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Alcohol during pregnancy can cause miscarriage, stillbirth and fetal alcohol spectrum disorders, including birth defects, behavioral disorders and impaired cognitive development. There is no known safe level. Yet in national survey data from 2015–2018, 19.6% of pregnant women and girls in their first trimester said they had drunk alcohol in the past 30 days — and many who drank were using other substances too.
The numbers
CDC analyzed the National Survey on Drug Use and Health, a household survey of the civilian, noninstitutionalized population aged 12 and older. Of 99,618 female respondents aged 12–44, 3,006 (3%) were pregnant.
| Pregnant respondents | First trimester | Second or third trimester | All |
|---|---|---|---|
| Drank in the past 12 months | 64.7% | ||
| Drank in the past 30 days ("current drinking") | 19.6% | 4.7% | 9.8% |
| Binge drank in the past 30 days (4+ drinks at once) | 10.5% | 1.4% | 4.5% |
About half of the pregnant women who drank in the past month also binge drank. Much lower drinking later in pregnancy suggests that some who drank before pregnancy stopped once they knew they were pregnant.
Alcohol plus other substances
- Current drinkers: 38.2% also reported current use of at least one other substance — tobacco and marijuana most often.
- Past-year drinkers: 41.7% also used at least one other substance in the past year, most commonly tobacco (30.3%), marijuana (21.9%) and opioids (7.0%).
- All pregnant respondents: 19.6% reported past-year drinking plus tobacco use, 14.2% drinking plus marijuana, and 4.5% drinking plus opioids; 2.7% reported current drinking plus tobacco and 2.0% current drinking plus marijuana.
Evidence is sparse, but combining alcohol with other substances could make outcomes worse. Prenatal tobacco exposure has been linked to preterm birth, sudden infant death syndrome and preterm-related death; tobacco and marijuana to low birth weight and altered fetal brain development; and exposure to marijuana, nicotine, cocaine, methamphetamine, opioids or combinations to long-term effects on cognition and brain connectivity.
What should happen
The U.S. Preventive Services Task Force recommends alcohol screening and brief counseling for all adults in primary care. The American College of Obstetricians and Gynecologists recommends screening every patient in obstetric-gynecologic care for alcohol use and substance use disorders, and counseling that no amount of alcohol is known to be safe in pregnancy. Its guidance doesn't address using several substances at once, but these findings suggest screening, intervention and referral to treatment for polysubstance use could improve the health of mothers and children.
Limits
The data are self-reported, and stigma and legal concerns may lead to underreporting. The survey captures only the past 12 months and 30 days, not whole pregnancies, so use over a full pregnancy is likely higher. Some estimates were suppressed for small samples, and some pregnancies may not yet have been recognized, which would lead to underestimates.
Sources
Based on Lucinda J. England, Carolyne Bennett, Clark H. Denny, et al., "Alcohol Use and Co-Use of Other Substances Among Pregnant Females Aged 12–44 Years — United States, 2015–2018," Morbidity and Mortality Weekly Report, volume 69, Centers for Disease Control and Prevention; a work of the United States government in the public domain. CDC later published an erratum to the report.
Licenza: CC0 1.0 (pubblico dominio) · Tratto da www.cdc.gov
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