Trends in alcohol consumption during pregnancy in Australia , 2001 – 2010

Aim: The aim of the current study is to examine, using cross-sectional data, the role of maternal age, period (year of pregnancy) and cohort (year of birth) as predictors of alcohol consumption during pregnancy over a 10-year period. Design: Four cross-sectional surveys were examined, both separately and together. Setting: Using cross-sectional data, there does appear to be a positive relationship between maternal age and alcohol consumption during pregnancy; however, within any one survey period, it is difficult to determine if these patterns are due to period or cohort effects. Participants: The National Drug Strategy Household Survey (NDSHS) is a large-scale survey administered to more than 20,000 respondents. Across four survey periods, 3,281 women reported being pregnant in the 12 months prior to the survey. Measures: The section on pregnancy and alcohol in the NDSHS 2001, 2004, 2007 and 2010. Findings: Age was a significant positive predictor of alcohol consumption during pregnancy in 2010. However, when the four data sets were combined, period appeared to be a stronger predictor, with younger groups and cohorts decreasing consumption at a faster rate over time than older groups and cohorts. Conclusions: Although age and cohort do play a role in the likelihood of alcohol consumption among Australian women during pregnancy, period is the most important predictor, indicating that alcohol consumption among pregnant women is decreasing. Furthermore, knowledge of pregnancy results in a marked decrease in consumption, suggesting a possible focus for prevention campaigns. Current Australian estimates of Fetal Alcohol Spectrum Disorders (FASD) range from 0.06 to 0.68 per 1,000 live births (Mutch, Peadon, Elliott, & Bower, 2009), and estimates of the economic cost of FASD in the United States range up to US$8.3 billion per year (Popova, Stade, Bekmuradov, Lange, & Rehm, 2011). FASD are likely under-reported and the economic costs to society likely underestimated (Popova, Lange, Burd, & Rehm, 2012). FASD are caused by a pregnant woman consuming excessive alcohol during pregnancy (Khalil & O'Brien, 2010). Aside from FASD, drinking during pregnancy has also been positively linked with preterm birth (O'Leary, Nassar, Kurinczuk, & Bower, 2009), low birth weight (Meyer-Leu, Lemola, Daeppen, Deriaz, & Gerber, 2011) and increased risk for sudden infant death syndrome (Athanasakis, Karavasiliadou, & Styliadis, 2011). Monitoring the rate of alcohol consumption during pregnancy over time is an important contribution to efforts to reduce the incidence of FASD and related disorders. It is clear that a substantial proportion of Australian women do drink at least some alcohol during pregnancy. A survey on the drinking habits of pregnant women in Sydney found that over 20% had consumed alcohol in the week prior to being surveyed (Lain, Ford, Hadfield, & Roberts, 2010). In a study where 81% of women reported drinking alcohol during pregnancy, 0.2% of the sample reported drinking more than 20 units (i.e., standard drinks of 10 grams of IJADR International Journal of Alcohol and Drug Research The Official Journal of the Kettil Bruun Society for Social and Epidemiological Research on Alcohol Correspondence: Sarah Callinan, Centre for Alcohol Policy Research, Turning Point Alcohol and Drug Centre, 54-62 Gertrude St, Fitzroy, VIC Australia, 3065. Telephone: +61 3 8413 8475; E-mail: [email protected] Financial support: This work was supported by the Foundation for Alcohol Research and Education, an independent, charitable organisation working to prevent the harmful use of alcohol in Australia (www.fare.org.au). Jason Ferris was also supported by the Australian Research Centre of Excellence in Policing and Security (www.ceps.edu.au/home). FARE and CEPS had no input into the design, analysis or interpretation of this study or in the decision to submit this work for publication. The authors would also like to thank Therese Reitan for her valuable insight and comments on this paper.