Understanding drinking during pregnancy among urban American Indians and African Americans: health messages, risk beliefs, and how we measure consumption.
BACKGROUND
Little is known about urban American Indian and African American women's drinking during pregnancy, or their beliefs about the risk of doing so. However, rates of fetal alcohol syndrome (FAS) are believed to be highest among those ethnic groups.


METHODS
The Developing Effective Educational Resources (DEER) project recruited pregnant American Indian, African American, and white women from urban California areas (n = 321), to develop culturally appropriate consumption measures, to gather epidemiological data about drinking during pregnancy, and to assess exposure and reactions to health warnings intended to encourage abstinence during pregnancy.


RESULTS
The study found high levels of exposure to health warnings among all ethnic groups, but many women were unclear about the actual consequences of FAS, about the risk of drinking even beer or wine or wine coolers, or about the value of reducing intake at any time during pregnancy. The majority of the women who drank malt liquor, fortified wine, wine, and spirits reported having larger than standard drinks, and daily drinkers had the highest levels of reporting error. When drink size was considered in the calculation of alcohol volume, average daily volume of consumption during pregnancy increased to the FAS risk level (average daily volume > or = 1) in the overall sample and among the African American and white subjects.


CONCLUSIONS
Because some women, especially heavy drinkers, will continue drinking despite exposure to abstention-oriented health messages, it may be prudent to develop campaigns and interventions that provide factual information to help at-risk women reduce their drinking during pregnancy. Women could be advised of beverage equivalency, of standard drink sizes, and of how their own drinks compare with standard ones. Reliance on standard drink sizes in research can result in significant underreporting of consumption, especially among pregnant risk drinkers.
Kaskutas
L A
LA
Alcohol Research Group, Berkeley, California 94709, USA. lkaskutas@arg.org
D001741:Black or African American; D000428:Alcohol Drinking; D000431:Ethanol / Q000008:administration & dosage*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007198:Indians, North American; D008913:Minority Groups; D011247:Pregnancy; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014505:Urban Population
D000431:Ethanol