title: Prevalence and predictors of alcohol use during pregnancy: findings from international multicentre cohort studies.
abstract: OBJECTIVE
  To compare the prevalence and predictors of alcohol use in multiple cohorts.
  
  
  METHODS
  Cross-cohort comparison of retrospective and prospective studies.
  
  
  METHODS
  Population-based studies in Ireland, the UK, Australia and New Zealand.
  
  
  METHODS
  17,244 women of predominantly Caucasian origin from two Irish retrospective studies (Growing up in Ireland (GUI) and Pregnancy Risk Assessment Monitoring System Ireland (PRAMS Ireland)), and one multicentre prospective international cohort, Screening for Pregnancy Endpoints (SCOPE) study.
  
  
  METHODS
  Prevalence of alcohol use pre-pregnancy and during pregnancy across cohorts. Sociodemographic factors associated with alcohol consumption in each cohort.
  
  
  RESULTS
  Alcohol consumption during pregnancy in Ireland ranged from 20% in GUI to 80% in SCOPE, and from 40% to 80% in Australia, New Zealand and the UK. Levels of exposure also varied substantially among drinkers in each cohort ranging from 70% consuming more than 1-2 units/week in the first trimester in SCOPE Ireland, to 46% and 15% in the retrospective studies. Smoking during pregnancy was the most consistent predictor of gestational alcohol use in all three cohorts, and smokers were 17% more likely to drink during pregnancy in SCOPE, relative risk (RR)=1.17 (95% CI 1.12 to 1.22), 50% more likely to drink during pregnancy in GUI, RR=1.50 (95% CI 1.36 to 1.65), and 42% more likely to drink in PRAMS, RR=1.42 (95% CI 1.18 to 1.70).
  
  
  CONCLUSIONS
  Our data suggest that alcohol use during pregnancy is prevalent and socially pervasive in the UK, Ireland, New Zealand and Australia. New policy and interventions are required to reduce alcohol prevalence both prior to and during pregnancy. Further research on biological markers and conventions for measuring alcohol use in pregnancy is required to improve the validity and reliability of prevalence estimates.
authors.affiliation: National Perinatal Epidemiology Centre, Cork University Maternity Hospital, Wilton, Cork, Ireland Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
authors.forename: Linda M
authors.initials: LM
authors.lastname: O'Keeffe
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, Cork, Ireland.
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Kearney
authors.affiliation: The Irish Centre for Foetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland.
authors.forename: Fergus P
authors.initials: FP
authors.lastname: McCarthy
authors.affiliation: Department of Epidemiology and Public Health, University College Cork, Cork, Ireland The Irish Centre for Foetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland.
authors.forename: Ali S
authors.initials: AS
authors.lastname: Khashan
authors.affiliation: National Perinatal Epidemiology Centre, Cork University Maternity Hospital, Wilton, Cork, Ireland.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Greene
authors.affiliation: Division of Women's Health, Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK.
authors.forename: Robyn A
authors.initials: RA
authors.lastname: North
authors.affiliation: Division of Women's Health, Women's Health Academic Centre, King's College London, and King's Health Partners, London, UK.
authors.forename: Lucilla
authors.initials: L
authors.lastname: Poston
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, South Auckland Clinical School, University of Auckland, Auckland, New Zealand.
authors.forename: Lesley M E
authors.initials: LM
authors.lastname: McCowan
authors.affiliation: National Centre for Growth & Development and Maternal and Fetal Health, Liggins Institute, University of Auckland, Auckland District Health Board and Counties Manukau District Health Board, Auckland, New Zealand.
authors.forename: Philip N
authors.initials: PN
authors.lastname: Baker
authors.affiliation: Women's and Children's Division Lyell McEwin Hospital, University of Adelaide, Adelaide, South Australia.
authors.forename: Gus A
authors.initials: GA
authors.lastname: Dekker
authors.affiliation: St James University Hospital, Leeds, UK.
authors.forename: James J
authors.initials: JJ
authors.lastname: Walker
authors.affiliation: Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Rennae
authors.initials: R
authors.lastname: Taylor
authors.affiliation: The Irish Centre for Foetal and Neonatal Translational Research (INFANT), University College Cork, Cork, Ireland Department of Obstetrics and Gynecology, University College Cork, Cork, Ireland.
authors.forename: Louise C
authors.initials: LC
authors.lastname: Kenny
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D005260:Female; D015438:Health Behavior; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D016014:Linear Models; D009520:New Zealand / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult
keywords: EPIDEMIOLOGY; OBSTETRICS; PUBLIC HEALTH