One in 10 Pregnant Women Drink Alcohol, CDC Reports

Diana Phillips

September 24, 2015

Despite widespread warnings about the dangers of alcohol for a developing fetus, one in 10 pregnant women in a national survey reported having consumed alcohol within 30 days of the survey. Of those women, approximately one third engaged in binge drinking, according to a report from the Centers for Disease Control and Prevention (CDC).

Further, among all women of childbearing age who reported binge drinking in the past 30 days, the frequency of binge drinking among pregnant women was significantly higher, at 4.6 episodes, than it was among nonpregnant women, at 3.1 episodes. Binge drinking is defined as the consumption of four or more drinks on one occasion.

"One possible explanation for this might be that women who binge drink during pregnancy are more likely to be alcohol-dependent than the average female binge drinker, and therefore binge drink more frequently," write Cheryl Tan, MPH, an epidemiologist in the CDC's National Center on Birth Defects and Developmental Disabilities, Atlanta, Georgia, and colleagues in an article published in the September 25 issue of the Morbidity and Mortality Weekly Report.

The report, which is based on data from the CDC's 2011-2013 Behavioral Risk Factor Surveillance System (BRFSS), also indicates that alcohol use in pregnant women was highest among women aged 35 to 44 years, at 18.6%, followed by college graduates, at 13.0%, and unmarried women, at 12.9%.

Among nonpregnant women, more than half (53.6%) reported drinking alcohol in the past 30 days, and 18.2% reported binge drinking during the same period, the authors write.

The estimated prevalence of any alcohol use and binge drinking among the survey sample, which includes pregnant and nonpregnant women aged 18 to 44 years, is higher in the current study than estimated by reports based on 2006-2010 BRFSS data.

"The differences in estimates between the two periods are likely related to method¬ological changes in the BRFSS in 2011, rather than actual shifts in the prevalence of alcohol use," the authors write. These differences include the inclusion of sampling via cell phones and the use of a new, iterative weighting method.

The findings point to the need for more robust screening, education, and intervention for alcohol use, the authors stress. "Women who binge drink during pregnancy and are not alcohol-dependent would benefit from alcohol screening and brief intervention, which involves screening patients using validated questions, followed by a brief counselling intervention to advise patients who screen positive to set goals and take steps toward reducing their alcohol consumption." In contrast, the authors recommend that patients with more severe alcohol problems be referred for specialized care.

Several population-level strategies have been recommended to reduce excessive alcohol consumption and associated harm. For instance, the US Preventive Services Task Force recommends universal alcohol screening and brief interventions in the primary care setting for all individuals, including pregnant women, aged 18 years or older, the authors write.

The CDC is also working with Fetal Alcohol Spectrum Disorders Practice and Implementation Centers and National Partners to promote systems-level awareness of evidence-based fetal alcohol spectrum disorders prevention strategies.

"Adopting this comprehensive approach to reduce excessive alcohol use among pregnant women and women of childbearing age is an important step toward achiev¬ing the Healthy People 2020 objectives of reducing alcohol use among pregnant women, and ultimately reducing FASDs and other alcohol-related adverse birth outcomes," the authors conclude.

The authors have no relevant financial relationships to disclose.

Morb Mortal Wkly Rep. 2015;64:1042-1046. Full text

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