Pregnancy-related alcohol use among women in the United States, 1988-95

Objectives To determine secular trends in pregnancy-related reduction in frequent alcohol use (i.e. greater than or equal to 5 drinks/occasion or greater than or equal to 7 drinks/ week) among US women, 1988-95. Methods Using data from the Behavioral Risk Factor Surveillance System, we obtained the prevalence rate ratio (PRR) for alcohol use by pregnant women compared with that by non-pregnant women, with an emphasis on frequent use, and the median number of drinks consumed per week. Results The overall PRR for any alcohol use did not vary significantly (p > 0.05) over the study period, decreasing from 0.34 (95% confidence interval (CI) 0.29-0.40) during 1988-89, to 0.24 (95% CI 0.21-0.28) in 1990-93, and then increasing to 0.30 (95% CI 0.25-0.37) in 1995. The pregnancy-related reduction for any alcohol use was smallest among women who were aged 31-44 years, non-white or unmarried. The PRR for frequent drinking varied significantly over time, decreasing from 0.20 (95% CI 0.12-0.33) during 1988-89 to 0.08 (95% CI 0.05-0.12) in 1990-91 and then increasing to 0.26 (95% CI 0.16-0.40) in 1995 (p < 0.05). For frequent drinking, the pregnancy-related reduction was smallest among non-white women and among unmarried women. The median number of drinks consumed per week remained steady over time for both pregnant (any, 1.0; frequent, 5.0) and non-pregnant women (any 1.5; frequent, 6.0). Conclusion Among reproductive-age women who are frequent alcohol users, the likelihood of continuing frequent alcohol use into pregnancy has increased in recent years, but the amount consumed has remained stable. Public health efforts aimed at increasing the availability of interventions for alcohol-using women of reproductive age are needed to prevent alcohol-exposed pregnancies.