Effects of birth weight of alcohol and caffeine consumption during pregnancy

Change in alcohol, tobacco and coffee consumption in pregnant women: evolution between 1988 and 1992 in an area of high consumption

OBJECTIVE

Analyse the evolution of alcohol, tobacco and coffee consumption during pregnancy in a population characterized by a high level of consumption and a low socioeconomic situation.

STUDY DESIGN

Data were obtained from two studies done with the same protocol and questionnaire in the Roubaix Public Maternity Hospital in 1988 (176 women) and 1992 (235 women); the two periods were compared using univariate tests and multiple logistic regression to control for social factors.

RESULTS

Between 1988 and 1992, there was a clear decrease in alcohol consumption, a slight decrease in coffee consumption and an increase in tobacco use. These changes affected usual consumption as well as consumption during pregnancy. The increase in tobacco use was no longer significant after controlling for social factors. However, the decrease in alcohol consumption affected all women regardless of sociodemographic characteristics, and remained significant after controlling for these characteristics.

CONCLUSION

Several factors support the hypothesis that the decrease in the reported alcohol consumption is real, for consumptions in the low to moderate range. However, it is difficult to identify the role of the several factors involved in this evolution: behaviour of the general population, attitude among pregnant women, information and sensitization of prenatal care providers. Besides, one negative aspect needs to be considered: the stability of the incidence of fetal alcohol syndrome, probably reflecting the stability of the proportion of very heavy consumers.

Attitudes and behavior of pregnant women and health professionals towards alcohol and tobacco consumption

The objective of this study was to identify those factors that influence pregnant women's behavior towards alcohol consumption, so that they could be taken into account when developing alcohol prevention programs in prenatal care. Tobacco use was also studied to identify similarities and differences in attitudes and behavior. A sample of 176 women was interviewed using a structured questionnaire in the prenatal clinics or post-partum wards. Most women were aware that alcohol and tobacco could be harmful to their babies; however heavy drinkers recognized the influence of alcohol in pregnancy less often than the others. Sixty percent of the women, even among the light drinkers, thought that two drinks per day was a reasonable level of consumption during pregnancy. When asked who could be helpful in decreasing their alcohol consumption, most women mentioned their husband, and the doctor or midwife. This is in contrast to our finding that less than 20% of heavy drinkers were advised to reduce alcohol consumption, as compared to 70% of heavy smokers. The results point to the potential for more active interventions on alcohol reduction by health personnel during prenatal care.