title: Pregnancy outcomes of mothers with an alcohol-related diagnosis: a population-based cohort study for the period 1983-2007.
abstract: OBJECTIVE
  To examine fetal outcomes of mothers with an alcohol-related diagnosis.
  
  
  METHODS
  Population-based cohort.
  
  
  METHODS
  Western Australia (WA).
  
  
  METHODS
  Births on the WA Midwives Notification System (1983-2007).
  
  
  METHODS
  Infants of mothers with an alcohol-related diagnosis [International Classification of Disease (ICD), 9th/10th revisions] recorded on WA health data sets (non-Aboriginal n = 13 807; Aboriginal n = 9766) were identified through the WA data linkage system. A comparison cohort of infants born to mothers without an alcohol diagnosis was frequency matched on maternal age, year of birth of the offspring, and Aboriginal status (non-Aboriginal n = 40 148; Aboriginal n = 20 643).
  
  
  METHODS
  Poisson regression-generated adjusted relative risk (aRR) and 95% confidence intervals (95% CIs) for small for gestational age (SGA), preterm birth, and low-Apgar score, calculated separately for non-Aboriginal and Aboriginal infants of mothers with an alcohol diagnosis recorded during pregnancy and any alcohol diagnosis. Population-attributable fractions were calculated.
  
  
  RESULTS
  The aRR for non-Aboriginal infants when a maternal alcohol diagnosis was recorded during pregnancy ranged from 1.79 (95% CI 1.42-2.16) for SGA to 2.57 (95% CI 1.69-4.27) for preterm birth <32 weeks of gestation, and for Aboriginal infants ranged from 2.69 (95% CI 2.28-3.16) to 1.99 (95% CI 1.40-2.84), respectively. The highest population-attributable fractions were for any alcohol diagnosis and for Aboriginal infants. For Aboriginal births, approximately 9% (95% CI 4.74-12.97) and 10.1% (95% CI 5.50-14.49) of moderate and very preterm births, respectively, and 24.4% (95% CI 13.5-21.2%) of SGAs were attributable to having a mother with any alcohol-related diagnosis.
  
  
  CONCLUSIONS
  Mothers with an alcohol diagnosis are at increased risk of poor pregnancy outcomes. The public health impact of maternal alcohol-use disorders on fetal outcomes is significant.
authors.affiliation: Centre for Population Health Research, Curtin University, Perth, Australia.
authors.forename: V M
authors.initials: VM
authors.lastname: Srikartika
authors.affiliation: Division of Population Sciences, Telethon Kids Institute, University of Western Australia, Perth, Australia.
authors.forename: C M
authors.initials: CM
authors.lastname: O'Leary
mesh_terms: D000328:Adult; D019973:Alcohol-Related Disorders / Q000208:ethnology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000208:ethnology / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D016012:Poisson Distribution; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology; D011256:Pregnancy Outcome; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D014904:Western Australia / Q000453:epidemiology
keywords: Alcohol and pregnancy; cohort study; data linkage; pregnancy outcomes; preterm birth; small for gestational age