Alcohol Use and Binge Drinking Among Women of Childbearing Age

United States, 2006-2010

Claire M. Marchetta, MPH; Clark H. Denny, PhD; R. Louise Floyd, DSN; Nancy E. Cheal, PhD; Joseph E. Sniezek, MD; Lela R. McKnight-Eily, PhD

Disclosures

Morbidity and Mortality Weekly Report. 2012;61(28):534-538. 

In This Article

Abstract and Introduction

Introduction

Alcohol use during pregnancy is a leading preventable cause of birth defects and developmental disabilities. Alcohol-exposed pregnancies (AEPs) can lead to fetal alcohol syndrome and other fetal alcohol spectrum disorders (FASDs), which result in neurodevelopmental deficits and lifelong disability.[1] In 2005, the Surgeon General issued an advisory urging women who are pregnant or who might become pregnant to abstain from alcohol use.[2] Healthy People 2020 set specific targets for abstinence from alcohol use (MICH-11.1) and binge drinking (MICH-11.2) for pregnant women.[3] To estimate the prevalence of any alcohol use and binge drinking in the past 30 days among women aged 18–44 years, CDC analyzed 2006–2010 Behavioral Risk Factor Surveillance System (BRFSS) data. Based on their self-reports, an estimated 51.5% of nonpregnant women used alcohol, as did 7.6% of pregnant women. The prevalence of binge drinking was 15.0% among nonpregnant women and 1.4% among pregnant women. Among pregnant women, the highest prevalence estimates of reported alcohol use were among those who were aged 35–44 years (14.3%), white (8.3%), college graduates (10.0%), or employed (9.6%). Among binge drinkers, the average frequency and intensity of binge episodes were similar, approximately three times per month and six drinks on an occasion, among those who were pregnant and those who were not. Clinical practices that advise women about the dangers associated with drinking while pregnant, coupled with community-level interventions that reduce alcohol-related harms, are necessary to mitigate AEP risk among women of childbearing age and to achieve the Healthy People 2020 objectives.

BRFSS is a state-based, random-digit–dialed telephone survey that collects information on health-related behaviors from a representative sample of civilian, noninstitutionalized adults aged ≥18 years. CDC aggregated and analyzed BRFSS data for 2006–2010 from all 50 states and the District of Columbia for 345,076 women aged 18–44 years. The median response rate among states, based on Council of American Survey and Research Organizations guidelines, ranged from 50.6% to 54.6%, and the median cooperation rate ranged from 72.1% to 76.9%.* The prevalence of any alcohol use, defined as having at least one drink of any alcoholic beverage in the past 30 days, and binge drinking, defined for women as four or more drinks on an occasion in the past 30 days, among pregnant and nonpregnant women, were estimated. Logistic regression was used to examine, separately for pregnant and nonpregnant women, the association of selected demographic characteristics with any alcohol use and with binge drinking. The regression model adjusted for age, race/ethnicity, education, employment, and marital status. The average number of binge episodes in the past 30 days (frequency) and the average maximum number of drinks consumed on an occasion in the past 30 days (intensity) among binge drinkers were estimated with 95% confidence intervals. Because of small sample sizes, binge drinking frequency and intensity estimates for demographic subgroups among pregnant women were unreliable and are not reported. Data were weighted to state population estimates and combined to represent a nationwide estimate. Analyses were conducted using statistical software to account for the complex sampling method used in BRFSS.

The study population of 345,076 women aged 18–44 years included 13,880 (4.0%) pregnant women and 331,196 (96.0%) women who were not pregnant. Prevalence estimates for any alcohol use in the past 30 days during 2006–2010 were 7.6% among pregnant women and 51.5% among nonpregnant women (Table 1). The 2006–2010 prevalence estimates for binge drinking in the past 30 days were 1.4% among pregnant women and 15.0% among nonpregnant women.

Among pregnant women, those aged 35–44 years reported the highest prevalence of any alcohol use (14.3%) (adjusted odds ratio [AOR] = 3.3), compared with women aged 18–24 years (4.5%). Among pregnant women, the odds of reporting binge drinking were nearly two and a half times greater among those who were employed (AOR = 2.4), compared with those who were not employed, and even greater for those who were unmarried (AOR = 3.1), compared with those who were married.

Among nonpregnant women, white women reported the highest prevalence of any alcohol use (58.3%) and binge drinking (17.7%) in the past 30 days, compared with nonpregnant women in any of the other race/ethnicity groups. Compared with their Hispanic counterparts, nonpregnant white women reported higher prevalences of alcohol use (AOR = 1.9) and binge drinking (AOR = 1.8). The prevalence of reported binge drinking among nonpregnant women aged 18–24 years (20.5%) was nearly double that of nonpregnant women aged 35–44 years (11.8%).

Among pregnant and nonpregnant women who reported binge drinking, the estimated average frequency and intensity of binge drinking were similar, approximately three times per month and six drinks on an occasion (Figure). Among age groups of nonpregnant women, average frequency and intensity of binge episodes were highest among women aged 18–24 years (3.3 times per month and 6.7 drinks on an occasion) (Table 2). The frequency and intensity of binge drinking episodes decreased with increasing education. On average, women with a high school diploma or less reported binge drinking 3.4 times per month and 6.4 drinks on an occasion, compared with 2.5 times per month and 5.4 drinks on an occasion among college graduates. Frequency and intensity of binge drinking episodes also were greater among unmarried women (3.3 times per month and 6.4 drinks on an occasion), compared with married women (2.6 times per month and 5.4 drinks on an occasion).

Figure 1.

Estimated average frequency* and intensity of binge drinking§ among women of childbearing age who reported binge drinking in the past 30 days — Behavioral Risk Factor Surveillance System, United States, 2006–2010
* Number of times respondent reported consuming four or more drinks on an occasion in the past 30 days.
Largest number of drinks consumed on an occasion in the past 30 days.
§ Defined as having consumed four or more drinks on an occasion at least one time in the past 30 days.
95% confidence interval.

* The response rate reflects telephone sampling efficiency and the degree of participation among eligible respondents contacted. The cooperation rate reflects the proportion of persons who completed an interview among eligible persons contacted.
Pregnancy status was assessed by asking the woman if, to her knowledge, she was currently pregnant. BRFSS questionnaires are available at http://www.cdc.gov/brfss/questionnaires/questionnaires.htm.

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