Drinking In Early Pregnancy Research Articles

Characteristic associated with alcohol drinking in early pregnancy: a cross sectional study

We aimed to identify characteristics associated with alcohol drinking before and during pregnancy to better target pregnancy guidance and public health campaigns. A cross sectional study including 1895 pregnant women interviewed at 16 weeks’ gestation. Information on characteristics and drinking habits before and during pregnancy was collected by in-person interview. Associations between characteristics and alcohol consumption were estimated by ordinal logistic regression models. Average alcohol intake before pregnancy was categorised; 0; > 0–3; > 3–6; > 6 drinks/week; and intake during pregnancy 0; < 1; 1–3; > 3 drinks/week; binge drinking 0; 1; 2; 3; ≥ 4 episodes. Characteristics for average alcohol intake before pregnancy were older age, odds ratio (OR) 3.99 (95% CI 2.77–5.74) when being 35 years or older. Schooling > 10 years, being primiparous and partner’s alcohol consumption were also significantly associated with average alcohol intake before pregnancy. Characteristics for average alcohol intake during pregnancy were age 25 to < 35 years, OR 0.78 (CI 95% 0.61–0.98) and being single OR 1.52 (CI 95% 1.01–2.29). Characteristics for binge drinking during pregnancy were smoking OR 1.34 (CI 95% 1.06–1.69) when binge drinking was defined as ≥ 3 drinks/occasion and OR 1.49 (CI 95% 1.18–1.91) when defined as ≥ 5 drinks/ occasion. Other characterises found with a significant association were schooling > 10 years, being single, being primiparous and partner’s alcohol consumption. We identified characteristics that may be considered when counselling pregnant women or women planning to conceive. Public persuasive campaigns can be used to reach the general public, especially women of childbearing age, before they start planning to conceive, but also their partners, since women with partners consuming alcohol, did show to be more likely to consume alcohol during pregnancy.

Degree of pregnancy planning and recommended pregnancy planning behavior among women with and without chronic medical conditions - A large hospital-based cross-sectional study.

Pregnancy planning allows women to engage in pregnancy planning behaviors to optimize health status in the preconception period. Women with chronic medical conditions have a higher risk for adverse pregnancy outcomes and therefore preconception care is recommended. The aim was to compare pregnancy planning among women with and without chronic medical conditions, and to assess adherence to the recommended pregnancy planning behaviors on folic acid intake, physical activity and abstention from smoking and alcohol, among women with and without chronic medical conditions stratified by pregnancy planning. A cross-sectional study with data from 28794 pregnancies. Pregnancy planning was measured with the Swedish Pregnancy Planning Scale. Multiple Poisson regression with robust variance estimates was used to assess the associations between chronic medical condition (yes/no and main categories) and pregnancy planning, and chronic medical condition status and pregnancy planning behaviors stratified by pregnancy planning. In the study population, 74% reported high degree of pregnancy planning, and 22% had one or more chronic medical conditions. We found no overall association between chronic medical condition and pregnancy planning (adjusted rate ratio [RR] 1.00, 95% confidence interval [CI] 0.98-1.01). However, women with type 2 diabetes and mental illness were significantly less likely to plan their pregnancies than women without these conditions (aRR 0.73, 95% CI 0.61-0.88; aRR 0.91, 95% CI 0.87-0.96, respectively). Women with chronic medical conditions were more likely to adhere to the recommended planning behaviors; intake of folic acid, abstention from alcohol prior to pregnancy and no binge drinking in early pregnancy. Overall, pregnancies were highly planned. Women with chronic medical conditions did not show a higher degree of pregnancy planning than women without chronic medical conditions but were, however. more likely to adhere to the generally recommended pregnancy planning behaviors (ie intake of folic acid and abstention from alcohol intake). Only women with mental illness and type 2 diabetes reported a lower degree of pregnancy planning. It is important that we continuously address pregnancy planning and planning behaviors for both women with and women without chronic medical conditions, especially women with type 2 diabetes and mental illness.

Maternal alcohol consumption and risk of offspring with congenital malformation: the Japan Environment and Children\u2019s Study

BackgroundThe association between fetal exposure to alcohol and congenital structural disorders remains inconclusive. The present study searched for relationships between maternal alcohol consumption during pregnancy and the risk of congenital malformations.MethodsWe evaluated the fixed dataset of a large national birth cohort study including 73,595 mothers with a singleton live birth. Information regarding the alcohol consumption of mothers was obtained from self-reported questionnaires. Physicians assessed for 6 major congenital malformations (congenital heart defects [CHDs], male genital abnormalities, limb defects, cleft lip and/or cleft palate [orofacial clefts (OFC)], severe brain abnormalities, and gastrointestinal obstructions) up to 1 month after birth. Multiple logistic regression analysis was performed to identify associations between maternal alcohol consumption during pregnancy and each malformation.ResultsThe prevalence of maternal drinking in early pregnancy and until the second/third trimester was 46.6% and 2.8%, respectively. The onset of CHD was inversely associated with mothers who quit drinking during early pregnancy (OR 0.85, 95% CI 0.74–0.98). There was no remarkable impact of maternal drinking habit status on the other congenital malformations after adjustment for covariates.ConclusionsMaternal alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital malformations of interest.ImpactThis large-scale Japanese cohort study revealed that no teratogenic associations were found between maternal retrospective reports of periconceptional alcohol consumption and congenital malformations after adjustment for covariates.This is the first nationwide birth cohort study in Japan to assess the effect of maternal alcohol consumption during pregnancy on major congenital malformations.Our finding indicated that maternal low-to-moderate alcohol consumption during pregnancy, even in early pregnancy, displayed no significant adverse impact on congenital heart defects, male genital abnormalities, limb defects, orofacial clefts, severe brain abnormalities, or gastrointestinal obstructions.

Are Low-to-Moderate Average Alcohol Consumption and Isolated Episodes of Binge Drinking in Early Pregnancy Associated with Facial Features Related to Fetal Alcohol Syndrome in 5-Year-Old Children?

Fetal alcohol syndrome (FAS) typically is observed among individuals with high prenatal alcohol exposures (PAE), but exposure histories obtained in clinical diagnostic settings are often inaccurate. The present analysis used the Lifestyle During Pregnancy Study (LDPS) to assess the potential effects of low-to-moderate average weekly alcohol consumption and binge drinking in early pregnancy on facial features associated with FAS among children 5years of age. The analysis is a prospective follow-up study of 670 women and their children sampled from the LDPS cohort based on maternal alcohol consumption during pregnancy. The 4-Digit Code FAS Facial Photographic Analysis Software was used to measure the magnitude of expression of the 3 diagnostic facial features of FAS from standardized digital photographs. Logistic regression was used to estimate the odds of presenting with the FAS/partial fetal alcohol syndrome (PFAS) facial phenotypes relative to different patterns of prenatal alcohol exposure. Ten children presented with the FAS/PFAS facial phenotypes. None of the children sampled met the central nervous system (CNS) criteria for FAS or PFAS at age 5years. All remained at risk for PFAS since some types of CNS dysfunction associated with this diagnosis may only be assessed at older ages. The FAS/PFAS facial phenotypes were 8.5-fold more likely among children exposed to an average of 1 to 4 drinks/wk and 2.5-fold more likely among children with a single binge exposure in gestational weeks 3 to 4 compared to children with no such exposures. The magnitude of expression of the FAS facial phenotype was significantly correlated with all other diagnostic features of FAS: growth deficiency, microcephaly, and measures of CNS dysfunction. These findings suggest that low-to-moderate levels of PAE or isolated binge exposures may place some fetuses at risk for FAS/PFAS. Thus, conservative advice is still for women to abstain from alcohol consumption during pregnancy.

Alcohol Use During Pregnancy or Breastfeeding: A National Survey in France

Adverse effects are associated with alcohol drinking during pregnancy and breastfeeding. Data are lacking on the size of the population at risk and on the characteristics of women engaging in risky behaviors such as daily consumption or repeated binge drinking. A cross-sectional survey was carried out by telephone among a nationally representative sample of pregnant and postpartum women. Frequency of alcohol use and binge drinking was retrospectively measured according to distinct time periods. Multivariable regression models were used to identify the characteristics of women reporting risk-taking behaviors. A total of 3,603 women participated. Daily consumption was reported by 0.1% of pregnant women and by 0.4% of breastfeeding women. In early pregnancy, 8.0% of women reported binge drinking (≥1 episode) and 1.2% reported repeated binge drinking (≥3 episodes). Binge drinking was estimated at 1.1% in late pregnancy and at 6.8% during breastfeeding. Characteristics of drinkers varied across these different drinking patterns and subpopulations. Moderate drinking during pregnancy and breastfeeding was associated with higher educational level. Smoking increased with increased frequency of alcohol use. Repeated binge drinking in early pregnancy was associated with late recognition of the pregnancy, while binge drinking in late pregnancy was associated with smoking. Daily alcohol use during pregnancy or breastfeeding was limited, while binge drinking in early pregnancy was reported by a large proportion of women. Demographic and socioeconomic characteristics of drinkers varied across drinking patterns.

Alcohol consumption and binge drinking in early pregnancy. A cross-sectional study with data from the Copenhagen Pregnancy Cohort.

BackgroundSince 2007 the Danish Health and Medicines Authority has advised total alcohol abstinence from the time of trying to conceive and throughout pregnancy. The prevalence of binge drinking among pregnant Danish women has nevertheless been reported to be up to 48 % during early pregnancy. Since the introduction of the recommendation of total abstinence, no studies have examined pre-pregnancy lifestyle and reproductive risk factors associated with this behaviour in a Danish context. The aims of this study were therefore to describe the prevalence of weekly alcohol consumption and binge drinking in early pregnancy among women living in the capital of Denmark. Secondly to identify pre-pregnancy lifestyle and reproductive risk factors associated with binge drinking during early pregnancy.MethodsData were collected from September 2012 to August 2013 at the Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark. Self-reported information on each woman’s socio-demographic characteristics, medical history, and lifestyle factors including alcohol habits was obtained from an electronic questionnaire filled out as part of the individual medical record. Descriptive analysis was conducted and multivariate logistic regression analysis was used to assess the potential associated risk factors (adjusted odds ratio (aOR)).ResultsQuestionnaires from 3,238 women were included. A majority of 70 %, reported weekly alcohol consumption before pregnancy. The prevalence decreased to 3 % during early pregnancy. The overall proportion of women reporting binge drinking during early pregnancy was 35 % (n = 1,134). The following independent risk factors for binge drinking in early pregnancy were identified: lower degree of planned pregnancy, smoking and alcohol habits before pregnancy ((1 unit/weekly aOR 4.48, CI: 3.14 - 6.40), (2–7 units aOR 10.23, CI: 7.44-14.06), (≥8 units aOR 33.18, CI: 19.53-56.36)). Multiparity and the use of assisted reproductive technology were associated with lower odds of binge drinking in early pregnancy.ConclusionThe prevalence of weekly alcohol consumption decreased considerably during early pregnancy compared with pre-pregnancy levels. Nevertheless one third of the pregnant women engaged in binge drinking. Identification of risk factors for this behaviour renders it possible not only to design prevention strategies, but also to target those most at risk.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0757-z) contains supplementary material, which is available to authorized users.

Low to Moderate Average Alcohol Consumption and Binge Drinking in Early Pregnancy: Effects on Choice Reaction Time and Information Processing Time in Five-Year-Old Children.

BackgroundDeficits in information processing may be a core deficit after fetal alcohol exposure. This study was designed to investigate the possible effects of weekly low to moderate maternal alcohol consumption and binge drinking episodes in early pregnancy on choice reaction time (CRT) and information processing time (IPT) in young children.MethodParticipants were sampled based on maternal alcohol consumption during pregnancy. At the age of 60–64 months, 1,333 children were administered a modified version of the Sternberg paradigm to assess CRT and IPT. In addition, a test of general intelligence (WPPSI-R) was administered.ResultsAdjusted for a wide range of potential confounders, this study showed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT. There was, however, an indication of slower CRT associated with binge drinking episodes in gestational weeks 1–4.ConclusionThis study observed no significant effects of average weekly maternal alcohol consumption during pregnancy on CRT or IPT as assessed by the Sternberg paradigm. However, there were some indications of CRT being associated with binge drinking during very early pregnancy. Further large-scale studies are needed to investigate effects of different patterns of maternal alcohol consumption on basic cognitive processes in offspring.

Characteristics of women who consume alcohol before and after pregnancy recognition in a Canadian sample: a prospective cohort study.

High levels of alcohol consumption during pregnancy are teratogenic to fetal development, yet less is known about the effects of low levels of consumption. Only a few studies have reported on the predictors and maternal characteristics associated with different alcohol consumption patterns prior to and following pregnancy recognition. The All Our Babies longitudinal study in Alberta, Canada was used to analyze the association of maternal characteristics with binge drinking prior to pregnancy recognition and low to moderate levels after pregnancy recognition among 2,246 women who consumed alcohol 1year prior to pregnancy. Bivariate and multivariable analyses were conducted. Thirteen percent of women reported binge drinking prior to pregnancy recognition. Forty-six percent reported drinking after pregnancy recognition, almost all at low to moderate levels. Significant, independent predictors (odds ratio, 95% confidence interval) of binge drinking in early pregnancy included high school or less education (3.61, 1.81 to 7.19), some or completed university/college (2.23, 1.16 to 4.27), nulliparity (1.62, 1.19, 2.20), not trying to get pregnant (1.92, 1.37 to 2.69), smoked in the year prior to pregnancy (1.98, 1.43 to 2.73), binge drinking in the year prior to pregnancy (10.83, 6.71 to 17.46), and low dispositional optimism (1.73, 1.23 to 2.42). Independent predictors of low to moderate average levels of consumption after pregnancy recognition included not trying to get pregnant (1.91, 1.45 to 2.52), prepregnancy body mass index <25.0kg/m(2) (1.41, 1.61 to 1.72), smoking in the year before pregnancy (1.90, 1.43 to 2.53), and binge drinking in the year before pregnancy (2.62, 2.16 to 3.18). Common risk factors for different alcohol consumption patterns are unintended pregnancy and substance use behaviors prior to pregnancy. Other risk factors were specific to the different patterns. Targeted strategies that address the needs of alcohol or nicotine using women and that can reduce the risk of unintended pregnancy may be beneficial.

Educational Differences in Continuing or Restarting Drinking in Early and Late Pregnancy: Role of Psychological and Physical Problems

Many women continue drinking alcohol during pregnancy. This study aimed to describe educational differences in continued drinking in early and late pregnancy and to examine the contribution of psychological and physical factors to the explanation of educational differences. We examined 4,885 women enrolled in the Amsterdam Born Children and their Development study. Information on alcohol intake during pregnancy was based on self-reports at the 16th week of gestation and at 3 months postpartum. Only women who reported alcohol intake before pregnancy were included. Explanatory factors were alcohol intake before pregnancy, psychological problems, and physical problems. The risk of continued drinking in early pregnancy was increased in higher educated women (odds ratio [OR] = 1.41, 95% CI [1.25, 1.60]); in addition, in late pregnancy, higher educated women had an increased risk of restarting (OR = 1.67, 95% CI [1.37, 2.04]) and continuing drinking (OR = 1.77, 95% CI [1.36, 2.30]). The intensity of alcohol intake before pregnancy and all physical and psychological problems together explained 17.1% and 8.8% of the educational differences in continued drinking in early pregnancy, respectively. Higher educated women are more likely to continue drinking during pregnancy. The intensity of alcohol intake before pregnancy and physical and psychological problems contributed to the explanation of continued drinking. However, other factors may play a greater role, such as cultural factors and social norms.

Erratum

BJOG: An International Journal of Obstetrics & GynaecologyVolume 120, Issue 10 p. 1302-1302 ErratumFree Access Erratum This article corrects the following: The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on executive function in 5-year-old children Å Skogerbø, US Kesmodel, T Wimberley, H Støvring, J Bertrand, NI Landrø, EL Mortensen, Volume 119Issue 10BJOG: An International Journal of Obstetrics & Gynaecology pages: 1201-1210 First Published online: June 20, 2012 First published: 13 August 2013 https://doi.org/10.1111/1471-0528.12419AboutSectionsPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL In the following article1 there was an error in a sentence in the results section of the abstract. The sentence read: In adjusted analyses, binge drinking in gestational week 9 or later was significantly associated with elevated Behavioural Regulation Index parent Scores (OR 2.04, 95% CI 0.33–3.76), and with the risk of high scores on the Metacognitive Index assessed by the teacher (OR 2.06, 95% CI 1.01–4.23). It should have read: In adjusted analyses, binge drinking in gestational week 9 or later was significantly associated with elevated Behavioural Regulation Index parent Scores (2.04, 95% CI 0.33–3.76), and with the risk of high scores on the Metacognitive Index assessed by the teacher (OR 2.06, 95% CI 1.01–4.23). We apologise for this error. Reference 1Skogerbø Å, Kesmodel U, Wimberley T, Støvring H, Bertrand J, Landrø N, et al. The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on executive function in 5-year-old children. BJOG 2012; 119: 1201– 10. Volume120, Issue10September 2013Pages 1302-1302 ReferencesRelatedInformation

The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on behaviour in 5‐year‐old children: a prospective cohort study on 1628 children

To examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on behaviour in children at the age of 5 years. Prospective cohort study. Neuropsychological testing in four Danish cities, 2003-2008. A total of 1628 women and their children sampled from the Danish National Birth Cohort. Participants were sampled based on maternal alcohol drinking patterns during early pregnancy. When the children were 5 years of age the parent and teacher versions of the Strengths and Difficulties Questionnaire (SDQ) were completed by the mothers and a preschool teacher, respectively. The full statistical model included the following potential confounding factors: maternal binge drinking or low to moderate alcohol consumption, respectively; parental education; maternal IQ; prenatal maternal smoking; the child's age at testing; the child's gender; maternal age; parity; maternal marital status; family home environment; postnatal parental smoking; prepregnancy maternal body mass index (BMI); and the child's health status. Behaviour among children assessed by the SDQ parent and teacher forms. Adjusted for all potential confounding factors, no statistically significant associations were observed between maternal low to moderate average weekly alcohol consumption and SDQ behavioural scores (OR 1.1, 95% CI 0.5-2.3; OR 1.1, 95% CI 0.6-2.1 for the total difficulties scores) or between binge drinking and SDQ behavioural scores (OR 1.2, 95% CI 0.8-1.7; OR 0.8, 95% CI 0.6-1.2). This study observed no consistent effects of low to moderate alcohol consumption or binge drinking in early pregnancy on offspring behaviour at the age of 5 years.

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The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on selective and sustained attention in 5-year-old children

The aim was to examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on children's attention at 5 years of age. Prospective follow-up study. Neuropsychological testing in four Danish cities 2003-2008. A cohort of 1628 women and their children sampled from the Danish National Birth Cohort. Participants were sampled based on maternal alcohol consumption during pregnancy. At 5 years of age, the children were tested with the recently developed Test of Everyday Attention for Children at Five (TEACh-5). Parental education, maternal IQ, maternal smoking in pregnancy, the child's age at testing, gender, and tester were considered core confounding factors, whereas the full model also controlled the following potential confounding factors: maternal binge drinking or low to moderate alcohol consumption, age, body mass index (BMI), parity, home environment, postnatal smoking in the home, child's health status, and indicators for hearing and vision impairments. TEACh-5 attention scores. There were no significant effects on test performance in children of mothers drinking up to 8 drinks per week compared with children of mothers who abstained, but there was a significant association between maternal consumption of 9 or more drinks per week and risk of a low overall attention score (OR 3.50, 95% CI 1.15-10.68). No consistent or significant associations were observed between binge drinking and attention test scores. The findings suggest an effect of maternal consumption of 9 or more drinks per week on attention functions in children, but the study detected no effects of lower levels of maternal consumption and no consistent effects of maternal binge drinking.

The effects of low to moderate alcohol consumption and binge drinking in early pregnancy on executive function in 5‐year‐old children

To examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on children's executive functions at the age of 5 years. Follow-up study. Neuropsychological testing in four Danish cities 2003-2008. Population A cohort of 1628 women and their children sampled from the Danish National Birth Cohort. Participants were sampled based on maternal alcohol drinking patterns during early pregnancy. When the children were 5 years old, the parent and teacher forms of the Behaviour Rating Inventory of Executive Function (BRIEF) were completed by the mothers and a preschool teacher. Parental education, maternal IQ, prenatal maternal smoking, the child's age at testing, and the child's gender were considered core confounding factors. The full model also included maternal binge drinking or low to moderate alcohol consumption, maternal age, parity, maternal marital status, family home environment, postnatal parental smoking, pre-pregnancy maternal body mass index (BMI), and the health status of the child. The BRIEF parent and teacher forms. Adjusted for all potential confounding factors, no statistically significant associations between maternal low to moderate average weekly consumption and BRIEF index scores were observed.In adjusted analyses, binge drinking in gestational week 9 or later was significantly associated with elevated Behavioural Regulation Index parent Scores (2.04, 95% CI 0.33–3.76), and with the risk of high scores on the Metacognitive Index assessed by the teacher (OR 2.06, 95% CI 1.01–4.23) [corrected]. This study did not observe significant effects of low to moderate alcohol consumption during pregnancy on executive functioning at the age of 5 years. Furthermore, only weak and no consistent associations between maternal binge drinking and executive functions were observed.

The effect of different alcohol drinking patterns in early to mid pregnancy on the child’s intelligence, attention, and executive function

To conduct a combined analysis of the estimated effects of maternal average weekly alcohol consumption, and any binge drinking, in early to mid pregnancy on general intelligence, attention, and executive function in 5-year-old children. Follow-up study. Neuropsychological testing in four Danish cities 2003-2008. A cohort of 1628 women and their children sampled from the Danish National Birth Cohort. Participants were sampled based on maternal alcohol consumption during early pregnancy. At age 5 years, the children were tested for general intelligence, attention, and executive function. The three outcomes were analysed together in a multivariate model to obtain joint estimates and P values for the association of alcohol across outcomes. The effects of low to moderate alcohol consumption and binge drinking in early pregnancy were adjusted for a wide range of potential confounding factors. Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R), the Test of Everyday Attention for Children at Five (TEACh-5), and the Behavior Rating Inventory of Executive Functions (BRIEF) scores. Multivariate analyses showed no statistically significant effects arising from average weekly alcohol consumption or any binge drinking, either individually or in combination. These results replicate findings from separate analyses of each outcome variable. The present study contributes comprehensive methodological and statistical approaches that should be incorporated in future studies of low to moderate alcohol consumption and binge drinking during pregnancy. Furthermore, as no safe level of drinking during pregnancy has been established, the most conservative advice for women is not to drink alcohol during pregnancy. However, the present study suggests that small volumes consumed occasionally may not present serious concern.

Prevalence and Correlates of Drinking in Early Pregnancy Among Women who Stopped Drinking on Pregnancy Recognition

Women of child bearing age that regularly drink alcohol are at risk for drinking in early pregnancy. Evidence indicates a majority of women stop alcohol consumption on pregnancy recognition. However, there is a dearth of studies reporting on patterns and correlates of drinking in early pregnancy prior to stopping on pregnancy recognition, which the current study aims to address. In 2005, a New Zealand nationwide cross-sectional survey was conducted on a random sample of 1,256 women aged 16-40 years. Data were collected via an interviewer-administered questionnaire using a web-assisted telephone interviewing system. Of the 1,256 women who participated, 127 (10 %) were currently pregnant and 425 women (34 %) were previously pregnant. Half of currently pregnant women and 37 % of previously pregnant women reported that they ceased drinking on recognising pregnancy. Women categorised as "risky drinkers" and those aged 16-24 years had higher odds to drink and binge drink in early pregnancy, compared with non-risky drinkers and women of other age categories respectively. A majority of women stop alcohol consumption on pregnancy recognition but prior to this, drink at levels posing a risk for the developing foetus. Women most at risk for drinking and binge drinking in early pregnancy were younger in age and exhibited risky drinking behaviour prior to pregnancy. A targeted intervention to reduce the risk for an alcohol exposed pregnancy is warranted for sexually active younger women in New Zealand and elsewhere.

Estimating Bias From Loss to Follow-up in the Danish National Birth Cohort

Loss to follow-up in cohort studies may result in biased association estimates. Of 61,895 women entering the Danish National Birth Cohort and completing the first data-collection phase, 37,178 (60%) opted to be in the 7-year follow-up. Using national registry data to obtain end point information on all members of the cohort, we estimated associations in the baseline and the 7-year follow-up participant populations for 5 exposure-outcome associations: (a) size at birth and childhood asthma, (b) assisted reproductive treatment and childhood hospitalizations, (c) prepregnancy body mass index and childhood infections, (d) alcohol drinking in early pregnancy and childhood developmental disorders, and (e) maternal smoking in pregnancy and childhood attention-deficit hyperactivity disorder (ADHD). We estimated follow-up bias in the odds or rate ratios by calculating relative ratios. For all but one of the above analyses, the bias appeared to be small, between -10% and +8%. For maternal smoking in pregnancy and childhood ADHD, we estimated a positive bias of approximately 33% (95% bootstrap limits of -30% and +152%). The presence and magnitude of bias due to loss to follow-up depended on the nature of the factors or outcomes examined, with the most pronounced contribution in this study coming from maternal smoking. Our methods and results may inform bias analyses in future pregnancy cohort studies.

The Association Between Maternal Alcohol Use and Smoking in Early Pregnancy and Congenital Cardiac Defects

Alcohol use is an extremely prevalent but preventable risk factor among women seeking to become pregnant. Many women continue to use alcohol in the early stages of pregnancy before they are aware they are pregnant. Research is unclear about the role of maternal alcohol use during pregnancy and congenital cardiac defects, one of the leading types of birth defects in the United States. Data from the Pregnancy Risk Assessment Monitoring Survey (PRAMS) were used to examine maternal alcohol use and its association with congenital cardiac defects. Various measures of alcohol use in the 3 months prior to pregnancy, as well as smoking and other risk factors for congenital cardiac defects, were linked to birth certificate data for nine states over a 10-year period (1996-2005). In this case-control study, cases included infants with a congenital cardiac defect indicated on the birth certificate, and the control group consisted of healthy, normal weight infants with no indication of a congenital abnormality on their birth certificate. Complex samples logistic regression models were used to study the relationships between several measures of alcohol use, including binge drinking and binge drinking on more than once occasion, and the interaction between alcohol use and smoking with the odds of congenital cardiac defects. A significant increase in congenital cardiac defects was found among mothers who reported binge drinking more than once in the 3 months prior to pregnancy compared to mothers who did not report binge drinking (adjusted odds ratio [aOR] 2.99, 95% confidence interval [CI] 1.19-7.51). There was a significant interaction between any binge drinking or binge drinking more than once and cigarette use, which corresponded to a substancial increase in congenital cardiac defects (aOR 12.65, 95% CI 3.54-45.25 and aOR 9.45, 95% CI 2.53-35.31, respectively). Multiple episodes of maternal binge drinking in early pregnancy may increase the odds of congenital cardiac defects, and we found this relationship was more dramatic when combined with maternal smoking.

In Utero Alcohol Exposure and Prediction of Alcohol Disorders in Early Adulthood

Little is known about the contribution of fetal alcohol exposure to the development of alcohol disorders in early adulthood. To examine the independent effect of maternal alcohol use during early vs late periods in pregnancy on the time of onset of alcohol disorders in offspring. Follow-up study of the Mater-University of Queensland Study of Pregnancy and Its Outcomes (MUSP), a population-based birth cohort study commenced in Brisbane, Australia, in 1981 and designed to examine the association of maternal alcohol exposure with the onset of alcohol disorders. Mothers and children were followed up at birth, 6 months, and 5, 14, and 21 years after the initial interview. Maternal alcohol use was assessed before pregnancy, in early and late pregnancy, and at the 5- and 14-year follow-up visits. Alcohol disorders in early adulthood were assessed at age 21 years using the lifetime version of the Composite International Diagnostic Interview-computerized version. Population-based birth cohort study. A subsample of 2138 participants for whom complete data were available at the 21-year follow-up. Onset of alcohol disorder from adolescence to 21 years of age. In utero alcohol exposure of 3 or more glasses was associated with alcohol disorders. The fully adjusted odds ratios (95% confidence intervals) of developing early-onset alcohol disorders at age 21 years were 2.95 (1.62-5.36) for those exposed to maternal drinking in early pregnancy and 1.35 (0.69-2.63) for those exposed in late pregnancy. There was also a strong association between alcohol exposure in early pregnancy and late-onset alcohol disorders (odds ratio, 3.29 [95% confidence interval, 1.74-6.24]). Our results provide support for a biological origin of adult alcohol disorders and suggest that the association is not explained solely by maternal drinking or smoking during childhood and adolescence or other intervening factors. Further research is needed to understand the mechanisms underlying the association.

Maternal alcohol consumption during pregnancy and physical outcomes up to 5 years of age: a longitudinal study.

To examine whether alcohol exposure in pregnancy affects weight and head circumference (HC) at birth and 5 years, and whether these effects are independent of cigarette exposure in pregnancy and social disadvantage. The Mater-University Study of Pregnancy (MUSP) involves a prospective cohort of 8556 mothers who were enrolled at first antenatal visit. The quantity and frequency of alcohol consumption in early and late pregnancy and a measure of binge drinking in early pregnancy were recorded. Weight and HC were measured on children seen at birth and at 5 years. Level of cigarette use in early pregnancy and maternal age and level of education and family income were also measured. Light and moderate alcohol consumption in early or later pregnancy had no independent effects on weight or HC at birth or 5 years. Binge drinking in early pregnancy was not associated with restricted HC, and there was no effect modification by concurrent cigarette use in early pregnancy. An apparent effect of alcohol in late pregnancy on birth weight was due to confounding by cigarette use, with social risk being an independent predictor. Alcohol ingestion up to moderate levels in pregnancy was not associated with deficits in either weight or HC at birth or at 5 years.