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Alcohol Use During Pregnancy Data from Maryland PRAMS, 2001-2005. Diana Cheng, M.D. Medical Director, Women’s Health Maryland Department of Health and Mental Hygiene. 2005 Maryland Births (74, 880 Births). Race/Ethnicity 49% White Non-Hispanic 33% Black Non-Hispanic
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Alcohol Use During Pregnancy Data from Maryland PRAMS, 2001-2005 Diana Cheng, M.D. Medical Director, Women’s Health Maryland Department of Health and Mental Hygiene
2005 Maryland Births (74, 880 Births) • Race/Ethnicity • 49% White Non-Hispanic • 33% Black Non-Hispanic • 6% Asian Non-Hispanic • 12% Hispanic • Age • 19% age 35+ • 9% age <20 • Other • 37% unmarried • 42% first birth, 10% 4th+ birth • 32% Medicaid
WA ME VT MN OR NY MI RI NYC NE NJ OH IL UT WV MD CO NC NM OK AR SC MS AL GA LA TX AK FL HI • Collaborative agreement between CDC and state health departments • Ongoing mail/phone survey of Maryland women each year, 2 to 6 months after delivery • Random sample • Stratified for birth weight and maternal age • Data collected for 2001-2005 births so far • Over 7,500 completed surveys • Response rate over 70% each year
Maryland Topics • assisted reproduction • reproductive health • vaccination • automobile safety • depression • oral health • bed-rest during pregnancy • circumcision • infections • neighborhood safety PRAMS Core Topics • alcohol and tobacco use • feelings about pregnancy • quality of prenatal care • physical abuse • infant health • stressors • medical disorders • living conditions • breastfeeding • folic acid use
PRAMS Survey Question, 2001-2005 “During the last 3 months of your pregnancy, how many alcoholic drinks did you have in an average week? • 14 drinks or more a week • 7-13 drinks a week • 4 to 6 drinks a week • 1-3 drinks a week • Less than 1 drink a week • I don’t know • I didn’t drink then” (“A drink is 1 glass of wine, wine cooler, can or bottle of beer, shot of liquor, or mixed drink” was added as an explanation to a previous question.)
1 Drink = 12 oz. can or bottle of beer (4.5% alcohol) 4-5 oz. wine (12% alcohol) 1.25 oz. liquor (80 proof/ 40% alcohol)
Number of Alcoholic Drinks Consumed During the Last 3 Months of Pregnancy, 2001-2005 PRAMS Drinkers 7.7%
Percent Mothers Who Reported Alcohol Use During the Last 3 Months of Pregnancy, 2001-2005 PRAMS
Percent Prenatal Smoking and Postpartum Depression by Alcohol Use, 2001-2005 PRAMS Prenatal Cigarette Use Postpartum Depression
Percentage of Low Birth Weight Infants by Alcohol Use, 2001-2005 PRAMS
“At any time during your prenatal care, did a doctor, nurse, or other health care worker ask if you were drinking alcoholic beverages (beer, wine, wine cooler, or liquor)?” PRAMS Survey Question, 2001-2003
PRAMS Survey Question, 2001-2005 “ During any of your prenatal care visits, did a doctor, nurse, or other health care worker talk with you about any of the things listed below?Please count only discussions, not reading materials or videos. How smoking during pregnancy could affect my baby Breastfeeding my baby How drinking alcohol during pregnancy could affect my baby Using a seat belt during my pregnancy Birth control methods to use after my pregnancy Medicines that are safe to take during my pregnancy How using illegal drugs could affect my baby Doing tests to screen for birth defects or diseases that run in my family What to do if my labor starts early Getting tested for HIV Physical abuse to women by their husbands or partners”
“… I drank 7 times a week, I was instructed by my doc to drink one wine cooler at night to relax my cervix and to stop me from going into labor.”PRAMS mother
PRAMS Survey Question, 2001-2005 “During the last 3 months of your pregnancy, how many times did you drink 5 alcoholic drinks or more in one sitting? • 14 drinks or more a week • 7-13 drinks a week • 4 to 6 drinks a week • 1-3 drinks a week • Less than 1 drink a week • I don’t know • I didn’t drink then” (“A drink is 1 glass of wine, wine cooler, can or bottle of beer, shot of liquor, or mixed drink” was added as an explanation to a previous question.)
Number of Binge Episodes During the Last 3 Months of Pregnancy, 2001-2005 PRAMS
Alcohol Use* Among Women Ages 18-44, Maryland *preliminary Maryland BRFSS ’95-’06 data, binge definition change in 2006
Chronic Drinking Trends, MarylandMale and Female *preliminary Maryland BRFSS ’95-’06 data
Binge* Drinking Trends, MarylandMale and Female *preliminary Maryland BRFSS ’95-’06 data, binge definition change in 2006
Limitations of PRAMS • Self-report • Recall bias • Responder bias • Social desirability bias • Definition of drink • 3-month prenatal period • Quality of counseling • Sample size small for many indices
Alcohol Use During PregnancyMaryland, 2001-2005 PRAMS • During the last 3 months of pregnancy • 8% of mothers reported alcohol consumption • <1% reported binge drinking • *Consumption of 1+ drink per week was associated with • prenatal smoking • postpartum depression • infant low birth weight • During prenatal visits • 30% were not counseled about alcohol effects • 19% were not asked about alcohol consumption • Preconceptional alcohol use increasing • Family planning important • Need for more research, education, advocacy, support *restricted results due to small PRAMS data sample