Determinants of alcohol cessation, reduction and no reduction during pregnancy

Abstract

Despite public health initiatives targeting the harmful effects of alcohol exposure on fetal growth, 12% of pregnant women report current alcohol use. For women who reported drinking alcohol prior to pregnancy, we examined several factors as predictors of three alcohol use patterns during the third trimester of pregnancy: cessation, reduction and no reduction. Using the 2002-2009 Pregnancy Risk Assessment Monitoring System (PRAMS) dataset (311,428 records), a multinomial logistic regression model was constructed to compare alcohol risk by category: (1) cessation vs. reduction (2) no reduction vs. reduction. In this sample, 49.4% drank alcohol before pregnancy. Among those who drank before pregnancy, ~87% quit drinking during pregnancy, 6.6% reduced, and about 6.4% reported no reduction. Older women and those with higher education were more likely to reduce than quit their alcohol use. Conversely, women who were black or Hispanic, overweight, obese, or multiparas were more likely to quit than to reduce their prenatal alcohol consumption. Several stressors such as abuse during pregnancy increased their risk of not quitting or not reducing alcohol during the last trimester of pregnancy. Differentiating prenatal alcohol use patterns can inform the design of targeted interventions and public health policies to meet the Healthy People 2020 objective for achieving a national rate of 98.3% alcohol abstinence during pregnancy.