EXECUTIVE SUMMARY
New statistics from the Centers for Disease Control and Prevention indicate that more than 3 million women between the ages of 15 and 44 are at risk of exposing their developing baby to alcohol because they are drinking and not using birth control to prevent pregnancy.
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The report also found that three in four women who want to get pregnant as soon as possible do not stop drinking alcohol when they stop using birth control.
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Prenatal Alcohol Exposure Is Associated With A Range Of Adverse Reproductive Outcomes And Can Cause Fetal Alcohol Spectrum Disorders That Are Characterized By Lifelong Physical, Behavioral, And Intellectual Disabilities. Such Outcomes Are Completely Preventable If A Woman Abstains From Alcohol While Pregnant.
The latest statistics from Centers for Disease Control and Prevention (CDC) indicate that more than 3 million women between the ages of 15 and 44 are at risk of exposing their developing babies to alcohol because they are drinking and not using birth control to prevent pregnancy.1 The report also found that three in four women who want to get pregnant as soon as possible do not stop drinking alcohol when they stop using birth control.1
Alcohol can permanently harm a developing baby before a woman knows she is pregnant, said Anne Schuchat, MD, CDC principal deputy director. About half of all pregnancies in the United States are unplanned,2 and even if planned, most women won’t know they are pregnant for the first month or so, when they still might be drinking, noted Schuchat in a press statement accompanying the new report.
Prenatal alcohol exposure is associated with a range of adverse reproductive outcomes and can cause fetal alcohol spectrum disorders that are characterized by lifelong physical, behavioral, and intellectual disabilities.3 Such outcomes are completely preventable if a woman abstains from alcohol while pregnant. To compile the report, CDC researchers analyzed data from the 2011-2013 National Survey of Family Growth, which gathers information on family life, marriage, divorce, pregnancy, infertility, use of birth control, and men’s and women’s health.
Prevalence estimates of risk for an alcohol-exposed pregnancy were calculated for 4,303 nonpregnant, nonsterile women ages 15-44 by selected demographic and behavioral factors. A woman was considered to be at risk for an alcohol-exposed pregnancy if, in the past month, she was not sterile, her partner was not known to be sterile, she had vaginal sex with a male, she drank any alcohol, and she did not use birth control. A woman was considered to be trying to get pregnant if a desired pregnancy was the reason she and her partner stopped using contraception.
Overall, 3.3 million women (7.3% of women ages 15-44 who were having sex, who were non-pregnant and non-sterile) were at risk of exposing their developing baby to alcohol if they were to become pregnant, analysis data indicate.1 Every woman who is pregnant or trying to get pregnant, as well as her partner, want a healthy baby, but they might not be aware that drinking alcohol at any stage of pregnancy can cause a range of disabilities for their child, stated Coleen Boyle, PhD, director of the CDC’s National Center on Birth Defects and Developmental Disabilities.
“It is critical for healthcare providers to assess a woman’s drinking habits during routine medical visits; advise her not to drink at all if she is pregnant, trying to get pregnant or sexually active and not using birth control; and recommend services if she needs help to stop drinking,” said Boyle in a statement accompanying the new report.
The U.S. Preventive Services Task Force recommends alcohol screening and brief intervention for all adults in primary care.4 A single screening question about whether a patient recently has consumed more than five drinks in one day (more than four drinks for females) has been found to be effective in identifying at-risk drinking among primary care patients.5
The question “How many times in the past year have you had X or more drinks in a day?” (where X is five for men and four for women) can be included on an intake questionnaire or asked orally while collecting vital signs. Patients who score positive then should receive the full Alcohol Use Disorders Identification Test (AUDIT US) to determine their level of risk and any signs of dependence.
The AUDIT exam, a 10-item screening instrument, was developed through international testing by the World Health Organization. It asks questions about alcohol consumption during the past year, symptoms of alcohol dependence, and alcohol-related problems or harm. It categorizes those taking the exam into four groups: those unlikely to be at risk, those at risk because they drink excessively, those who already have experienced problems related to their drinking, and those who are likely to have alcohol dependence. (Find information about the AUDIT exam and guidance on implementing alcohol screening in “Planning and Implementing Screening and Brief Intervention for Risky Alcohol Use: A Step-by-Step Guide for Primary Care Practices” at http://1.usa.gov/1pU8wf5.)
REFERENCES
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Green PP, McKnight-Eily LR, Tan CH, et al. Vital signs: Alcohol-exposed pregnancies — United States, 2011-2013. Morb Mortal Wkly Rep 2016; 65(4):91-97.
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Finer LB, Zolna MR. Shifts in intended and unintended pregnancies in the United States, 2001–2008. Am J Public Health 2014; 104(Suppl 1):S43-S48.
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May PA, Baete A, Russo J, et al. Prevalence and characteristics of fetal alcohol spectrum disorders. Pediatrics 2014; 134:855-866.
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Moyer VA, Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: U.S. preventive services task force recommendation statement. Ann Intern Med 2013; 159:210-218.
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Smith PC, Schmidt SM, Allensworth-Davies D, et al. Primary care validation of a single-question alcohol screening test. J Gen Intern Med 2009; 24(7):783-788.
