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Prevalence of alcohol use before and during pregnancy and predictors of drinking during pregnancy: a cross sectional study in Sweden
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
Mälardalen University, Sweden.
Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
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2013 (English)In: BMC Public Health, ISSN 1471-2458, Vol. 13, no 780Article in journal (Refereed) Published
Abstract [en]


There is a paucity of research on predictors for drinking during pregnancy among women in Sweden and reported prevalence rates differ considerably between studies conducted at different antenatal care centres. Since this knowledge is relevant for preventive work the aim of this study was to investigate these issues using a multicenter approach.


The study was conducted at 30 antenatal care centers across Sweden from November 2009 to December 2010. All women in pregnancy week 18 or more with a scheduled visit were asked to participate in the study. The questionnaire included questions on sociodemographic data, alcohol consumption prior to and during the pregnancy, tobacco use before and during pregnancy, and social support.


Questionnaires from 1594 women were included in the study. A majority, 84%, of the women reported alcohol consumption the year prior to pregnancy; about 14% were categorized as having hazardous consumption, here defined as a weekly consumption of > 9 standard drinks containing 12 grams of pure alcohol or drinking more than 4 standard drinks at the same occasion. Approximately 6% of the women consumed alcohol at least once after pregnancy recognition, of which 92% never drank more than 1 standard drink at a time. Of the women who were hazardous drinkers before pregnancy, 19% reduced their alcohol consumption when planning their pregnancy compared with 33% of the women with moderate alcohol consumption prior to pregnancy. Factors predicting alcohol consumption during pregnancy were older age, living in a large city, using tobacco during pregnancy, lower score for social support, stronger alcohol habit before pregnancy and higher score for social drinking motives.


The prevalence of drinking during pregnancy is relatively low in Sweden. However, 84% of the women report drinking in the year preceding pregnancy and most of these women continue to drink until pregnancy recognition, which means that they might have consumed alcohol in early pregnancy. Six factors were found to predict alcohol consumption during pregnancy. These factors should be addressed in the work to prevent alcohol-exposed pregnancies.

Place, publisher, year, edition, pages
BioMed Central , 2013. Vol. 13, no 780
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-97660DOI: 10.1186/1471-2458-13-780ISI: 000323754500003OAI: diva2:649988

Funding Agencies|Swedish National Institute of Public Health||

Available from: 2013-09-19 Created: 2013-09-19 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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Skagerström (Malmsten), JannaAlehagen, SiwFranzén Årestedt, KristoferNilsen, Per
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