Alcohol Use During Pregnancy Data from Maryland PRAMS, 20012005

1
Alcohol Use During Pregnancy Data from Maryland
PRAMS, 2001-2005

• Diana Cheng, M.D.
• Medical Director, Womens Health
• Maryland Department of Health and Mental Hygiene

2
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 lt20
• Other
• 37 unmarried
• 42 first birth, 10 4th birth
• 32 Medicaid

3

• 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

4

• 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

5
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 dont know
• I didnt 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.)

6
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)
7
Number of Alcoholic Drinks Consumed During the
Last 3 Months of Pregnancy, 2001-2005 PRAMS
Drinkers 7.7
8
Percent Mothers Who Reported Alcohol Use During
the Last 3 Months of Pregnancy, 2001-2005 PRAMS
9
Percent Prenatal Smoking and Postpartum
Depression by Alcohol Use, 2001-2005 PRAMS
Prenatal Cigarette Use
Postpartum Depression
10
Percentage of Low Birth Weight Infants by
Alcohol Use, 2001-2005 PRAMS
11
PRAMS Survey Question, 2001-2003

• 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)?

12
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

13
Prenatal Counseling Reported 2001-2005 PRAMS
14
Percentage of Women Not Receiving Counseling
About Alcohol
15
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

16
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 dont know
• I didnt 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.)

17
Number of Binge Episodes During the Last 3 Months
of Pregnancy, 2001-2005 PRAMS
18
Alcohol Use Among Women Ages 18-44, Maryland
preliminary Maryland BRFSS 95-06 data, binge
definition change in 2006
19
Chronic Drinking Trends, MarylandMale and Female
preliminary Maryland BRFSS 95-06 data
20
Binge Drinking Trends, MarylandMale and Female
preliminary Maryland BRFSS 95-06 data, binge
definition change in 2006
21
Alcohol Use 3 Months Before Pregnancy 2001 and
2005 PRAMS
22
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

23
Alcohol Use During PregnancyMaryland, 2001-2005
PRAMS

• During the last 3 months of pregnancy
• 8 of mothers reported alcohol consumption
• lt1 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