMC Pregnancy Childbirth

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“…[25] Previous research has found that alcohol use prior to pregnancy, particularly binge and weekly drinking, increase the risk of alcohol use during pregnancy. [20], [26]–[28] Binge and weekly drinking before pregnancy can therefore be considered risky drinking patterns, putting women at risk of experiencing an alcohol-exposed pregnancy and potential fetal harm.…”

Section: Introductionmentioning

confidence: 99%

Risky Drinking Patterns Are Being Continued into Pregnancy: A Prospective Cohort Study

et al. 2014

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BackgroundRisky patterns of alcohol use prior to pregnancy increase the risk of alcohol-exposed pregnancies and subsequent adverse outcomes. It is important to understand how consumption changes once women become pregnant.ObjectiveThe aim of this study was to describe the characteristics of women that partake in risky drinking patterns before pregnancy and to examine how these patterns change once they become pregnant.MethodsA sample of 1577 women from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health were included if they first reported being pregnant in 2000, 2003, 2006, 2009 and reported risky drinking patterns prior to that pregnancy. Multinomial logistic regression was used to determine which risky drinking patterns were most likely to continue into pregnancy.ResultsWhen reporting risky drinking patterns prior to pregnancy only 6% of women reported weekly drinking only, whereas 46% reported binge drinking only and 48% reported both. Women in both binge categories were more likely to have experienced financial stress, not been partnered, smoked, used drugs, been nulliparous, experienced a violent relationship, and were less educated. Most women (46%) continued these risky drinking patterns into pregnancy, with 40% reducing these behaviors, and 14% completely ceasing alcohol consumption. Once pregnant, women who binged only prior to pregnancy were more likely to continue (55%) rather than reduce drinking (29%). Of the combined drinking group 61% continued to binge and 47% continued weekly drinking. Compared with the combined drinking group, binge only drinkers prior to pregnancy were less likely to reduce rather than continue their drinking once pregnant (OR = 0.37, 95% CI = 0.29, 0.47).ConclusionsOver a third of women continued risky drinking into pregnancy, especially binge drinking, suggesting a need to address alcohol consumption prior to pregnancy.

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“…Factors associated with binge drinking during pregnancy in this study were smoking (past or current), illicit drug use, younger age and being unmarried. Other risk factors for continuation of alcohol use during pregnancy include stressful life events prior to conception and a high level of pre-pregnancy alcohol consumption [9, 10]. Women may be less likely to drink during pregnancy if they have experienced any difficulty conceiving [10].…”

Section: Introductionmentioning

confidence: 99%

Alcohol and fertility: how much is too much?

Heertum

Rossi

2017

Fertil Res and Pract

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Alcohol use is prevalent in the United States. Given that a substantial portion of the drinking population is of reproductive age, it is not uncommon for couples who are attempting conception, or for women who are already pregnant, to be regularly consuming alcohol. Alcohol use is associated with multiple reproductive risks, including having a child with a Fetal Alcohol Spectrum Disorder, increased risk of fetal loss, and decreased chance of live birth. This review serves to examine the risks of alcohol in the context of reproductive health.

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Predictors of antenatal alcohol use among Australian women: a prospective cohort study

Cited by 37 publications

References 39 publications

Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder

Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder

Risky Drinking Patterns Are Being Continued into Pregnancy: A Prospective Cohort Study

Alcohol and fertility: how much is too much?

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