Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes--a prospective cohort study

• Published in: BMC pregnancy and childbirth 2013-01, Vol.13 (1), p.8-8, Article 8
• Main Authors: Murphy, Deirdre J, Mullally, Aoife, Cleary, Brian J, Fahey, Tom, Barry, Joe
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Alcohol; Alcohol Drinking - adverse effects; Alcohol exposure; Alcohol use; Binge drinking; Cohort Studies; Female; Fetal Growth Retardation - chemically induced; Health Behavior; Historical account; Hospitals; Humans; Infant; Infant, Newborn; Infants; Logistic Models; Perinatal outcomes; Pregnancy; Prospective cohort study; Public health; Risk Factors; Smoke; Smoking; Smoking - adverse effects; Studies; Womens health
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/1471-2393-13-8

There has been limited research addressing whether behavioural change in relation to alcohol exposure in pregnancy results in better perinatal outcomes. A cohort study of 6725 women who booked for antenatal care and delivered in a large urban teaching hospital in 2010-2011. A detailed history of alcohol consumption pre-pregnancy and during early pregnancy was recorded at the first antenatal visit with follow-up of the mother and infant until discharge following birth. Adverse perinatal outcomes were compared for 'non-drinkers', 'ex-drinkers' and 'current drinkers'. Of the 6017 (90%) women who reported alcohol consumption prior to pregnancy 3325 (55%) engaged in binge drinking and 266 (4.4%) consumed more than 14 units on average per week. At the time of booking 5649 (94%) women were ex-drinkers and of the 368 women who continued to drink 338 (92%) had a low intake (0-5 units per week), 30 (8%) an excess intake (6-20+ units per week) and 93 (25%) reported at least one episode of binge drinking. Factors associated with continuing to drink in early pregnancy included older maternal age (30-39 years), (OR 1.6; 95% CI 1.3 to 1.8), Irish nationality (OR 3.1; 95% CI 2.2 to 4.3) and smoking (OR 2.6; 95% CI 1.9 to 3.5). Ex-drinkers had similar perinatal outcomes to non-drinkers. Compared to non-drinkers current drinking was associated with an increased risk of intrauterine growth restriction (IUGR) (13% versus 19%, crude OR 1.6; 95% CI 1.1 to 2.2, adjusted OR 1.2; 95% CI 0.8 to 1.8). The greatest risk of IUGR was among women who continued to both drink and smoke, (9% versus 32%, crude OR 4.8; 95% CI 3.3 to 7.0, adjusted OR 4.5; 95% CI 3.1 to 6.7). Public Health campaigns need to emphasise the potential health gains of abstaining from both alcohol and smoking in pregnancy.