title: Geographic and maternal characteristics associated with alcohol use in pregnancy.
abstract: BACKGROUND
  To date, no studies have used population-level data to investigate whether maternal location of residence (metropolitan vs. regional/remote populations) is associated with alcohol use in pregnancy. This information has important implications for appropriate service provision.
  
  
  METHODS
  Information on all live births in New South Wales, Australia, was linked to records of alcohol-related admissions for mothers of these births over a 6-year period (2000 to 2006). Cases were women who had at least 1 alcohol-related hospital admission during pregnancy or at birth. Controls were women who had at least 1 live birth over that same time period but no alcohol-related hospital admissions during that time. Admissions were considered to be alcohol-related based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) code. Demographic, obstetric, and neonatal variables were compared.
  
  
  RESULTS
  A total of 417,464 singleton birth records were analyzed, 488 of which were coded positive for at least 1 alcohol-related ICD-10-AM diagnosis. Characteristics associated with alcohol-related admissions in pregnancy were residence in a remote/very remote area, being Australian-born, having had a previous pregnancy, smoking in the current pregnancy, and presenting late to antenatal care. Alcohol-exposed pregnancies were associated with a range of poor obstetric and neonatal outcomes, with no geographic differences noted. However, women in regional/remote areas were less likely to attend specialist obstetric hospitals.
  
  
  CONCLUSIONS
  This study shows the need for standardized screening programs for alcohol use in pregnancy and where problematic use is detected, for clear clinical guidelines on management and referral.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2026, Australia. l.burns@unsw.edu.au
authors.forename: Lucy
authors.initials: L
authors.lastname: Burns
authors.forename: Emma
authors.initials: E
authors.lastname: Black
authors.forename: Jennifer R
authors.initials: JR
authors.lastname: Powers
authors.forename: Deborah
authors.initials: D
authors.lastname: Loxton
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Elliott
authors.forename: Anthony
authors.initials: A
authors.lastname: Shakeshaft
authors.forename: Adrian
authors.initials: A
authors.lastname: Dunlop
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000208:ethnology* / Q000523:psychology; D001315:Australia / Q000208:ethnology; D001719:Birth Certificates; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D038801:International Classification of Diseases / Q000639:trends; D008425:Maternal Behavior / Q000523:psychology; D008875:Middle Aged; D015997:Neonatal Screening / Q000639:trends; D010343:Patient Admission / Q000639:trends; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology* / Q000523:psychology; D012424:Rural Population; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology / Q000523:psychology; D014505:Urban Population; D055815:Young Adult