Drinking During Pregnancy, 2021–2024: About One in Seven Pregnant Women Reported Alcohol in the Past Month

Drinking alcohol during pregnancy can cause miscarriage, stillbirth and other poor birth outcomes, as well as fetal alcohol spectrum disorders — a group of lifelong behavioral, intellectual and physical conditions. No amount of alcohol during pregnancy is known to be safe, and the more often and more heavily someone drinks, the higher the risk.

One study found a slight upward trend in drinking and binge drinking in pregnancy from 2011 to 2018, though not a steady one; another found 13.5% of pregnant women drank and 5.2% binge drank during 2018–2020. To bring the numbers up to date, CDC analyzed the Behavioral Risk Factor Surveillance System (BRFSS) — a yearly state-based telephone survey of adults — for 2021–2024.

Definitions

Women whose sex at birth was female were asked whether they were currently pregnant (not which trimester). Over the past 30 days:

The first two follow the 2020–2025 Dietary Guidelines for Americans; heavy drinking follows CDC's definition. Data from all 50 states and the District of Columbia were pooled, covering 8,546 to 8,579 pregnant women aged 18–49, depending on the measure.

How many drank

Current drinking in the past 30 days among pregnant women aged 18–49, by U.S. Department of Health and Human Services region, BRFSS 2021–2024 (8,579 women). CDC

• Of those who drank, 33.2% also binge drank and 14.7% also drank heavily.
• The rates didn't differ significantly from year to year.
• The 2021–2024 figure, 15.2%, appears higher than the 13.5% of 2018–2020.

Who drank more

By region, current drinking was significantly higher in HHS Region 1 (19.9%) than in Region 6 (10.4%), Region 7 (11.8%) and Region 8 (12.4%) — broadly the same pattern as drinking in the general U.S. population.

Why these groups?

• Studies suggest some people drink to cope with stress and bad feelings — though alcohol can itself alter or worsen the body's stress pathways.
• Marriage and living with a partner have been linked to less substance use, perhaps partly through social support, though relationship quality and other things matter too.

What could help

In the clinic

• Routine screening for alcohol use and for mental health conditions in prenatal care, with brief counseling and referral to specialized services.
• The U.S. Preventive Services Task Force (2018) recommends screening adults for unhealthy alcohol use, including in pregnancy, and brief counseling.
• The American College of Obstetricians and Gynecologists recommends screening every pregnant woman for anxiety and depression, with systems in place to get people the services they need.

In the community

• Point-of-sale signs about the harms of drinking in pregnancy.
• Sales taxes on alcoholic drinks, which reach the whole population.
• Interventions tailored to local context and cultural norms, given the regional differences.

Limits

• Women pregnant for less than 30 days may have reported drinking from before they knew — which could overstate drinking, since women tend to cut down on learning they're pregnant.
• Self-reports may understate drinking, and the survey questions miss some patterns, so heavy drinking may be undercounted.
• Very early pregnancies may go unrecognized and unreported.
• The data are cross-sectional, so which came first — distress or drinking — is unknown.
• Without trimester data, patterns through pregnancy couldn't be studied.

Sources

Based on Thomas SA, Gosdin LK, Terplan M, Kim SY, Deputy NP, "Alcohol Consumption During Pregnancy Among Women Aged 18–49 Years — United States, 2021–2024," MMWR volume 75, number 22, Centers for Disease Control and Prevention; a work of the United States government in the public domain.