Alcohol consumption during pregnancy: cross-sectional survey

OBJECTIVE: to assess the prevalence and pattern of alcohol consumption pre-conception and/or during the first trimester using the Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) and T-ACE (Tolerance, Annoyance, Cut Down and Eye-Opener) alcohol screening questionnaires, and determine the socio-demographic predictors of drinking in this time period.

DESIGN: cross sectional survey of a consecutive sample of 500 pregnant women attending their first antenatal appointment at approximately 10-11 weeks gestation.

SETTING: two antenatal clinics in the South West of England.

FINDINGS: of the 409 women respondents, we found a quarter of women reported drinking alcohol despite being aware they are pregnant. Between two to three in every 100 women reported drinking six or more units on a single occasion (heavy episodic or 'binge' drinking) at least monthly or weekly in the past three months. A similar proportion reported exceeding the recommended drinking limits of one to two units, once or twice a week. The majority of heavy episodic drinkers were otherwise low risk drinkers. 5.4% of respondents had an AUDIT-C score of 3 or more, and 22.2% a T-ACE score of 2 or more, indicating risk drinking in the peri-conception period. Drinking pre-conception and/or during the first trimester was more likely if women were multiparous and of white ethnicity.

KEY CONCLUSIONS: in this study pregnant women attending an antenatal appointment were willing to complete brief alcohol screening questionnaires. A minority of women reported drinking pre-conception and/or during the first trimester with a small percentage drinking at levels potentially harmful to the fetus.

IMPLICATIONS FOR PRACTICE: use of these questionnaires would help midwives gather information about alcohol use to help identify women drinking at levels in excess of recommended limits in order that appropriate advice and support be offered.