“Older not Wiser”? Alcohol use in pregnancy and maternal age

Which age group is more likely to drink during pregnancy?

An article published a couple of weeks ago in the Maternal and Child Health Journal explores the relationship between the age of mothers and alcohol use in pregnancy.

The study authors Meschke, Holl, and Messelt summarize the research to-date on the subject:

“In general, younger women are more likely to drink, binge drink, and face a greater risk of meeting the DSM-IV criteria for alcohol abuse than older women. Younger women’s pregnancies, particularly teens’, are more likely to be unintentional and recognized later, increasing the risk of prenatal drinking. Despite these data, older age is associated with an increased risk of alcohol use during pregnancy.”

What this group of researchers wanted to explore further was how risk factors and patterns of drinking during pregnancy varied between different age groups. The study looked at 9,004 women residing in Minnesota, Montana, North Dakota, and South Dakota (four states which reportedly have some of the highest binge drinking rates for women ages 18-44 in the US).

Like other studies, they found that older women (age 35+) were more likely to drink during pregnancy than younger women. Yet teens and younger women had the greatest number of risk factors for drinking while pregnant (e.g., unmarried, first birth, smoking prenatally, greater levels of depressed mood, more experiences of alcohol misuse). The trend that emerges is: Risk factors associated with greater drinking during pregnancy decreases with age while the  proportion of women using alcohol during their pregnancy increases with age.

It’s an interesting thing to think about. Older mothers-to-be represent a minority of births yet drink at a higher rate during pregnancy. And they are less likely to present with risk factors that could be a sign of alcohol misuse. What’s going on? Do people make assumptions that older women know better and don’t think to mention the possible harms of alcohol? Are there other factors in the lives of women ages 35+ that are influencing alcohol use? Does this suggest a need to focus more FASD prevention efforts on different age groups?


Meschke, L.L., Holl, J., and Messelt, S. (2012). Older Not Wiser: Risk of Prenatal Alcohol Use by Maternal Age. Maternal and Child Health Journal. DOI 10.1007/s10995-012-0953-7

Walker, M., Al-Sahab, B., Islam, F., & Tamim, H. (2011). The epidemiology of alcohol utilization during pregnancy: an analysis of the Canadian Maternity Experiences Survey (MES). BMC Pregnancy and Childbirth, 11(1), 52. Free full-text available.

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