BMC Public Health | |
Determinants of pregnant women's compliance with alcohol guidelines: a prospective cohort study | |
Deborah J Loxton1  Frances J Kay-Lambkin2  Jennifer R Powers1  Alexis J Hure1  Amy E Anderson1  | |
[1] Priority Research Centre for Gender, Health and Ageing, University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia;National Drug and Alcohol Research Centre, University of New South Wales, Randwick, NSW, 2032, Australia | |
关键词: Women's health; Prevalence; Prenatal care; Pregnancy; Patient compliance; Health behaviour; Guidelines; Alcohol drinking; | |
Others : 1163104 DOI : 10.1186/1471-2458-12-777 |
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received in 2012-04-18, accepted in 2012-08-31, 发布年份 2012 | |
【 摘 要 】
Background
In 2009, Australian alcohol guidelines for pregnancy changed from low to no alcohol intake. Previous research found a high proportion of pregnant Australian women drank during pregnancy; however, there has been limited investigation of whether pregnant women comply with 2009 alcohol guidelines. The purpose of this study was to provide an assessment of pregnant women’s compliance with 2009 Australian alcohol guidelines and identify predictors of such compliance, including previous drinking behaviour.
Methods
Cross-sectional analysis of prospective data from the 1973–1978 cohort of the Australian Longitudinal Study on Women’s Health was conducted. Women aged 30–36 years who were pregnant at the 2009 survey and had data on alcohol use were included (n = 837). Compliance with 2009 alcohol guidelines for pregnancy was defined as no alcohol intake. Predictors of compliance were analysed using multivariate logistic regression, controlling for area of residence, in three separate models to account for multicollinearity between measures of previous alcohol intake (compliance with 2001 guidelines; frequency and quantity; bingeing). Private health insurance, household income, and illicit drug use were entered into all models and retained if significant.
Results
72% of pregnant women did not comply with the 2009 alcohol guidelines and 82% of these women drank less than seven drinks per week, with no more than one or two drinks per drinking day. The odds of complying with abstinence increased by a factor of 3.48 (95% CI 2.39-5.05) for women who previously complied with the 2001 alcohol guidelines and decreased by a factor of 0.19 (95% CI 0.08-0.66) if household incomes were $36,400 or more. In other models the odds of complying were lower for women who consumed alcohol before pregnancy at least weekly (OR = 0.40, 95% CI 0.25-0.63) or binged (OR ≥ 0.18, 95% CI 0.10-0.31) and were higher for those who abstained (OR = 45.09; 95% CI 8.63-235.49) prior to pregnancy.
Conclusion
Most pregnant women did not comply with alcohol guidelines promoting abstinence. Prior alcohol behaviour was the strongest predictor of compliance during pregnancy, suggesting alcohol use should be addressed in women of child-bearing age. The study is limited by the relatively short timeframe between the official introduction of the 2009 guidelines and the date the surveys were sent out. Widespread dissemination of the guidelines may be necessary to help increase guideline compliance by pregnant women.
【 授权许可】
2012 Anderson et al.; licensee BioMed Central Ltd.
【 预 览 】
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【 图 表 】
Figure 1.
【 参考文献 】
- [1]Health behavior and health education: Theory, research and practice. 4th edition. Edited by Glanz K, Rimer BK, Viswanath K. San Francisco: Jossey-Bass; 2008.
- [2]National Health and Medical Research Council: Is there a safe level of daily consumption of alcohol for men and women? [prepared by Pols R and Hawks D]. 2nd edition. Canberra: Commonwealth of Australia; 1992.
- [3]National Health and Medical Research Council: Australian alcohol guidelines: health risks and benefits. Canberra: Commonwealth of Australia; 2001.
- [4]National Health and Medical Research Council: Australian guidelines to reduce health risks from drinking alcohol. Canberra: Commonwealth of Australia; 2009.
- [5]Society of Obstetricians and Gynaecologists of Canada: Alcohol use and pregnancy consensus clinical guidelines. J Obstet Gynaecol Can 2010, 32:S1-S32.
- [6]The Danish National Board of Health: Healthy habits – before, during and after pregnancy.1st English edition (translated from the 2nd Danish edition). The Danish National Board of Health and The Danish Committee for Health Education; 2010.
- [7]U.S. Surgeon General: U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy [press release]. 2005. [United States Department of Health and Human Services] http://www.come-over.to/FAS/SurGenAdvisory.htm webcite
- [8]National Institute for Health and Clinical Excellence: Antenatal care: Routine care for the healthy pregnant woman. NICE Clinical Guideline 62. London: NICE; 2008.
- [9]Colvin L, Payne J, Parsons D, Kurinczuk JJ, Bower C: Alcohol consumption during pregnancy in nonindigenous West Australian women. Alcoho Clin Exper Res 2007, 31:276-284.
- [10]Powers JR, Loxton DJ, Burns LA, Shakeshaft A, Elliott EJ, Dunlop AJ: Assessing pregnant women's compliance with different alcohol guidelines: An 11-year prospective study. Med J Aust 2010, 192:690-693.
- [11]Zammit SL, Skouteris H, Wertheim EH, Paxton SJ, Milgrom J: Pregnant women's alcohol consumption: The predictive utility of intention to drink and prepregnancy drinking behavior. J Womens Health 2008, 17:1513-1522.
- [12]Andersen AM, Olsen J, Gronbaek MN: Did the changed guidelines on alcohol and pregnancy by the National Board of Health and Welfare change alcohol consumption of pregnant women? Ugeskr Laeger 2001, 163:1561-1565.
- [13]Skagerstróm J, Chang G, Nilsen P: Predictors of Drinking During Pregnancy: A Systematic Review. J Womens Health 2011, 20:901-913.
- [14]Bobo JK, Klepinger DH, Dong FB: Identifying social drinkers likely to consume alcohol during pregnancy: Findings from a prospective cohort study. Psychol Rep 2007, 101:857-870.
- [15]Chang G, McNamara TK, Orav EJ, Wilkins-Haug L: Alcohol use by pregnant women: Partners, knowledge, and other predictors. J Stud Alcohol 2006, 67:245-251.
- [16]Harrison PA, Sidebottom AC: Alcohol and drug use before and during pregnancy: An examination of use patterns and predictors of cessation. Matern Child Health J 2009, 13:386-394.
- [17]Nilsen P, Holmqvist M, Hultgren E, Bendtsen P, Cedergren M: Alcohol use before and during pregnancy and factors influencing change among Swedish women. Acta Obstet Gynecol Scand 2008, 87:768-774.
- [18]Strandberg-Larsen K, Rod Nielsen N, Andersen A-MN, Olsen J, Grønbæk M: Characteristics of women who binge drink before and after they become aware of their pregnancy. Euro J Epidemiol 2008, 23:565-572.
- [19]Bobo JK, Klepinger DH, Dong FB: Changes in the prevalence of alcohol use during pregnancy among recent and at-risk drinkers in the NLSY cohort. J Womens Health 2006, 15:1061-1070.
- [20]Callinan S, Room R: Alcohol consumption during pregnancy: Results from the 2010 National Drug Strategy Household Survey. 2012. [Deakin, ACT: Centre for Alcohol Policy Research, Foundation for Alcohol Research and Education] http://www.fare.org.au/media-news/ webcite
- [21]Brown WJ, Bryson L, Byles JE, Dobson AJ, Lee C, Mishra G, Schofield M: Women's Health Australia: recruitment for a national longitudinal cohort study. Women Health 1998, 28:23-40.
- [22]Women’s Health Australiahttp://www.alswh.org.au/ webcite
- [23]Hure AJ, Powers JR, Mishra GD, Herbert DL, Byles JE, Loxton D: Miscarriage, Preterm Delivery, and Stillbirth: Large Variations in Rates within a Cohort of Australian Women. PLoS One 2012, 7:e37109.
- [24]Powers J, Loxton D: The impact of attrition in an 11-year prospective longitudinal study of younger women. Ann Epidemiol 2010, 20:318-321.
- [25]Goransson M, Magnusson Å, Bergman H, Rydberg U, Heilig M: Fetus at risk: Prevalence of alcohol consumption during pregnancy estimated with a simple screening method in Swedish antenatal clinics. Addiction 2003, 98:1513-1520.
- [26]Alvik A, Heyerdahl S, Haldorsen T, Lindemann R: Alcohol use before and during pregnancy: A population-based study. Acta Obstet Gynecol Scand 2006, 85:1292-1298.
- [27]Tamaki T, Kaneita Y, Ohida T, Harano S, Yokoyama E, Osaki Y, Takemura S, Hayashi K: Alcohol consumption behavior of pregnant women in Japan. Prev Med 2008, 47:544-549.
- [28]Crozier SR, Robinson SM, Borland SE, Godfrey KM, Cooper C, Inskip HM: Do women change their health behaviours in pregnancy? Findings from the Southampton Women's Survey. Paed Perinat Epidemiol 2009, 23:446-453.
- [29]Centers for Disease Control and Prevention: Alcohol use among pregnant and nonpregnant women of childbearing age --- United States, 1991–2005. MMWR 2009, 58:529-532.
- [30]Public Health Agency of Canada: Make every mother and child count. Report on maternal and child health in Canada. Ottawa: PHAC; 2005.
- [31]Comasco E, Hallberg G, Helander A, Oreland L, Sundelin-Wahlsten V: Alcohol Consumption Among Pregnant Women in a Swedish Sample and Its Effects on the Newborn Outcomes. Alcohol Clin Exper Res 2012.
- [32]Li Z, McNally L, Hilder L, Sullivan E: Australia’s mothers and babies 2009. Perinatal statistics series no. 25. Cat. no. PER 52. Sydney: AIHW National Perinatal Epidemiology and Statistics Unit; 2011.
- [33]McNamara TK, Orav EJ, Wilkins-Haug L, Chang G: Risk during pregnancy–self-report versus medical record. Am J Obstet Gynecol 2005, 193:1981-1985.
- [34]Alvik A, Haldorsen T, Lindemann R: Consistency of Reported Alcohol Use by Pregnant Women: Anonymous Versus Confidential Questionnaires With Item Nonresponse Differences. Alcohol Clin Exper Res 2005, 29:1444-1449.
- [35]Jones SC, Eval M, Telenta J, Cert G, Shorten A, Johnson K: Midwives and pregnant women talk about alcohol: what advice do we give and what do they receive? Midwifery 2011, 27:489-496.
- [36]Britt H, Miller G, Charles J, Henderson J, Bayram C, Pan Y, Valenti L, Harrison C, Fahridin S, O’Halloran J: General practice activity in Australia, 2008–09. Canberra: Australian Institute of Health and Welfare; 2009.
- [37]Harris M, Bennett J, Del Mar C, Fasher M, Foreman L, Furler J, Johnson C, Joyner B, Litt J, Mazza D, Smith J, Tomlins R, Bailey L, London J, Snowdon T: Guidelines for preventive activities in general practice. 7th edition. South Melbourne: The Royal Australian College of General Practitioners; 2009.
- [38]Payne J, Elliott E, D'Antoine H, O'Leary C, Mahony A, Haan E, Bower C: Health professionals' knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy. Aust N Z J Public Health 2005, 29:558-564.
- [39]Cabana MD, Rand CS, Powe NR, Wu AW, Wilson MH, Abboud P-AC, Rubin HR: Why don't physicians follow clinical practice guidelines? A framework for improvement. JAMA 1999, 282:1458-1465.
- [40]Flodgren G, Parmelli E, Doumit G, Gattellari M, O’Brien MA, Grimshaw J, Eccles MP: Local opinion leaders: effects on professional practice and health care outcomes. Cochrane Database of Systematic Reviews 2011. Issue 8. Art. No.: CD000125
- [41]Elder RW, Shults RA, Sleet DA, Nichols JL, Thompson RS, Rajab W: Effectiveness of mass media campaigns for reducing drinking and driving and alcohol-involved crashes: A systematic review. Am J Prev Med 2004, 27:57-65.
- [42]Fairbank L, O'Meara S, Renfrew MJ, Woolridge M, Sowden AJ, Lister-Sharp D: A systematic review to evaluate the effectiveness of interventions to promote the initiation of breastfeeding. Health Technol Assess 2000, 4:1-171.
- [43]Barry K, Caetano R, Chang G, DeJoseph M, Miller L, O’Connor M, Olson H, Floyd R, Weber M, DeStefano F, Dolina S, Leeks K: Reducing alcohol-exposed pregnancies: a report of the National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect. Atlanta, GA: Centers for Disease Control and Prevention; 2009.
- [44]Kesmodel U, Schiøler Kesmodel P: Drinking During Pregnancy: Attitudes and Knowledge Among Pregnant Danish Women, 1998. Alcohol Clin Exper Res 2002, 26:1553-1560.
- [45]Floyd RL, Sobell M, Velasquez MM, Ingersoll K, Nettleman M, Sobell L, Mullen PD, Ceperich S, von Sternberg K, Bolton B, Skarpness B, Nagaraja J: Preventing Alcohol-Exposed Pregnancies: A Randomized Controlled Trial. Am J Prev Med 2007, 32:1-10.
- [46]Stade BC, Bailey C, Dzendoletas D, Sgro M, Dowswell T, Bennett D: Psychological and/or educational interventions for reducing alcohol consumption in pregnant women and women planning pregnancy. Cochrane Database of Systematic Reviews 2009. Issue 2. Art. No.: CD004228