Characteristics of women who consume alcohol before and after pregnancy recognition in a Canadian sample: a prospective cohort study.

BACKGROUND: High levels of alcohol consumption during pregnancy are teratogenic to fetal development, yet less is known about the effects of low levels of consumption. Only a few studies have reported on the predictors and maternal characteristics associated with different alcohol consumption patterns prior to and following pregnancy recognition. METHODS: The All Our Babies longitudinal study in Alberta, Canada was used to analyze the association of maternal characteristics with binge drinking prior to pregnancy recognition and low to moderate levels after pregnancy recognition among 2,246 women who consumed alcohol 1 year prior to pregnancy. Bivariate and multivariable analyses were conducted. RESULTS: Thirteen percent of women reported binge drinking prior to pregnancy recognition. Forty-six percent reported drinking after pregnancy recognition, almost all at low to moderate levels. Significant, independent predictors (odds ratio, 95% confidence interval) of binge drinking in early pregnancy included high school or less education (3.61, 1.81 to 7.19), some or completed university/college (2.23, 1.16 to 4.27), nulliparity (1.62, 1.19, 2.20), not trying to get pregnant (1.92, 1.37 to 2.69), smoked in the year prior to pregnancy (1.98, 1.43 to 2.73), binge drinking in the year prior to pregnancy (10.83, 6.71 to 17.46), and low dispositional optimism (1.73, 1.23 to 2.42). Independent predictors of low to moderate average levels of consumption after pregnancy recognition included not trying to get pregnant (1.91, 1.45 to 2.52), prepregnancy body mass index <25.0 kg/m(2) (1.41, 1.61 to 1.72), smoking in the year before pregnancy (1.90, 1.43 to 2.53), and binge drinking in the year before pregnancy (2.62, 2.16 to 3.18). CONCLUSIONS: Common risk factors for different alcohol consumption patterns are unintended pregnancy and substance use behaviors prior to pregnancy. Other risk factors were specific to the different patterns. Targeted strategies that address the needs of alcohol or nicotine using women and that can reduce the risk of unintended pregnancy may be beneficial.