Pregnancy Intention and Maternal Alcohol Consumption

Abstract

Objective To evaluate whether women planning a pregnancy are less likely to use alcohol in early pregnancy than those with unintended pregnancies. Methods Right From the Start (2000–2012) is a prospective, community-based pregnancy cohort. Maternal demographic, reproductive, and behavioral data were collected in telephone interviews at enrollment (mean ± SD: 48 ± 13 days of gestation) and later in the first trimester (mean ± SD: 85 ± 21 days). Alcohol consumption characteristics were included in the interviews. We used logistic regression to investigate the association of pregnancy intention with alcohol use. Results Among 5,036 women, 55% reported using alcohol in the first trimester, with 6% continuing use at the first trimester interview. Pregnancy was planned by 70% of participants. Alcohol use occurred in 55% and 56% of intended and unintended pregnancies, respectively (p=0.32). Adjusting for confounders, women with intended pregnancies were 31% less likely to consume any alcohol in early pregnancy (adjusted OR (aOR): 0.69, 95% CI: 0.60–0.81) or binge drink (aOR: 0.68, 95% CI: 0.54–0.86). Most women, regardless of intention, stopped or decreased alcohol consumption in early pregnancy. Conclusion The majority of women, irrespective of intention, stopped or decreased drinking after pregnancy recognition. This suggests promoting early pregnancy awareness could prove more effective than promoting abstinence from alcohol among all who could conceive.

Alcohol Use in Pregnancy and Miscarriage: A Systematic Review and Meta‐Analysis

“…Timing of alcohol exposure during pregnancy likely plays a critical role in determining risk of miscarriage (Hertz‐Picciotto et al., ), but there is no consensus on how to leverage this information when measuring risk. More than half of the women consume alcohol during pregnancy, but most quit or sharply decrease their consumption upon pregnancy recognition (Day et al., ; McCormack et al., ; Pryor et al., ). While half of the studies in this review assessed whether a change from prepregnancy alcohol use occurred, this information was seldom incorporated into measures of association.…”

Alcohol Intake in Early Pregnancy and Spontaneous Preterm Birth: A Cohort Study

“…Further, as a result of the question formulations, binge drinking reflected the whole period of early pregnancy, while average weekly alcohol intake only captured consumption at the time of questionnaire completion after referral to antenatal care. Typically, women cease or restrict alcohol consumption when recognizing pregnancy (McCormack et al, ; Pryor et al, ; Strandberg‐Larsen et al, ). Accordingly, our measure of average weekly alcohol intake may on average be lower than women’s actual weekly alcohol intake in the whole period of early pregnancy.…”

“…Currently, 13 to 18% of Danish women between 25 and 34 years of age drink 7 drinks or more per week (1 drink being equal to 12 g of pure alcohol), while 23 to 25% regularly consume 5 drinks or more on a single occasion (binge drinking as defined by the Danish Health Authority; Strandberg‐Larsen and Grønbæk, ). Although the majority of women cease or decrease alcohol consumption once they recognize that they are pregnant (McCormack et al, ; Pryor et al, ; Strandberg‐Larsen et al, ), 35 to 40% of Danish women engage in binge drinking in very early pregnancy (Iversen et al, ; Kesmodel et al, ). From a public health perspective, it is urgent to clarify potential detrimental effects of maternal alcohol consumption in early pregnancy.…”

The effect of periconceptional alcohol exposure on renal and cardiovascular development and function

“…Interestingly, it has been reported that women over the age of 35 are more likely to drink during pregnancy and women with a university degree and a high level of household income continue to drink after the first trimester of pregnancy (Cameron et al, 2013). More recent studies suggest that while women often decrease alcohol intake upon knowledge of pregnancy, up to 50-60% of women are consuming alcohol around the time of conception (McCormack et al, 2017;Pryor et al, 2017). A long term study evaluating pregnancies in two groups of women from the same hospital in Brisbane report that while the proportion of women drinking at moderate to high levels prior to pregnancy has increased in the past 30 years, alcohol consumption by the time of first antenatal clinic visit is greatly reduced (Kingsbury et al, 2017).…”

“…Despite guidelines recommending abstinence of alcohol both when planning and throughout pregnancy, recent studies suggest that significant proportions of women are drinking alcohol prior to pregnancy recognition. Studies from both Australia and the USA report that between 50-60% of women are consuming alcohol around conception with a large proportion of these women decreasing intake when they become aware they are pregnant (McCormack et al, 2017;Pryor et al, 2017).…”