Image credit: Malcolm Browne, via flickr

Image credit: Malcolm Browne, via flickr

A recent study by Colleen O’Leary and colleagues in Western Australia explored trends in alcohol-use disorders in pregnant women between 1985 and 2006.

Rather than focusing on the prevalence of FASD in children, the researchers chose to focus on mothers of children with a diagnosis of FASD and determine whether these mothers had their alcohol use formally recognized by health care providers or whether they received health services to address alcohol misuse. They also examined alcohol-related diagnoses (e.g., heavy alcohol consumption) to gain a sense of whether alcohol use and misuse was being addressed by health care providers before, after, and during pregnancy.

This population-based cohort study using linked, longitudinal, health, mental health, and drug and alcohol data sets. Overall, 5839 non-Aboriginal mothers and 2583 Aboriginal gave birth between 1985 and 2006 who had an alcohol-related diagnosis recorded on one or more of the hospital morbidity, mental health outpatients, or drug and alcohol data sets. This group of women was compared with another group of women without an alcohol-related diagnosis and who were matched on maternal age, year of birth of offspring, and Aboriginal status.

The researchers found a substantial increase in the proportion of births with an alcohol diagnosis recorded during pregnancy across the 22 years for all mothers. For both non-Aboriginal and Aboriginal mothers, around 80% of the pregnancy alcohol diagnoses were recorded for births occurring from 1995 to 2006.

This trend may be related to changes in knowledge and awareness regarding the effects of alcohol use during pregnancy. In 2001, alcohol and pregnancy was included for the first time in the Australian national policy agenda. This resulted in considerable debate and, in 2009, guidelines regarding alcohol use during pregnancy shifted to promote abstinence.

One of the most interesting findings from this study was that the majority (70%) of mothers who had a child diagnosed with FAS did not have an alcohol diagnosis recorded during pregnancy. While there are a wide range of possible reasons for this (e.g., health care providers not routinely discussing alcohol use with women, women not feeling comfortable disclosing their alcohol use, general perception that alcohol use is not a major concern), it does suggest that there are many pregnant women who are not receiving support and information regarding their alcohol use and are not being referred to other services and supports. This raises questions about the different ways that health care providers, program planners, and policy analysts can be working to create a more responsive and supportive system to women with alcohol misuse concerns.

For more on FASD prevention in Western Australia, see earlier posts:

 References

Alati, T. (2013). In Western Australia, 70% of mothers of babies with fetal alcohol syndrome did not have an alcohol-related diagnosis recorded during pregnancy. Evidence-based Nursing. doi: 10.1136/eb-2013-101456

O’Leary, C., Halliday, J., Bartu, A., D’Antoine, H., and Bower, C. (2013). Alcohol-use disorders during and within 1 year of pregnancy: a population-based cohort study 1985–2006. BJOG, 120: 744–53.