Abstract
Accurate information on dose, frequency and timing of maternal alcohol consumption is critically important when investigating fetal risks from prenatal alcohol exposure. Identification of distinct alcohol use behaviours can also assist in developing directed public health messages about possible adverse child outcomes, including Fetal Alcohol Spectrum Disorder. We aimed to determine group-based trajectories of time-specific, unit-level, alcohol consumption using data from 1458 pregnant women in the Asking Questions about Alcohol in Pregnancy (AQUA) longitudinal study in Melbourne, Australia. Six alcohol consumption trajectories were identified incorporating four timepoints across gestation. Labels were assigned based on consumption in trimester one and whether alcohol use was continued throughout pregnancy: abstained (33.8%); low discontinued (trimester one) (14.4%); moderate discontinued (11.7%); low sustained (13.0%); moderate sustained (23.5%); and high sustained (3.6%). Median weekly consumption in trimester one ranged from 3 g (low discontinued) to 184 g of absolute alcohol (high sustained). Alcohol use after pregnancy recognition decreased dramatically for all sustained drinking trajectories, indicating some awareness of risk to the unborn child. Further, specific maternal characteristics were associated with different trajectories, which may inform targeted health promotion aimed at reducing alcohol use in pregnancy.
Highlights
Accurate information on dose, frequency and timing of maternal alcohol consumption is critically important when investigating fetal risks from prenatal alcohol exposure
Increasing use of meta-analysis to consolidate research evidence has highlighted the lack of detailed, comparable measures of prenatal alcohol exposure (PAE) which can be aggregated across studies[5,6]
The Asking Questions about Alcohol (AQUA) longitudinal cohort study commenced in July 2011 and comprises a cohort of 1570 mother/child dyads recruited from the general population in early pregnancy
Summary
Frequency and timing of maternal alcohol consumption is critically important when investigating fetal risks from prenatal alcohol exposure. Our understanding of the dose–response relationship between prenatal alcohol exposure (PAE) and adverse child outcomes, especially at low levels of exposure, is limited despite several decades of research. Increasing use of meta-analysis to consolidate research evidence has highlighted the lack of detailed, comparable measures of PAE which can be aggregated across studies[5,6]. These measures should provide detailed information on metric units (e.g. grams of absolute alcohol) that characterise consumption patterns at specific pregnancy timepoints
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