title: Behavioural change in relation to alcohol exposure in early pregnancy and impact on perinatal outcomes--a prospective cohort study.
abstract: BACKGROUND
  There has been limited research addressing whether behavioural change in relation to alcohol exposure in pregnancy results in better perinatal outcomes.
  
  
  METHODS
  A cohort study of 6725 women who booked for antenatal care and delivered in a large urban teaching hospital in 2010-2011. A detailed history of alcohol consumption pre-pregnancy and during early pregnancy was recorded at the first antenatal visit with follow-up of the mother and infant until discharge following birth. Adverse perinatal outcomes were compared for 'non-drinkers', 'ex-drinkers' and 'current drinkers'.
  
  
  RESULTS
  Of the 6017 (90%) women who reported alcohol consumption prior to pregnancy 3325 (55%) engaged in binge drinking and 266 (4.4%) consumed more than 14 units on average per week. At the time of booking 5649 (94%) women were ex-drinkers and of the 368 women who continued to drink 338 (92%) had a low intake (0-5 units per week), 30 (8%) an excess intake (6-20+ units per week) and 93 (25%) reported at least one episode of binge drinking. Factors associated with continuing to drink in early pregnancy included older maternal age (30-39 years), (OR 1.6; 95% CI 1.3 to 1.8), Irish nationality (OR 3.1; 95% CI 2.2 to 4.3) and smoking (OR 2.6; 95% CI 1.9 to 3.5). Ex-drinkers had similar perinatal outcomes to non-drinkers. Compared to non-drinkers current drinking was associated with an increased risk of intrauterine growth restriction (IUGR) (13% versus 19%, crude OR 1.6; 95% CI 1.1 to 2.2, adjusted OR 1.2; 95% CI 0.8 to 1.8). The greatest risk of IUGR was among women who continued to both drink and smoke, (9% versus 32%, crude OR 4.8; 95% CI 3.3 to 7.0, adjusted OR 4.5; 95% CI 3.1 to 6.7).
  
  
  CONCLUSIONS
  Public Health campaigns need to emphasise the potential health gains of abstaining from both alcohol and smoking in pregnancy.
authors: Academic Department of Obstetrics & Gynaecology, Coombe Women and Infants University Hospital & Trinity College Dublin, Dublin, Dublin 8, Republic of Ireland. deirdre.j.murphy@tcd.ie
authors: Deirdre J
authors: DJ
authors: Murphy
authors: Aoife
authors: A
authors: Mullally
authors: Brian J
authors: BJ
authors: Cleary
authors: Tom
authors: T
authors: Fahey
authors: Joe
authors: J
authors: Barry
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D015331:Cohort Studies; D005260:Female; D005317:Fetal Growth Retardation / Q000139:chemically induced*; D015438:Health Behavior; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D011247:Pregnancy; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*