Predictors of Drinking During Pregnancy: A Systematic Review
Publication: Journal of Women's Health
Volume 20, Issue Number 6
Abstract
Background: Many pregnant women continue to drink alcohol despite clinical recommendations and public health campaigns about the risks associated with alcohol use during pregnancy. This review examines the predictors of prenatal alcohol use, with the long-term goal of developing more effective preventive efforts.
Methods: A literature search of several databases for relevant articles was undertaken. Studies were included if they occurred in the context of antenatal care, collected data during the woman's pregnancy (between 1999 and 2009), investigated predictors of any drinking, had a population-based orientation (e.g., did not focus only on high-risk drinkers), and were published in English in a scientific peer-reviewed journal between 1999 and 2009.
Results: Fourteen studies published between 2002 and 2009 fulfilled the inclusion criteria (United States, 4; Europe, 4; Australia and New Zealand, 3; Japan, 2; and Uganda, 1). The predictors of prenatal alcohol use most consistently identified were prepregnancy alcohol consumption and having been abused or exposed to violence. Less consistent predictors of drinking during pregnancy were high income/social class and positive dependence screen. Unemployment, marital status, and education level were examined in many studies but found to be predictive only infrequently.
Conclusions: Women's prepregnancy alcohol consumption (i.e., quantity and frequency of typical drinking) and exposure to abuse or violence were consistently associated with drinking during pregnancy. Antenatal care providers should assess these factors for improved detection of women at risk for alcohol-exposed pregnancies.
Get full access to this article
View all available purchase options and get full access to this article.
References
1.
Mills JLGraubard BIHarley EE et al. Maternal alcohol consumption and birth weight. How much drinking during pregnancy is safe?JAMA19842521875-1879. 1. Mills JL, Graubard BI, Harley EE, et al. Maternal alcohol consumption and birth weight. How much drinking during pregnancy is safe? JAMA 1984;252:1875–1879.
2.
Sampson PDBookstein FLBarr HMStreissguth AP. Prenatal alcohol exposure, birthweight, and measures of child size from birth to age 14 yearsAm J Public Health1994841421-1428. 2. Sampson PD, Bookstein FL, Barr HM, Streissguth AP. Prenatal alcohol exposure, birthweight, and measures of child size from birth to age 14 years. Am J Public Health 1994;84:1421–1428.
3.
Carmichael Olson HStreissguth APSampson PDBarr HMBookstein FLThiede K. Association of prenatal alcohol exposure with behavioral and learning problems in early adolescenceJ Am Acad Child Adolesc Psychiatry1997361187-1894. 3. Carmichael Olson H, Streissguth AP, Sampson PD, Barr HM, Bookstein FL, Thiede K. Association of prenatal alcohol exposure with behavioral and learning problems in early adolescence. J Am Acad Child Adolesc Psychiatry 1997;36:1187–1894.
4.
Sood BDelaney-Black VCovington C et al. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. Dose-response effectPediatrics2001108E34. 4. Sood B, Delaney-Black V, Covington C, et al. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. Dose-response effect. Pediatrics 2001;108:E34.
5.
Stratton KHowe CBattaglia F. Fetal alcohol syndrome: Diagnosis, epidemiology, prevention and treatmentWashington, DCNational Academy Press1996. 5. Stratton K, Howe C, Battaglia F, eds. Fetal alcohol syndrome: Diagnosis, epidemiology, prevention and treatment. Washington, DC: National Academy Press, 1996.
6.
Streissguth APSampson PDOlson HC et al. Maternal drinking during pregnancy: Attention and short-term memory in 14-year-old offspring—A longitudinal prospective studyAlcohol Clin Exp Res199418202-218. 6. Streissguth AP, Sampson PD, Olson HC, et al. Maternal drinking during pregnancy: Attention and short-term memory in 14-year-old offspring—A longitudinal prospective study. Alcohol Clin Exp Res 1994;18:202–218.
7.
Sayal KHeron JGolding JEmond A. Prenatal alcohol exposure and gender differences in childhood mental health problems: A longitudinal populations-based studyPediatrics2007119426-434. 7. Sayal K, Heron J, Golding J, Emond A. Prenatal alcohol exposure and gender differences in childhood mental health problems: A longitudinal populations-based study. Pediatrics 2007;119:426–434.
8.
Nilsen PHolmqvist MHultgren EBendtsen PCedergren M. Alcohol use before and during pregnancy and factors influencing change among Swedish womenActa Obstet Gynecol Scand200887768-774. 8. Nilsen P, Holmqvist M, Hultgren E, Bendtsen P, Cedergren M. Alcohol use before and during pregnancy and factors influencing change among Swedish women. Acta Obstet Gynecol Scand 2008;87:768–774.
9.
Centers for Disease Control and Prevention. Alcohol consumption among women who are pregnant or who might become pregnant—United States, 2002MMWR2004531178-1181. 9. Centers for Disease Control and Prevention. Alcohol consumption among women who are pregnant or who might become pregnant—United States, 2002. MMWR 2004;53:1178–1181.
10.
Donnelly JCCooley SMWalsh TASarkar RDurnea UGeary MP. Illegal drug use, smoking and alcohol consumption in a low-risk Irish primigravid populationJ Perinat Med20083670-72. 10. Donnelly JC, Cooley SM, Walsh TA, Sarkar R, Durnea U, Geary MP. Illegal drug use, smoking and alcohol consumption in a low-risk Irish primigravid population. J Perinat Med 2008;36:70–72.
11.
Kesmodel UKesmodel PSLarsen ASecher NJ. Use of alcohol and illicit drugs among pregnant Danish women, 1998Scand J Public Health2003315-11. 11. Kesmodel U, Kesmodel PS, Larsen A, Secher NJ. Use of alcohol and illicit drugs among pregnant Danish women, 1998. Scand J Public Health 2003;31:5–11.
12.
Higgins PGClough DHFrank BWallerstedt C. Changes in health behaviors made by pregnant substance usersInt J Addict1995301323-1333. 12. Higgins PG, Clough DH, Frank B, Wallerstedt C. Changes in health behaviors made by pregnant substance users. Int J Addict 1995;30:1323–1333.
13.
Davis PMCarr TL. Needs assessment and current practice of alcohol risk assessment of pregnant women and women of childbearing age by primary health care professionalsCan J Clin Pharmacol200815e214-e222. 13. Davis PM, Carr TL. Needs assessment and current practice of alcohol risk assessment of pregnant women and women of childbearing age by primary health care professionals. Can J Clin Pharmacol 2008;15:e214–e222.
14.
Ernhart CBMorrow-Tlucack MSokol RJMartier S. Underreporting of alcohol use in pregnancyAlcohol Clin Exp Res198812506-511. 14. Ernhart CB, Morrow-Tlucack M, Sokol RJ, Martier S. Underreporting of alcohol use in pregnancy. Alcohol Clin Exp Res 1988;12:506–511.
15.
Robles NDay NL. Recall of alcohol consumption during pregnancyJ Stud Alcohol199051403-407. 15. Robles N, Day NL. Recall of alcohol consumption during pregnancy. J Stud Alcohol 1990;51:403–407.
16.
Alvik AHeyerdahl SHaldorsen TLindemann R. Alcohol use before and during pregnancy: A population-based studyActa Obstet Gynecol Scand2006851292-1298. 16. Alvik A, Heyerdahl S, Haldorsen T, Lindemann R. Alcohol use before and during pregnancy: A population-based study. Acta Obstet Gynecol Scand 2006;85:1292–1298.
17.
Göransson MMagnusson ÅBergman HRydberg UHeilig M. Fetus at risk: Prevalence of alcohol consumption during pregnancy estimated with a simple screening method in Swedish antenatal clinicsAddiction2003981513-1520. 17. Göransson M, Magnusson Å, Bergman H, Rydberg U, Heilig M. Fetus at risk: Prevalence of alcohol consumption during pregnancy estimated with a simple screening method in Swedish antenatal clinics. Addiction 2003;98:1513–1520.
18.
Harrison PASidebottom AC. Alcohol and drug use before and during pregnancy: An examination of use patterns and predictors of cessationMatern Child Health J200913386-394. 18. Harrison PA, Sidebottom AC. Alcohol and drug use before and during pregnancy: An examination of use patterns and predictors of cessation. Matern Child Health J 2009;13:386–394.
19.
Hotham EAli RWhite JRobinson J. Pregnancy-related changes in tobacco, alcohol and cannabis use reported by antenatal patients at two public hospitals in South AustraliaAust NZ J Obstet Gynaecol200848248-254. 19. Hotham E, Ali R, White J, Robinson J. Pregnancy-related changes in tobacco, alcohol and cannabis use reported by antenatal patients at two public hospitals in South Australia. Aust NZ J Obstet Gynaecol 2008;48:248–254.
20.
Leonardson GRLoudenburg RStruck J. Factors predictive of alcohol use during pregnancy in three rural statesBehav Brain Funct200738. 20. Leonardson GR, Loudenburg R, Struck J. Factors predictive of alcohol use during pregnancy in three rural states. Behav Brain Funct 2007;3:8.
21.
McLeod DPullon SCookson TCornford E. Factors influencing alcohol consumption during pregnancy and after giving birthNZ Med J2002115U29. 21. McLeod D, Pullon S, Cookson T, Cornford E. Factors influencing alcohol consumption during pregnancy and after giving birth. NZ Med J 2002;115:U29.
22.
Meschke LLHellerstedt WHoll JAMesselt S. Correlates of prenatal alcohol useMatern Child Health J200812442-451. 22. Meschke LL, Hellerstedt W, Holl JA, Messelt S. Correlates of prenatal alcohol use. Matern Child Health J 2008;12:442–451.
23.
Namagembe IJackson LWZullo MDFrank SHByamugisha JKSethi AK. Consumption of alcoholic beverages among pregnant urban Ugandan womenMatern Child Health J2009[Epub ahead of print] 23. Namagembe I, Jackson LW, Zullo MD, Frank SH, Byamugisha JK, Sethi AK. Consumption of alcoholic beverages among pregnant urban Ugandan women. Matern Child Health J 2009. [Epub ahead of print]
24.
O'Connor MJWhaley SE. Alcohol use in pregnant low-income womenJ Stud Alcohol200364773-783. 24. O'Connor MJ, Whaley SE. Alcohol use in pregnant low-income women. J Stud Alcohol 2003;64:773–783.
25.
Palma SPrado-Crespo RMariscal MPerez-Iglesias RLlorca JDelgado-Rodriguez M. Weekday but not weekend alcohol consumption before pregnancy influences alcohol cessation during pregnancyEur J Public Health200717394-399. 25. Palma S, Prado-Crespo R, Mariscal M, Perez-Iglesias R, Llorca J, Delgado-Rodriguez M. Weekday but not weekend alcohol consumption before pregnancy influences alcohol cessation during pregnancy. Eur J Public Health 2007;17:394–399.
26.
Tamaki TKaneita YOhida T et al. Alcohol consumption behavior of pregnant women in JapanPrev Med200847544-549. 26. Tamaki T, Kaneita Y, Ohida T, et al. Alcohol consumption behavior of pregnant women in Japan. Prev Med 2008;47:544–549.
27.
Yamamoto YKaneita YYokoyama E et al. Alcohol consumption and abstention among pregnant Japanese womenJ Epidemiol200818173-181. 27. Yamamoto Y, Kaneita Y, Yokoyama E, et al. Alcohol consumption and abstention among pregnant Japanese women. J Epidemiol 2008;18:173–181.
28.
Zammit SLSkouteris HWertheim EHPaxton SJMilgrom J. Pregnant women's alcohol consumption: The predictive utility of intention to drink and prepregnancy drinking behaviorJ Womens Health2008171513-1522. 28. Zammit SL, Skouteris H, Wertheim EH, Paxton, SJ, Milgrom J. Pregnant women's alcohol consumption: The predictive utility of intention to drink and prepregnancy drinking behavior. J Womens Health 2008;17:1513–1522.
29.
Ethen MKRamadhani TAScheuerle AE et al. Alcohol consumption by women before and during pregnancyMatern Child Health J200913274-285 29. Ethen MK, Ramadhani TA, Scheuerle AE, et al. Alcohol consumption by women before and during pregnancy. Matern Child Health J 2009;13:274–285
30.
Verplanken BWood W. Interventions to break and create consumer habitsJ Public Policy Marketing20062590-103. 30. Verplanken B, Wood W. Interventions to break and create consumer habits. J Public Policy Marketing 2006;25:90–103.
31.
Aarts HPaulussen TSchaalma H. Physical exercise habit: On the conceptualization and formation of habitual health behavioursHealth Educ Res199712363-374. 31. Aarts H, Paulussen T, Schaalma, H. Physical exercise habit: On the conceptualization and formation of habitual health behaviours. Health Educ Res 1997;12:363–374.
32.
Nilsen P. Brief alcohol intervention to prevent drinking during pregnancy: An overview of research findingsCurr Opin Obstet Gynecol200921496-500. 32. Nilsen P. Brief alcohol intervention to prevent drinking during pregnancy: An overview of research findings. Curr Opin Obstet Gynecol 2009;21:496–500.
33.
World Health Organization. International statistical classification of diseases and related health problems, 10th revised version2007apps.who.int/classifications/apps/icd/icd10online/January12010. 33. World Health Organization. International statistical classification of diseases and related health problems, 10th revised version, 2007. Available at apps.who.int/classifications/apps/icd/icd10online/ Accessed January 1, 2010.
34.
American Psychiatric Association. The diagnostic and statistical manual of psychiatric disorders4th(DSM-IV).Washington, DCAmerican Psychiatric Association2004. 34. American Psychiatric Association. The diagnostic and statistical manual of psychiatric disorders, 4th ed. (DSM-IV). Washington, DC: American Psychiatric Association, 2004.
35.
Chang G. Alcohol-screening instruments for pregnant womenAlcohol Res Health200125204-209. 35. Chang G. Alcohol-screening instruments for pregnant women. Alcohol Res Health 2001;25:204–209.
36.
Martin SLBeaumont JLKupper LL. Substance use before and during pregnancy: Links to intimate partner violenceAm J Drug Alcohol Abuse200329599-617. 36. Martin SL, Beaumont JL, Kupper LL. Substance use before and during pregnancy: Links to intimate partner violence. Am J Drug Alcohol Abuse 2003;29:599–617.
37.
Gmel GRehm J. Harmful alcohol useAlcohol Res Health20032752-62. 37. Gmel G, Rehm J. Harmful alcohol use. Alcohol Res Health 2003;27:52–62.
38.
Grant BFStintson FSDawson DA et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiological Survey on Alcohol and Related ConditionsArch Gen Psychiatry200461807-816 38. Grant BF, Stintson FS, Dawson DA, et al. Prevalence and co-occurrence of substance use disorders and independent mood and anxiety disorders: Results from the National Epidemiological Survey on Alcohol and Related Conditions. Arch Gen Psychiatry 2004;61:807–816
39.
Kushner MGAbrams KBorchhardt C. The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findingsClin Psychol Rev200020149-171. 39. Kushner MG, Abrams K, Borchhardt C. The relationship between anxiety disorders and alcohol use disorders: A review of major perspectives and findings. Clin Psychol Rev 2000;20:149–171.
40.
Floyd RLDecoufle PHungerford DW. Alcohol use prior to pregnancy recognitionAm J Prev Med199917101-107. 40. Floyd RL, Decoufle P, Hungerford DW. Alcohol use prior to pregnancy recognition. Am J Prev Med 1999;17:101–107.
41.
Ebrahim SHDiekman STFloyd RLDecoufle P. Comparison of binge drinking among pregnant and nonpregnant women, United States, 1991–1995Am J Obstet Gynecol19991801-7. 41. Ebrahim SH, Diekman ST, Floyd RL, Decoufle P. Comparison of binge drinking among pregnant and nonpregnant women, United States, 1991–1995. Am J Obstet Gynecol 1999;180:1–7.
42.
Tough STofflemire KClarke MNewburn-Cook C. Do women change their drinking behaviors while trying to conceive? An opportunity for preconception counselingClin Med Res2006497-105. 42. Tough S, Tofflemire K, Clarke M, Newburn-Cook C. Do women change their drinking behaviors while trying to conceive? An opportunity for preconception counseling. Clin Med Res 2006;4:97–105.
43.
Cnattingius SLambe M. Trends in smoking and overweight during pregnancy: Prevalence, risks of pregnancy complications, and adverse pregnancy outcomesSemin Perinatol200226286-295. 43. Cnattingius S, Lambe M. Trends in smoking and overweight during pregnancy: Prevalence, risks of pregnancy complications, and adverse pregnancy outcomes. Semin Perinatol 2002;26:286–295.
44.
Social Issues Research Center. Social and cultural aspects of drinking—A report to the Amsterdam GroupOxford, UKSIRC1998. 44. Social Issues Research Center. Social and cultural aspects of drinking—A report to the Amsterdam Group. Oxford, UK:SIRC, 1998.
45.
Huckle TYou RQCasswell S. Socio-economic status predicts drinking patterns but not alcohol-related consequences independentlyAddiction20101051192-1202. 45. Huckle T, You RQ, Casswell S. Socio-economic status predicts drinking patterns but not alcohol-related consequences independently. Addiction 2010;105:1192–1202.
46.
Rogers SMMiller HGTurner CF. Effects of interview mode on bias in survey measurements of drug use: Do respondent characteristics make a difference?Subst Use Misuse1998332179-2200. 46. Rogers SM, Miller HG, Turner CF. Effects of interview mode on bias in survey measurements of drug use: Do respondent characteristics make a difference? Subst Use Misuse 1998;33:2179–2200.
47.
Comasco ENordquist NLeppert J et al. Adolescent alcohol consumption: Biomarkers PEth and FAEE in relation to interview and questionnaire dataJ Stud Alcohol Drugs200970797-804. 47. Comasco E, Nordquist N, Leppert J, et al. Adolescent alcohol consumption: Biomarkers PEth and FAEE in relation to interview and questionnaire data. J Stud Alcohol Drugs 2009;70:797–804.
Information & Authors
Information
Published In
Copyright
Copyright 2011, Mary Ann Liebert, Inc.
History
Published online: 14 June 2011
Published in print: June 2011
Authors
Disclosure Statement
No competing financial interests exist.
Metrics & Citations
Metrics
Citations
Export Citation
Export citation
Select the format you want to export the citations of this publication.
View Options
Get Access
Access content
To read the fulltext, please use one of the options below to sign in or purchase access.⚠ Society Access
If you are a member of a society that has access to this content please log in via your society website and then return to this publication.