Associations of education and income with hazardous drinking among postpartum women in Japan: results from the TMM BirThree Cohort Study

Keiko Murakami,Fumiko Matsuzaki,Shinichi Kuriyama,Aoi Noda,Tomomi Onuma,Mami Ishikuro,Hirohito Metoki,Taku Obara,Fumihiko Ueno

doi:10.1186/s12199-021-00991-9

Abstract

BackgroundAlthough the postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan.MethodsWe analyzed data from 11,031 women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. Hazardous drinking was defined as ethanol intake of ≥20 g/day 1 year after delivery. We conducted multiple logistic regression analyses to examine whether educational attainment or equivalent household income was associated with hazardous drinking, adjusting for age, parity, drinking status during pregnancy, work status, postpartum depression, breastfeeding, and income/education. We also conducted stratified analyses by income and education groups.ResultsThe prevalence of hazardous drinking 1 year after delivery was 3.6%. Lower education was associated with hazardous drinking; the odds ratio (95% confidence interval) of high school education or lower compared with university education or higher was 2.17 (1.59–2.98). Lower income was also associated with hazardous drinking, but this association disappeared after further adjustments for education; the odds ratios (95% confidence intervals) of the lowest compared with highest level of income were 1.42 (1.04–1.94) and 1.12 (0.81–1.54), respectively. A significant interaction was detected; lower education and lower income were associated with increased risks of hazardous drinking only in a lower income group and lower education group, respectively.ConclusionsPostpartum women with lower education and lower income had higher risks of hazardous drinking in Japan.

Highlights

The postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan
We focused on hazardous drinking 1 year after delivery because there is evidence that parenting a child
Lower educational attainment was associated with an increased risk of hazardous drinking after adjusting for age and after adjusting for parity, drinking status during pregnancy, work status, postpartum depression, and breastfeeding; the adjusted Odds ratio (OR) of high school education or lower compared with university

Summary

Introduction

The postpartum period is suggested to provide an ideal opportunity for interventions to prevent hazardous drinking, evidence on the associations of education and income with hazardous drinking during this period is limited, including in Japan. The patterns of women’s drinking may change over their reproductive life course; most women reduce or abstain from alcohol use once they learn that they are pregnant [5], and many women have been found to return to drinking after their child is born [6, 7] This suggests that the postpartum period provides an ideal opportunity for interventions to prevent hazardous drinking. Unlike in other OECD countries, women with lower education in Japan have a higher risk of hazardous drinking [12], and income is not associated with hazardous drinking among women in Japan [12, 13]

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