alcohol use during pregnancy data from maryland prams, 2001-2005
DESCRIPTION
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 - PowerPoint PPT PresentationTRANSCRIPT
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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
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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
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• 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
OK
AKGA
FL
SCAL
NCCO
NM AR
IL
NYME
WV
WA
LA
UT OHNE
HI
VT
MDNYC
MS
OR MNMI
TX
RINJ
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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
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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.)
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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)
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4 - 6 drinks/wk0.2%
1 - 3 drinks/wk1.2%
7 - 13 drinks/wk
0.1%
< 1 drink/wk6.2%
Nondrinkers92.3%
Drinkers 7.7%
Number of Alcoholic Drinks Consumed During the Last 3 Months of Pregnancy, 2001-2005 PRAMS
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1.9
1.1
1.0
1.1 1.7
1.1
1.1
1.1
8.3
3.3
3.1
6.5
10.7
7.7
3.7
3.9
9.8
3.8
7.5
2.1
1.63.
3
0
2
4
6
8
10
12
14W
hite
Non
-His
p
Bla
ck N
on-H
isp
<25
25-3
4
+35
Mar
ried
Unm
arrie
d
<16
+16
<$20
,000
+$20
,000
Perc
ent
Light drinker, <1 drink/wkRegular drinker, 1-14 drinks/wk
Percent Mothers Who Reported Alcohol Use During the Last 3 Months of Pregnancy, 2001-2005 PRAMS
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10.77.2
25.4
19.8
13.8
32.4
0
10
20
30
40
NondrinkerLight drinkerRegular Drinker
Prenatal Cigarette Use Postpartum Depression
Percent Prenatal Smoking and Postpartum Depression by Alcohol Use, 2001-2005 PRAMS
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7.9
12.5
6.5
0
5
10
15
Nondrinker Light Drinker RegularDrinker
Perc
ent
Percentage of Low Birth Weight Infants by Alcohol Use, 2001-2005 PRAMS
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PRAMS Survey Question, 2001-2003
Yes 81%
No 19%
“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)?”
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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 babyBreastfeeding my babyHow drinking alcohol during pregnancy could affect my babyUsing a seat belt during my pregnancyBirth control methods to use after my pregnancyMedicines that are safe to take during my pregnancyHow using illegal drugs could affect my babyDoing tests to screen for birth defects or diseases that run in my familyWhat to do if my labor starts earlyGetting tested for HIVPhysical abuse to women by their husbands or partners”
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Prenatal Counseling Reported 2001-2005 PRAMS
42.548.1
61.969.170.5
78.479.9
83.484.8
87.888
0 20 40 60 80 100
ViolenceSeatbelt
Illegal drugsSmokingAlcohol
Birth controlBreastfeed
HIV testPreterm labor
MedsBirth defects
percentage
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Percentage of Women Not Receiving Counseling About Alcohol
34
23
38
19
13
28
39
12
24
35
18
34
0
20
40W
hite
Bla
ck
Asi
an
His
pani
c
Age
<20
20-3
5
35+
Edu
<12
12 >12
Med
icai
d
No
Med
icai
d
perc
ent
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“… 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
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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.)
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No binges99.5% >=1 binge
0.5%
Number of Binge Episodes During the Last 3 Months of Pregnancy, 2001-2005 PRAMS
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Alcohol Use* Among Women Ages 18-44, Maryland
1.1
4.95.9
7.2
10.7
14
0
4
8
12
16
'95,'97,'99 '01-'04 '06
perc
enta
ge
chronicbinge
*preliminary Maryland BRFSS ’95-’06 data, binge definition change in 2006
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Chronic Drinking Trends, MarylandMale and Female
4.6
5.6
1.1
5.9
0
2
4
6
'95,'97,'99 '06
perc
ent
malefemale
*preliminary Maryland BRFSS ’95-’06 data
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Binge* Drinking Trends, MarylandMale and Female
22
25.8
7.2
14
0
10
20
30
'95,'97,'99 '06
perc
ent
malefemale
*preliminary Maryland BRFSS ’95-’06 data, binge definition change in 2006
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Alcohol Use 3 Months Before Pregnancy 2001 and 2005 PRAMS
Chronic Drinking, 7+ Drinks/week
1.8
3
0
2
4
2001 2005
perc
ent
Binge Drinking, 5+ Drinks/time
13.214
0
5
10
15
2001 2005
perc
ent
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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
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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