Kiely M, Thornberry JS, Bhaskar B, Rodan MF. Patterns of alcohol consumption among pregnant African-American women in Washington, DC, USA. Paediatric and Perinatal Epidemiology 2011; 25: 328–339.
The objective of this paper is to describe the patterns and associated behaviours related to alcohol consumption among a selected sample of pregnant women seeking prenatal care in inner city Washington DC. Women receiving prenatal care at one of nine sites completed an anonymous alcohol-screening questionnaire. Questions concerned the amount, type and pattern of alcohol consumption. Women were categorised as at no, low, moderate or high risk for alcohol consumption during pregnancy. For comparisons of risk levels of drinking, bivariate associations were examined using Fisher's exact test. Odds ratios (ORs) and 95% confidence intervals (CIs) were also computed. Although 31% of current/recent drinkers stated that they continued to drink during pregnancy, responses to quantity/frequency questions revealed that 42% continued to do so. Women who were at high compared with moderate risk acknowledged that others were worried about their consumption [OR = 4.0, 95% CI 1.5, 10.6], that they drank upon rising [OR = 6.7, 95% CI 1.8, 26.9], had a need to reduce drinking [OR = 3.2, 95% CI 1.3, 8.1] and in the past 5 years had had fractures [OR = 4.2, 95% CI 1.0, 17.8] or a road traffic injury [OR = 3.4, 95% CI 1.0, 12.2]. Women in the high/moderate compared with low-risk group were more likely to have been injured in a fight or assault [OR = 2.7, 95% CI 1.3, 5.6]. This study validated the usefulness of our questionnaire in identifying women who were at risk for alcohol consumption during pregnancy across a range of consumption levels. Using our screening tool, women were willing to disclose their drinking habits. This low-cost method identifies women appropriate for targeting of interventions.