Consumption of alcohol during pregnancy-A multinational European study.

BACKGROUND Although single-country studies indicate alcohol consumption among some pregnant European women, it is difficult to interpret European differences. Few multinational studies exist using the same methodology. AIM To estimate the proportion of women consuming alcohol during pregnancy in Europe, and to analyze whether between country variations could be explained by sociodemography and smoking. METHODS An anonymous online questionnaire was accessible for pregnant women and new mothers in 11 European countries during two months between October 2011 and February 2012 in each country. The questionnaire covered alcohol consumption, sociodemographic factors, and smoking habits during pregnancy. Descriptive analyses and logistic regression models were conducted. FINDINGS The study population consisted of 7905 women, 53.1% pregnant and 46.9% new mothers. On average, 15.8% reported alcohol consumption during pregnancy. The highest proportion of alcohol consumption during pregnancy was found in the UK (28.5%), Russia (26.5%), and Switzerland (20.9%) and the lowest in Norway (4.1%), Sweden (7.2%), and Poland (9.7%). When reporting alcohol consumption during pregnancy, 39% consumed at least one unit per month. In Italy, Switzerland, and the UK, over half consumed at least one alcohol unit per month. Higher education and smoking before pregnancy were predictors of alcohol consumption during pregnancy. CONCLUSIONS Almost 16% of women resident in Europe consumed alcohol during pregnancy with large cross-country variations. Education and smoking prior to pregnancy could not fully explain the differences between the European countries. A united European strategy to prevent alcohol consumption during pregnancy is needed with focus on countries with the highest consumption.

[1]  R. Jepson,et al.  A realist evaluation of an antenatal programme to change drinking behaviour of pregnant women , 2015, Midwifery.

[2]  P. Primatesta,et al.  Alcohol and pregnancy: an international comparison. , 1993, Journal of public health medicine.

[3]  A. Einarson,et al.  Perception of risk regarding the use of medications and other exposures during pregnancy , 2010, European Journal of Clinical Pharmacology.

[4]  Nel Roeleveld,et al.  Web-based questionnaires: the future in epidemiology? , 2010, American journal of epidemiology.

[5]  S. Lewis,et al.  Effect of Prenatal Alcohol Exposure on Childhood Academic Outcomes: Contrasting Maternal and Paternal Associations in the ALSPAC Study , 2013, PloS one.

[6]  Lesley Smith,et al.  Alcohol consumption during pregnancy: cross-sectional survey. , 2014, Midwifery.

[7]  C. Bower,et al.  Guidelines for pregnancy: what's an acceptable risk, and how is the evidence (finally) shaping up? , 2012, Drug and alcohol review.

[8]  E. Steegers,et al.  Preconception care policy, guidelines, recommendations and services across six European countries: Belgium (Flanders), Denmark, Italy, the Netherlands, Sweden and the United Kingdom , 2015, The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception.

[9]  G. Gmel,et al.  International Comparisons of Alcohol Consumption , 2003, Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism.

[10]  G. Torre,et al.  Pregnancy e-health: a multicenter Italian cross-sectional study on internet use and decision-making among pregnant women , 2013, Journal of Epidemiology & Community Health.

[11]  Per Nilsen,et al.  Predictors of drinking during pregnancy: a systematic review. , 2011, Journal of women's health.

[12]  Tim Stockwell,et al.  Understanding standard drinks and drinking guidelines. , 2012, Drug and alcohol review.

[13]  K. Jones,et al.  Alcohol consumption patterns among pregnant women in the Moscow region of the Russian Federation. , 2006, Alcohol.

[14]  K. Årestedt,et al.  Prevalence of alcohol use before and during pregnancy and predictors of drinking during pregnancy: a cross sectional study in Sweden , 2013, BMC Public Health.

[15]  A. Grob,et al.  Drinking and smoking in pregnancy: what questions do Swiss physicians ask? , 2007, Swiss medical weekly.

[16]  R. Perez-Iglesias,et al.  Weekday but not weekend alcohol consumption before pregnancy influences alcohol cessation during pregnancy. , 2007, European journal of public health.

[17]  T. Balachova,et al.  Women's alcohol consumption and risk for alcohol-exposed pregnancies in Russia. , 2012, Addiction.

[18]  M. Cedergren,et al.  Alcohol use before and during pregnancy and factors influencing change among Swedish women , 2008, Acta obstetricia et gynecologica Scandinavica.

[19]  G. Gmel,et al.  Alcohol consumption and social inequality at the individual and country levels--results from an international study. , 2013, European journal of public health.

[20]  Lesley Smith,et al.  Brief screening questionnaires to identify problem drinking during pregnancy: a systematic review. , 2010, Addiction.

[21]  G. Gmel,et al.  Social inequalities in alcohol consumption and alcohol-related problems in the study countries of the EU concerted action 'Gender, Culture and Alcohol Problems: a Multi-national Study'. , 2006, Alcohol and alcoholism (Oxford, Oxfordshire). Supplement.

[22]  F. Kay-Lambkin,et al.  Women’s perceptions of information about alcohol use during pregnancy: a qualitative study , 2014, BMC Public Health.

[23]  A. Hofman,et al.  Assessment of maternal smoking status during pregnancy and the associations with neonatal outcomes. , 2011, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[24]  Patricia Harrison,et al.  Alcohol and Drug Use Before and During Pregnancy: An Examination of Use Patterns and Predictors of Cessation , 2009, Maternal and Child Health Journal.

[25]  L. Poston,et al.  Prevalence and predictors of alcohol use during pregnancy: findings from international multicentre cohort studies , 2015, BMJ Open.

[26]  S. Heyerdahl,et al.  Alcohol use before and during pregnancy: a population‐based study , 2006, Acta obstetricia et gynecologica Scandinavica.

[27]  M. Holmqvist,et al.  Towards improved alcohol prevention in Swedish antenatal care? , 2012, Midwifery.

[28]  E. Riley,et al.  Fetal Alcohol Spectrum Disorders: An Overview , 2011, Neuropsychology Review.

[29]  U. Kesmodel,et al.  Lack of consensus between general practitioners and official guidelines on alcohol abstinence during pregnancy. , 2011, Danish medical bulletin.

[30]  Priscilla H. Chan,et al.  Prevalence and predictors of maternal alcohol consumption in 2 regions of Ukraine. , 2014, Alcoholism, clinical and experimental research.

[31]  O. Spigset,et al.  Medication use in pregnancy: a cross-sectional, multinational web-based study , 2014, BMJ Open.

[32]  U. Kesmodel,et al.  Alcohol in pregnancy: attitudes, knowledge, and information practice among midwives in Denmark 2000 to 2009. , 2011, Alcoholism, clinical and experimental research.

[33]  M. Melchior,et al.  Tobacco and alcohol use in pregnancy in France: the role of migrant status: the nationally representative ELFE study. , 2015, Addictive behaviors.