OBJECTIVE: To estimate the prevalence of prenatal alcohol consumption and the extent of provider screening and discussion about alcohol use during pregnancy.
METHODS: Data were obtained from a stratified random sample of 12,611 mothers from Maryland who delivered live infants during the years 2001–2008 and completed the Maryland Pregnancy Risk Assessment Monitoring System survey. Analyses were conducted using Proc Surveyfreq in SAS 9.2.
RESULTS: Nearly 8% (95% confidence interval 7.1–8.4) of mothers from Maryland reported alcohol consumption during the last 3 months of pregnancy. The highest prevalence of late-pregnancy alcohol consumption was reported by mothers who were non-Hispanic white, (10.9%, confidence interval 9.8–11.9), aged 35 years or older (13.4%, confidence interval 12.4–14.4), and college graduates (11.4%, confidence interval 10.2–12.6) (P<.001). Nineteen percent (confidence interval 17.6–21.0) of mothers reported that their prenatal care provider did not ask whether they were drinking alcoholic beverages, and 30% (confidence interval 28.3–30.8) reported that a healthcare provider did not counsel them about the consequences of alcohol use on the child. Reported screening and counseling were least prevalent among mothers who were non-Hispanic white, aged 35 years or older, and college graduates (P<.01).
CONCLUSION: Despite the substantial number of women who continue to drink alcohol during pregnancy, healthcare providers do not routinely assess alcohol consumption or counsel all women about its harmful effects. Counseling was least prevalent among the same groups of women with the highest rates for drinking. Provider alcohol assessment, as recommended by the U.S. Surgeon General to prevent alcohol misuse, needs further promotion as a routine part of prenatal care.
LEVEL OF EVIDENCE: III
Prenatal screening and discussion about alcohol use occur least often among the women with the highest prevalence of self-reported alcohol consumption during pregnancy.
From the Center for Maternal and Child Health, Maryland Department of Health and Mental Hygiene, Baltimore, Maryland; Healthcare for the Homeless, Baltimore County, Baltimore, Maryland; Department of Family Medicine, Franklin Square Hospital Center, Baltimore, Maryland.
Corresponding author: Diana Cheng, MD, Maryland Department of Health and Mental Hygiene, 201 W. Preston Street, Room 313, Baltimore, MD 21201; e-mail: firstname.lastname@example.org.
Financial Disclosure The authors did not report any potential conflicts of interest.