Drinking in Pregnancy on the Rise, CDC Data Show

Alcohol consumption during pregnancy has been on the rise in recent years, with some groups, like unmarried women and women in frequent distress, more likely to partake, CDC data showed.

Responding to a survey, 15.2% of pregnant women reported drinking in the past 30 days, while 4.9% reported binge drinking, and 2.2% reported heavy drinking, said Nicholas Deputy, PhD, of the CDC’s National Center on Birth Defects and Developmental Disabilities, and colleagues.

Among pregnant women who reported current drinking, 33.2% also reported binge drinking and 14.7% also reported heavy drinking, they noted in the Morbidity and Mortality Weekly Report (MMWR).

“These findings reinforce the importance of integrating behavioral health screening, treatment, and other support into prenatal care,” they wrote.

Alcohol consumption during pregnancy is linked with adverse birth outcomes, like miscarriage and stillbirth, as well as fetal alcohol spectrum disorders. No known level of alcohol consumption is considered safe but higher intensity and frequency are linked to higher risks of these adverse outcomes. The American College of Obstetricians and Gynecologists and the CDC recommend completely abstaining from alcohol during pregnancy.

According to a previous CDC report, 13.5% of pregnant women in the U.S. reported current drinking in 2018-2020. Other research has shown that drinking while pregnant was on the rise for most of the 2010s.

Nikki Zite, MD, MPH, an ob/gyn with the University of Tennessee Graduate School of Medicine in Knoxville, who was not involved with the research, told MedPage Today that this increase in drinking while pregnant is “concerning.”

She noted that public health and provider education has shifted in recent years to combat mis- and disinformation about topics like vaccines, and it’s possible that less time was spent on substance use screening and education.

“Media coverage and public health campaigns that historically focused on the dangers of alcohol use in pregnancy have shifted to recommendations related to other substances — such as opioids or marijuana,” Zite said. “Hopefully this MMWR will remind providers and public health officials that awareness, screening, and support for those that are at increased risk of or already consuming alcohol during pregnancy is still needed despite competing priorities.”

Deputy and colleagues found that some groups were significantly more likely to drink during pregnancy. For instance, unmarried pregnant women had about twice the prevalence of current drinking (adjusted prevalence ratio [aPR] 1.8, 95% CI 1.4-2.2), binge drinking (aPR 2.2, 95% CI 1.3-3.7), and heavy drinking (aPR 2.0, 95% CI 1.1-3.6) compared with married women.

Pregnant women who reported frequent mental distress also had approximately twice the prevalence of current drinking (aPR 1.8, 95% CI 1.4-2.3) and binge drinking (aPR 1.8, 95% CI 1.2-2.6) and three times the prevalence of heavy drinking (aPR 3.0, 95% CI 1.7-5.0) compared with those who didn’t report frequent mental distress.

There were also significant regional differences, which generally aligned with observed drinking trends in the overall U.S. population. For instance, women living in New England had a higher prevalence of current drinking while pregnant (19.9%) versus women living in regions that span the mid-South and Mountain West (10.4% to 12.4%).

“Recommended clinical interventions include routine screening for alcohol consumption and mental health conditions, brief behavioral counseling, and referral to specialized services,” Deputy and team wrote. “Community-level approaches that include providing information about outcomes associated with alcohol consumption during pregnancy or address alcohol consumption among the general population might also help reduce prenatal alcohol exposure and prevent its associated adverse health outcomes.”

For this report, the researchers analyzed 2021-2024 data from the national Behavioral Risk Factor Surveillance System (BRFSS), an annual state-based survey of health behaviors, in order to assess the prevalence of self-reported drinking during pregnancy. Eligible respondents were women ages 18 to 49 who self-reported as pregnant; information on trimester was not collected.

Drinking levels were classified using Dietary Guidelines for Americans and CDC definitions. Current drinking was defined as one or more alcoholic drinks in the past 30 days, binge drinking was defined as four or more drinks on at least one occasion in the past 30 days, and heavy drinking was defined as eight or more drinks in a 1-week period in the past 30 days.

The authors noted a few limitations to their study, including that some respondents may have become pregnant during the 30 days prior to the survey and thus their reported alcohol use may have been prior to pregnancy, not during it. Additionally, self-reported pregnancy status may be incorrect and self-reported drinking may be influenced by social desirability and recall biases. The analysis didn’t include drinking patterns throughout pregnancy since respondents’ trimester information was not known.