Abstract
BackgroundEvidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy. Our aim was to investigate the prevalence, predictors and perinatal outcomes associated with peri-conceptional alcohol consumption.MethodsA cohort study of 61,241 women who booked for antenatal care and delivered in a large urban maternity hospital between 2000 and 2007. Self-reported alcohol consumption at the booking visit was categorised as low (0-5 units per week), moderate (6-20 units per week) and high (>20 units per week).ResultsOf the 81% of women who reported alcohol consumption during the peri-conceptional period, 71% reported low intake, 9.9% moderate intake and 0.2% high intake. Factors associated with moderate alcohol consumption included being in employment OR 4.47 (95% CI 4.17 to 4.80), Irish nationality OR 16.5 (95% CI 14.9 to 18.3), private health care OR 5.83 (95% CI 5.38 to 6.31) and smoking OR 1.86 (95% CI 1.73 to 2.01). Factors associated with high consumption included maternal age less than 25 years OR 2.70 (95% CI 1.86 to 3.91) and illicit drug use OR 6.46 (95% CI 3.32 to 12.60). High consumption was associated with very preterm birth (<32 weeks gestation) even after controlling for socio-demographic factors, adjusted OR 3.15 (95% CI 1.26-7.88). Only three cases of Fetal Alcohol Syndrome were recorded (0.05 per 1000 total births), one each in the low, moderate and high consumption groups.ConclusionsPublic Health campaigns need to emphasise the importance of peri-conceptional health and pre-pregnancy planning. Fetal Alcohol Syndrome is likely to be under-reported despite the high prevalence of alcohol consumption in this population.
Highlights
Evidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy
The aim of this study is to investigate the prevalence, socio-demographic predictors and perinatal outcomes associated with alcohol consumption in the peri-conceptional period using a large cohort of women booking for antenatal care and delivering in a Dublin maternity hospital
For the analyses subjects were divided into four groups: never drinkers, drinkers consuming 0-5 units per week, drinkers consuming 6-20 units per week and drinkers consuming greater than 20 units per week
Summary
Evidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy. Many women continue to consume alcohol in pregnancy despite an increasing body of evidence suggesting harm to the fetus. A recent Australian study reported that only 41% of pregnant women abstained from alcohol throughout each trimester [1]. The number of women who drink alcohol early in the first trimester before recognition of pregnancy is likely to be even higher. Ascertaining the true prevalence and extent of Studies linking alcohol consumption with first trimester miscarriage have been inconclusive [2,3,4] but a dose-related increase in second-trimester miscarriage has been reported [5]. A number of studies have reported a relationship between alcohol intake in pregnancy and behavioural and cognitive deficits in childhood and adolescence [9,10,11]. Bingedrinking in pregnancy is of concern, especially as this pattern of drinking has increased in the female population and is associated with unplanned pregnancy [12]
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