Peri-conceptual and mid-pregnancy drinking: A cross-sectional assessment in two Scottish health board areas using a 7-day Retrospective Diary

Aims. To evaluate the use of a 7-day Retrospective Diary (RD) to assess peri-conceptual and mid-pregnancy alcohol consumption.

Background. Alcohol consumption among women has increased significantly, and is of international concern. Heavy episodic (‘binge’) drinking is commonplace, and is associated with unintended pregnancy. Pre-pregnancy drinking is strongly associated with continued drinking in pregnancy. Evidence for standardised routine antenatal assessment of alcohol history and current drinking is patchy; consumption patterns are often not identified. Alcohol-exposed pregnancies may therefore be missed.
Design. Cross-sectional study (n=510) in two Scottish health board areas.

Methods. Face-to-face RD administration from February to June 2015 assessing alcohol consumption in peri-conceptual and mid-pregnancy periods. Women were recruited at the mid-pregnancy ultrasound clinic.

Results. Of 510 women, 470 (92.0%) drank alcohol before their pregnancy; 187 (39.9%) drank every week. Retrospective assessment of peri-conceptual consumption identified heavy episodic drinking (more than six units on one occasion) in 52.2% (n=266); 19.6% (n=100) reported drinking more than 14 units per week, mostly at the weekend; ‘mixing’ of drinks was associated with significantly higher consumption. While consumption tailed off following pregnancy recognition, 5.5% (n=28) still drank above recommended daily guidelines for pregnant women.

Conclusion. Significant peri-conceptual consumption levels suggest a substantial proportion of alcohol-exposed pregnancies. Not taking a detailed alcohol history, including patterns of consumption, will result in under-detection of alcohol-exposed pregnancies. The RD offers practitioners a detailed way of enquiring about alcohol history for this population.