Risky drinking patterns are being continued into pregnancy: A prospective cohort study

Risky patterns of alcohol use prior to pregnancy increase the risk of alcohol-exposed pregnancies and subsequent adverse outcomes. It is important to understand how consumption changes once women become pregnant. The aim of this study was to describe the characteristics of women that partake in risky drinking patterns before pregnancy and to examine how these patterns change once they become pregnant.

A sample of 1577 women from the 1973–78 cohort of the Australian Longitudinal Study on Women’s Health were included if they first reported being pregnant in 2000, 2003, 2006, 2009 and reported risky drinking patterns prior to that pregnancy.

  • When reporting risky drinking patterns prior to pregnancy only 6% of women reported weekly drinking only, whereas 46% reported binge drinking only and 48% reported both.
  • Women in both binge categories were more likely to have experienced financial stress, not been partnered, smoked, used drugs, been nulliparous, experienced a violent relationship, and were less educated.
  • Most women (46%) continued these risky drinking patterns into pregnancy, with 40% reducing these behaviours, and 14% completely ceasing alcohol consumption.
  • Once pregnant, women who binged only prior to pregnancy were more likely to continue (55%) rather than reduce drinking (29%).
  • Of the combined drinking group 61% continued to binge and 47% continued weekly drinking.
  • Compared with the combined drinking group, binge only drinkers prior to pregnancy were less likely to reduce rather than continue their drinking once pregnant.

Over a third of women continued risky drinking into pregnancy, especially binge drinking, suggesting a need to address alcohol consumption prior to pregnancy.

Citation: Anderson AE, Hure AJ, Forder PM, Powers J, Kay-Lambkin FJ, Loxton DJ (2014). Risky drinking patterns are being continued into pregnancy: A prospective cohort study. PLOS One, 9 e86171

Predictors of antenatal alcohol use among Australian women: A prospective cohort study

A large proportion of Australian women consume alcohol during pregnancy. It is important to identify predictors of such use; however no previous study has examined a comprehensive set of predictors using a population-based sample.

Data was obtained from women from the 1973-78 cohort of the Australian Longitudinal Study on Women’s Health, who indicated they were pregnant at survey two, three, four or five (from 2000-2009). Thirty-six variables were investigated as potential predictors of alcohol use during pregnancy, including sociodemographic factors, reproductive health, mental and physical health, health behaviours, alcohol guidelines and healthcare factors.

  • Most (82%) women continued to drink alcohol during pregnancy.
  • Women were more likely to drink alcohol during pregnancy if they had consumed alcohol on a weekly basis before pregnancy, binge drank before pregnancy, or if they were pregnant while alcohol guidelines recommended low alcohol versus abstinence.
  • Drinking during pregnancy was less likely if women had a Health Care Card or if they had ever had fertility problems.

Most Australian women who drank alcohol continued to do so during pregnancy. To ensure that women can make informed decisions about alcohol use during pregnancy, healthcare professionals should be providing all women with information about the potential harms of alcohol use and the reasons why abstinence is the safest option.

Citation: Anderson AE, Hure AJ, Powers JR, Kay-Lambkin FJ, Loxton DJ (2013). Predictors of antenatal alcohol use among Australian women: A prospective cohort study. BJOG, 120:1366-1374.

Determinants of pregnant women’s compliance with alcohol guidelines: A prospective cohort study

In 2009, Australian alcohol guidelines for pregnancy changed from low to no alcohol intake. Previous research found a high proportion of pregnant Australian women drank during pregnancy; however, there has been limited investigation of whether pregnant women comply with 2009 alcohol guidelines.

The purpose of this study was to provide an assessment of pregnant women’s compliance with 2009 Australian alcohol guidelines and identify predictors of such compliance. Data from 837 women from the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health was analysed, involving women aged 30–36 years who were pregnant at the 2009 survey.

  • 72% of pregnant women did not comply with the 2009 alcohol guidelines and 82% of these women drank less than seven drinks per week, with no more than one or two drinks per drinking day.
  • Women who previously complied with the 2001 alcohol guidelines were more than 3 times as likely to comply with the 2009 guidelines as those who did not.
  • Women whose household incomes were $36,400 or more were less likely to comply with the guidelines, as were women who consumed alcohol at least weekly prior to pregnancy
  • Those who abstained from alcohol prior to pregnancy were more likely to comply.

Most pregnant women did not comply with alcohol guidelines promoting abstinence. Prior alcohol behaviour was the strongest predictor of compliance during pregnancy, suggesting alcohol use should be addressed in women of child-bearing age.

Citation: Anderson AE, Hure AJ, Powers JR, Kay-Lambkin FJ, Loxton DJ (2012). Determinants of pregnant women’s compliance with alcohol guidelines: A prospective cohort study. BMC Public Health, 12:777. doi:10.1186/1471-2458-12-777

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Acquisition and utilization of information about alcohol use during pregnancy among Australian pregnant women and service providers

pregnant-216160_1280Because of an unknown safe level of alcohol consumption during pregnancy and inconsistent alcohol guidelines for pregnant women, it is unclear what information is being circulated with regard to alcohol use and pregnancy. This study aimed to explore how pregnant women and service providers acquire and utilize information about alcohol use during pregnancy.

The study involved 10-minute semi-structured interviews with 74 mothers of young children and focus groups with 14 service providers in urban and rural areas of New South Wales in 2008 and 2009.

  • Women and service providers expressed uncertainty about what the alcohol recommendations were for pregnant women.
  • Health care providers were inclined to discuss alcohol use with women they perceived to be high risk but not otherwise.
  • Women felt pressure to both drink and not drink during their pregnancies.
  • Those who drank discounted abstinence messages and reported a process of internal bargaining on issues such as the stage of their pregnancy and the type of beverages they consumed.
  • Those who abstained did so mainly because they were afraid of being held responsible for any problems with their pregnancies or infants that might have occurred from drinking.

Confusion surrounding the recommendations regarding alcohol use during pregnancy, inconsistency in addressing alcohol use with pregnant women, information overload, and a perceived culture of drinking appear to contribute to the high proportion of Australian women drinking during pregnancy.beer-199650_1280

Citation: Loxton D, Chojenta C, Anderson AE, Powers JR, Shakeshaft A, Burns L (2013). Acquisition and utilization of information about alcohol use during pregnancy among Australian pregnant women and service providers. Journal of Midwifery and Women’s Health, 58(5):523-530.

Contact person: Deborah Loxton Deborah.Loxton@newcastle.edu.au

What Women Think about Information on Alcohol Use in Pregnancy

wineglass-553467_1280What you need to know:

Australian alcohol guidelines changed in 2009 to state that not drinking is the safest option for women who are pregnant or those who may become pregnant. Women who reported being pregnant after the introduction of this recommendation explained a number of problems with the information they received about alcohol use during pregnancy. There were differences in the amount of information they received, the message that was conveyed to them, and also in how they interpreted the recommendation. To improve how this information is communicated so women can make an informed decision about whether to drink or abstain during pregnancy, women suggested that a clear, strong and consistent recommendation be provided to women by healthcare professionals as early as possible.

What this research is about:

Heavy alcohol use during pregnancy can have negative impacts on the mother and child, but the potential effects of light to moderate drinking are unclear. In Australia, this has meant that the recommendations about a safe level of alcohol use during pregnancy have changed over the years. The latest recommendations are that not drinking is the safest option. It is important that women are made aware of the potential harms and the lack of a known safe level of consumption. Women should be given enough information to feel confident in making their own personal decision on whether or not to drink alcohol during pregnancy. This study explored what women thought about the information they received about alcohol use during pregnancy.

What did the researchers do:

Telephone interviews were conducted with 19 women from the 1973-78 cohort of the Australian Longitudinal Study on Women’s Health (ALSWH) who had been pregnant after the 2009 alcohol recommendations were introduced.

What did the research find:

There were a lot of inconsistencies in the information that pregnant women received about alcohol use. Some women found that too much information was given, whereas others received none. The actual recommendations that the women were given varied from no alcohol to a little bit being okay. Conflicting messages were common. Women interpreted the information differently. Some believed that not knowing a safe level of alcohol use during pregnancy meant that small amounts were okay, but others concluded that that meant that no alcohol was safe. Overall, the women believed that there was a need to provide better information to pregnant women about alcohol use. They suggested thwoman-358779_1280at a clear, consistent recommendation be provided as early as possible, preferably by healthcare professionals.

How can you use this research:

Information about alcohol use during pregnancy should be provided systematically by healthcare professionals to all women of childbearing age. This will facilitate informed decision making by women who are pregnant or who may become pregnant.

Contact person: Amy Anderson Amy.Anderson@newcastle.edu.au

Citation: Anderson AE, Hure AJ, Kay-Lambkin FJ, Loxton DJ. Women’s perceptions of information about alcohol use during pregnancy: a qualitative study BMC Public Health 2014;14:1048

Young women becoming more active, and more stressed

Young Australian women are fatter, fitter and more fraught today than they were in the mid-’90s, according to the Australian Longitudinal Study on Women’s Health researchers.

The 17-year study, led by the University of Newcastle’s Professor Julie Byles and University of Queensland’s Professor Gita Mishra, found that 70 per cent of women aged between 18 and 23 in 2010 met Australian guidelines for physical activity, compared with 59 per cent in 1996.

Professor Mishra said that while this finding was encouraging, the percentage of overweight and obese young women was increasing.

“In 2013, 33 per cent of the young women surveyed were overweight or obese, compared with 20 per cent in 1996,” she said.

Professor Julie Byles said researchers also found that the prevalence of stress in this age group was higher than in the previous generation of young women surveyed in 1996. She said about half the young women surveyed said they had experienced high or very high psychological stress in the past year.

“The rate was even higher, 55 per cent, for women aged between 18 and 20 years, which probably reflects the stressful transition period between adolescence and young adulthood,” Professor Byles said. “Worryingly, we also found that 59 per cent of these young women had experienced suicidal thoughts in the past year, while 45 per cent had engaged in self-harming behaviour.”

Other notable findings in the report titled Health and wellbeing of women aged 18 to 23 in 2013 and 1996:Findings from the Australian Longitudinal Study on Women’s Health include:

Physical health: More than one in five young women reported frequent severe tiredness, back pain, headache or period pain, while one in four reported trouble sleeping – double the incidence reported in 1996. About one in three young women had low iron levels, and one in 25 young women had asthma.

Smoking: From 1996 to 2013, the percentage of women aged 18 to 23 who had never smoked increased from 53 per cent to 63 per cent, while there was also a substantial decline in the percentage of current smokers from one in three (32 per cent) to less than one in five (19 per cent).

Drinking: In 2013, one in four young women (26 per cent) drank alcohol weekly or more frequently (compared with 29 per cent in 1996). There was little change in drinking patterns since the 1996 survey.

Violence: One in five young women had experienced physical or sexual violence in the past 12 months while 56 per cent had experienced either form of violence at some point in their lives.

Bullying: One in five young women said they were bullied in the past 12 months while 70 per cent had been bullied at some point in their lives.

Intimate partner violence: The percentage of women who had been in a violent relationship had increased to 13 per cent in 2013, up from 11 per cent in 1996.

Impact of education: Women with less than a year 12 education fared worse in almost all categories surveyed – reporting poorer mental health; higher incidence of being bullied; more likely to have experienced intimate partner violence; more likely to have not used contraception and been pregnant at some stage; less likely to have received the Human Papillomavirus (HPV) vaccination.