Alcohol use before and during pregnancy. PRAMS Working Group.

A woman's excessive drinking during pregnancy can cause structural and behavioral abnormalities in her offspring. However, population-based data concerning maternal drinking behaviors are sparse. To describe drinking prevalences and patterns, we analyzed self-reported data from the Pregnancy Risk Assessment Monitoring Systems of Maine, Michigan, Oklahoma, and West Virginia. During 1988 and 1989, 6,319 mothers were surveyed two to six months after delivery; state-specific response rates ranged from 65.6% to 83.5%. We applied statistical weights to the sample from each state; thus, the results estimate state-specific prevalences. State-specific prevalences of drinking during the last three months of pregnancy were low: 6.8% to 15.1% of mothers reported light drinking (one to six drinks per week), 0.06% to 0.30% reported moderate drinking (seven to 13 drinks per week), and 0.03% to 0.13% reported heavy drinking (14 or more drinks per week). In contrast, prevalences of drinking during the three months before pregnancy were much higher: the range was 31.9% to 53.8% for light drinking, 1.6% to 3.0% for moderate drinking, and 0.6% to 1.3% for heavy drinking. State-specific prevalences of mothers who reported receiving prenatal counseling about alcohol's effects ranged from 66.3% to 75.0%. More heavy drinkers than light drinkers received counseling. These findings indicate that moderate and heavy drinking during late pregnancy is relatively rare. However, all levels of drinking near the time of conception are much higher, and these results suggest the need for research into methods of reducing drinking before pregnancy.