title: Hospital admissions for alcohol use disorders before, during, and after pregnancy: a study based on linked population data in new South Wales, Australia.
abstract: BACKGROUND
  Alcohol use disorders (AUD) during pregnancy can have profound lifelong effects on the baby, including fetal alcohol spectrum disorders (FASD). Hospital admission for AUD during pregnancy provides an opportunity for intervention. Characterization of women along the AUD spectrum during pregnancy aids the development of prevention strategies, policy, and clinical management guidelines aimed at this population. This study describes the hospital admission levels for AUD between the sixth month before pregnancy and the first year after birth and explores risk factors associated with the hospital admissions.
  
  
  METHODS
  This study was based on linked population data between 2002 and 2005 using the New South Wales (NSW) Midwives Data Collection (MDC) and the NSW Admitted Patients Data Collection (APDC), Australia. The study subjects included primiparous mothers who were admitted to hospital in the period from the sixth month before pregnancy to 1 year after birth with at least 1 of the following diagnoses (ICD-10-AM): mental and behavioral disorders due to the use of alcohol (MBDA) (F10.0-10.9); toxic effects of alcohol (T51.0-51.9); maternal care for suspected damage to fetus from alcohol (O35.4); or alcohol rehabilitation (Z50.2).
  
  
  RESULTS
  A total of 175 new mothers had 287 hospital admissions with the principal or stay AUD diagnoses during the study period in NSW. Of the 287 admissions, 181 admissions (63.07%) were reported for an alcohol-related disorder as the principal diagnosis. The hospital admission rate for AUD was 1.76/1,000 person-years (PY) (95% CI: 1.45 to 2.07) during the 6 months prepregnancy. The rate decreased to 0.49/1,000 PY (95% CI: 0.36 to 0.63) during pregnancy and to 0.82/1,000 PY (95% CI: 0.67 to 0.97) in the first year after birth. Women who smoked during pregnancy, lived in a remote area and were younger than 25 years, were more likely to be admitted to hospital with AUD diagnoses. Women in the middle disadvantaged quintile and born in other countries were less likely to be admitted to hospital with AUD diagnoses.
  
  
  CONCLUSIONS
  Hospital admission for AUD decreased significantly in pregnancy and the first year postpartum compared to the prepregnancy period.
authors.affiliation: National Perinatal Epidemiology and Statistics Unit, University of New South Wales (UNSW), Sydney, NSW, Australia.
authors.forename: Fenglian
authors.initials: F
authors.lastname: Xu
authors.forename: Michelle
authors.initials: M
authors.lastname: Bonello
authors.forename: Lucy
authors.initials: L
authors.lastname: Burns
authors.forename: Marie-Paule
authors.initials: MP
authors.lastname: Austin
authors.forename: Zhuoyang
authors.initials: Z
authors.lastname: Li
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D015331:Cohort Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D010343:Patient Admission; D011159:Population Surveillance / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011295:Prenatal Care / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
keywords: Alcohol; Australia; Mental Illness; Perinatal; Pregnancy