title: Determinants of alcohol cessation, reduction and no reduction during pregnancy.
abstract: OBJECTIVE
  Despite public health initiatives targeting the harmful effects of alcohol exposure on fetal growth, 12 % of pregnant women report current alcohol use. For women who reported drinking alcohol prior to pregnancy, we examined several factors as predictors of three alcohol use patterns during the third trimester of pregnancy: cessation, reduction and no reduction.
  
  
  METHODS
  Using the 2002-2009 Pregnancy Risk Assessment Monitoring System (PRAMS) dataset (311,428 records), a multinomial logistic regression model was constructed to compare alcohol risk by category: (1) cessation vs. reduction (2) no reduction vs. reduction.
  
  
  RESULTS
  In this sample, 49.4 % drank alcohol before pregnancy. Among those who drank before pregnancy, ~87 % quit drinking during pregnancy, 6.6 % reduced, and about 6.4 % reported no reduction. Older women and those with higher education were more likely to reduce than quit their alcohol use. Conversely, women who were black or Hispanic, overweight, obese, or multiparas were more likely to quit than to reduce their prenatal alcohol consumption. Several stressors such as abuse during pregnancy increased their risk of not quitting or not reducing alcohol during the last trimester of pregnancy.
  
  
  CONCLUSIONS
  Differentiating prenatal alcohol use patterns can inform the design of targeted interventions and public health policies to meet the Healthy People 2020 objective for achieving a national rate of 98.3 % alcohol abstinence during pregnancy.
authors.affiliation: Department of Health Administration and Policy, MS 1J3, College of Health and Human Services, George Mason University, 4400 University Drive, Fairfax, VA, 22030, USA, pkitsant@gmu.edu.
authors.forename: Panagiota
authors.initials: P
authors.lastname: Kitsantas
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Gaffney
authors.forename: Huichuan
authors.initials: H
authors.lastname: Wu
authors.forename: Jennifer C
authors.initials: JC
authors.lastname: Kastello
mesh_terms: D000328:Adult; D064829:Alcohol Abstinence / Q000706:statistics & numerical data*; D000428:Alcohol Drinking / Q000453:epidemiology*; D017579:Domestic Violence / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D006306:Health Surveys; D006801:Humans; D016015:Logistic Models; D008423:Maternal Age; D050177:Overweight / Q000453:epidemiology; D010298:Parity; D011247:Pregnancy; D011263:Pregnancy Trimester, Third; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology; D013315:Stress, Psychological / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult