Authors:
Srikartika VM, O'Leary CM
Authors notes:
BJOG: An International Journal of Obstetrics and Gynaecology.
Keywords:
alcohol and pregnancy, cohort study, data linkage, pregnancy outcomes, preterm birth, small for gestational age
Abstract:
To examine fetal outcomes of mothers with an alcohol-related diagnosis.
Population-based cohort in Western Australia (WA).
Births on the WA Midwives Notification System (1983-2007).
Infants of mothers with an alcohol-related diagnosis [International Classification of Disease (ICD), 9th/10th revisions] recorded on WA health data sets (non-Aboriginal n = 13 807; Aboriginal n = 9766) were identified through the WA data linkage system.
A comparison cohort of infants born to mothers without an alcohol diagnosis was frequency matched on maternal age, year of birth of the offspring, and Aboriginal status (non-Aboriginal n = 40 148; Aboriginal n = 20 643). Main outcome measures: Poisson regression-generated adjusted relative risk (aRR) and 95% confidence intervals (95% CIs) for small for gestational age (SGA), preterm birth, and low-Apgar score, calculated separately for non-Aboriginal and Aboriginal infants of mothers with an alcohol diagnosis recorded during pregnancy and any alcohol diagnosis. Population-attributable fractions were calculated.
The aRR for non-Aboriginal infants when a maternal alcohol diagnosis was recorded during pregnancy ranged from 1.79 for SGA to 2.57 for preterm birth <32 weeks of gestation, and for Aboriginal infants ranged from 2.69 to 1.99, respectively.
The highest population-atributable fractions were for any alcohol diagnosis and for Aboriginal infants.
For Aboriginal births, approximately 9% and 10.1% of moderate and very preterm births, respectively, and 24.4% of SGAs were attributable to having a mother with any alcohol-related diagnosis.
Mothers with an alcohol diagnosis are at increased risk of poor pregnancy outcomes. The public health impact of maternal alcohol-use disorders on fetal outcomes is significant.