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Predictors of Drinking During Pregnancy: A Systematic Review
Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
Brigham and Womens Hospital.
Linköping University, Department of Medical and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
2011 (English)In: Journal of Women's Health, ISSN 1540-9996, E-ISSN 1931-843X, Vol. 20, no 6, 901-913 p.Article, review/survey (Refereed) Published
Abstract [en]

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 womans 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: Womens 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.

Place, publisher, year, edition, pages
Mary Ann Liebert, Inc. , 2011. Vol. 20, no 6, 901-913 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-69901DOI: 10.1089/jwh.2010.2216ISI: 000291590700010OAI: diva2:433286

Original Publication: Janna Skagerstrom, Grace Chang and Per Nilsen, Predictors of Drinking During Pregnancy: A Systematic Review, 2011, Journal of Women's Health, (20), 6, 901-913. Copyright: Mary Ann Liebert, Inc.

Available from: 2011-08-09 Created: 2011-08-08 Last updated: 2015-10-30
In thesis
1. Alcohol consumption during pregnancy: Prevalence, predictors and prevention
Open this publication in new window or tab >>Alcohol consumption during pregnancy: Prevalence, predictors and prevention
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

It is well established that fetal alcohol exposure can disturb the development of the fetus and cause a range of effects for the affected child. However, research on the effects of exposure to lower levels is inconclusive and the subject is debated. Based on the precautionary principle women in many countries, Sweden included, are advised to maintain total abstinence throughout pregnancy. Regardless, studies have shown that a significant proportion of women consume alcohol around conception and throughout pregnancy. The overall aim of this thesis was to generate knowledge about the prevalence, predictors and prevention of alcohol consumption among women before and during pregnancy.

The aim was addressed in five studies using several datasets and methods. A systematic review of the international literature was undertaken to identify predictors of alcohol consumption during pregnancy (Study I). Questionnaires to midwives were used to investigate the alcohol-preventive work in antenatal care in Sweden (Study II). Questionnaires were also used to gather data on alcohol consumption before and during pregnancy from pregnant women across Sweden and from women who had given birth to a child in one area of Sweden (Study III and IV). Focus group interviews were used to assess non-pregnant women’s voices on alcohol consumption and pregnancy in Sweden (Study V).

The results from the studies showed that alcohol consumption was common among women of childbearing age in Sweden (Study III-V) and that there were social expectations for women to drink (Study V). During pregnancy, the expectation was the opposite, as pregnant women were expected to abstain from all alcohol consumption (Study V), which is in line with the total abstinence recommendation from antenatal care. The national “Risk Drinking” project led to revised alcohol-preventive routines in Swedish antenatal care, including screening of all pregnant women for hazardous alcohol use in the year preceding pregnancy, an important predictor of drinking during pregnancy (Study II). A great majority of pregnant women and new mothers reported abstinence from alcohol after pregnancy recognition (Study III and IV), yet the level of reported alcohol consumption during pregnancy appeared to be affected by formulation of the question (Study IV). Factors associated with more drinking during pregnancy in Sweden were: living in a major city, older maternal age, tobacco use, low social support, stronger pre-pregnancy drinking habits and stronger social drinking motives (Study III). In the international research, pre-pregnancy drinking habits, exposure to abuse or violence, high income or social class and positive screen for dependence were the factors most consistently reported to be associated with more drinking during pregnancy (Study I). Women of childbearing age were uncertain about the potential effects of drinking in the period around conception and the social expectations to abstain did not seem to be as strong in this period as after pregnancy  recognition (Study V). A majority of women reported having reduced their alcohol consumption only after they became aware that they are pregnant, meaning that they could have been dinking for several weeks in early pregnancy (Study III).

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2015. 127 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1470
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
urn:nbn:se:liu:diva-122375 (URN)10.3384/diss.diva-122375 (DOI)978-91-7519-024-2 (print) (ISBN)
Public defence
2015-11-20, Belladonna, Hus 511-001, Campus US, Linköping, 09:00 (Swedish)
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2015-11-12Bibliographically approved

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