Intergovernmental committee on Drugs working party on Fetal Alcohol Spectrum Disorders
Fetal Alcohol Spectrum Disorders in Australia: An Update
2.4 Predictors of drinking in pregnancy
A recent systematic review of fourteen studies from a range of countries examining predictors of alcohol use during pregnancy found that the most consistently reported predictors were pre-pregnancy alcohol use (quantity and frequency) and having been abused or exposed to violence. High income and a positive alcohol dependence screen were less consistent predictors of alcohol use in pregnancy. Unemployment, marital status and education level were found to be predictive infrequently (Skagerstrom et al. 2011).
An Australian study (included in the systematic review) that surveyed 248 pregnant women, found that family annual income was the only demographic variable significantly correlated with intention to drink and drinking during pregnancy. The higher the family income, the more likely women were to consume alcohol prior to pregnancy, respond that they intended to drink during pregnancy and to consume alcohol during pregnancy (Zammit et al. 2008). For women who drank after the pregnancy was confirmed, the quantity of alcohol consumed prior to pregnancy predicted the intention to drink in a future pregnancy, with heavier drinkers more likely to have the intention to drink. Drinking behaviour in pregnancy predicted fortnightly alcohol consumption in later pregnancy, after controlling for prepregnancy drinking and income.
Another Australian survey of women attending antenatal clinics in two South Australian hospitals found women with previous pregnancy losses were significantly more likely to report drinking alcohol during pregnancy. The only factor found to be independently associated with the likelihood of ceasing alcohol use during pregnancy was the pregnancy being the first pregnancy for the woman (Hotham et al. 2008). The prevalence of alcohol consumption in this study is lower than other samples of Australian women with 11.5, 12.5 and 15.6 percent reporting alcohol consumption for the different trimesters respectively.
In a national cross-sectional telephone survey, Peadon and colleagues found the majority (89.4%) of women reported recent (past 12 month) alcohol consumption. A third (34.1%) drank alcohol during their last pregnancy. The study found that a woman’s current drinking behaviour, their drinking behaviour during a past pregnancy and attitudes to alcohol use during pregnancy were the strongest predictors of alcohol consumption in pregnancy (Peadon et al. 2011). Women who drank more frequently or heavily, who had consumed alcohol in their past pregnancy, who intended to smoke in a future pregnancy or had neutral or positive attitudes to alcohol use in pregnancy were more likely to report they would consume alcohol in a future pregnancy.