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Peri-conceptual and mid-pregnancy drinking: A cross-sectional assessment in two Scottish health board areas using a 7-day Retrospective Diary.

Research paper by Andrew A Symon, Jean J Rankin, Hazel H Sinclair, Geraldine G Butcher, Kylie K Barclay, Rhona R Gordon, Michelle M MacDonald, Lesley L Smith

Indexed on: 25 Aug '16Published on: 25 Aug '16Published in: Journal of Advanced Nursing



Abstract

To evaluate the use of a 7-day Retrospective Diary to assess peri-conceptual and mid-pregnancy alcohol consumption.Alcohol consumption among women has increased significantly and is of international concern. Heavy episodic ('binge') drinking is commonplace and is associated with unintended pregnancy. Pre-pregnancy drinking is strongly associated with continued drinking in pregnancy. Routine antenatal assessment of alcohol history and current drinking is variable; potentially harmful peri-conceptual drinking may be missed if a woman reports low or no drinking during pregnancy.Cross-sectional study (n=510) in two Scottish health board areas.Face-to-face Retrospective Diary administration from February to June 2015 assessing alcohol consumption in peri-conceptual and mid-pregnancy periods. Women were recruited at the mid-pregnancy ultrasound clinic.Of 510 women, 470 (92.0%) drank alcohol before their pregnancy; 187 (39.9%) drank every week. Retrospective assessment of peri-conceptual consumption identified heavy episodic drinking (more than six units on one occasion) in 52.2% (n=266); 19.6% (n=100) reported drinking more than 14 units per week, mostly at the weekend; 'mixing' of drinks was associated with significantly higher consumption. While consumption tailed off following pregnancy recognition, 5.5% (n=28) still exceeded the recommended daily 2-unit limit in pregnancy. Multivariable logistic regression identified that women who 'binged' peri-conceptually were 3.2 times more likely to do this.Significant peri-conceptual consumption levels suggest a substantial proportion of alcohol-exposed pregnancies before pregnancy recognition. Not taking a detailed alcohol history, including patterns of consumption, will result in under-detection of alcohol-exposed pregnancies. The Retrospective Diary offers practitioners a detailed way of enquiring about alcohol history for this population. This article is protected by copyright. All rights reserved.