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Asking about alcohol consumption during pregnancy: how prevalence rate is affected by the formulation of the question
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Division of Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Gynaecology and Obstetrics in Linköping.
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Studies of alcohol consumption during pregnancy in Sweden have reported prevalence rates from 6% to 30%. The reason for these differences is unknown. The aim of this study was to compare how alcohol consumption is reported by pregnant women when asked explicitly to report drinking after pregnancy recognition compared with asking about drinking during pregnancy without stating if the time before pregnancy recognition should be included. Data were collected from two groups of women. The women in group A were asked to estimate their alcohol consumption during pregnancy and the women in group B were asked to estimate their alcohol consumption during pregnancy, after pregnancy recognition. There was a significant difference in the reported prevalence rate between the cohorts: 9.3% in cohort A (n=1041) and 6.8% in cohort B (n=933). The results from this study may explain some of the variations in previously reported prevalence rates. To be able to compare different studies, it is important to be clear about the methodological aspects.

Keyword [en]
Prevalence rate, alcohol consumption, pregnancy
National Category
Public Health, Global Health, Social Medicine and Epidemiology Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:liu:diva-122373OAI: oai:DiVA.org:liu-122373DiVA: diva2:865986
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2015-10-30Bibliographically approved
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.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1470
National Category
Obstetrics, Gynecology and Reproductive Medicine Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
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)
Opponent
Supervisors
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2015-11-12Bibliographically approved

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Skagerström, JannaFestin, KarinBlomberg, MarieNilsen, Per
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Division of Community MedicineFaculty of Medicine and Health SciencesDivision of Clinical SciencesDepartment of Gynaecology and Obstetrics in Linköping
Public Health, Global Health, Social Medicine and EpidemiologyObstetrics, Gynecology and Reproductive Medicine

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