Alcohol-exposed pregnancy: Characteristics associated with risk

Background: Prenatal alcohol exposure is a leading cause of neurodevelopmental deficits in children. Women who are fertile, drink alcohol, and have unprotected intercourse are at risk for an alcohol-exposed pregnancy, but little is known about this population. Methods: A survey was administered to 2672 English-speaking women aged 18 to 44 years from six settings, including an urban jail, a drug/alcohol treatment facility, a gynecology clinic, two primary care clinics, and respondents to a media solicitation. Bivariate and multivariate analyses were conducted to explore variables that were correlated with membership in the at-risk group. Results: Most respondents (70%) reported a household income of <$20,000; 68% had a high school or equivalent education; and 62% were African American. A total of 333 women (12.5%) met the a priori definition of "at risk" for an alcohol-exposed pregnancy. Stepwise logistic regression showed that recent drug use (odds ratio [OR]=3.1; 95% confidence interval [CI]=2.1-4.4); having smoked more than 100 cigarettes (OR=1.9, 95% CI=1.3-2.7); a history of inpatient treatment for drugs or alcohol (OR=1.8, 95% CI=1.3-2.4) or inpatient mental health treatment (OR=1.6, 95% CI=1.1-2.3); having multiple sex partners (OR=1.7, 95% CI=1.2-2.2); and recent physical abuse (OR=1.5, 95% CI=1.1-2.0) were significantly correlated with being at risk. Conclusions: It was possible to identify diverse settings with an increased prevalence of women at risk for an alcohol-exposed pregnancy. Within these settings, women at risk were characterized by an increased frequency of selected behaviors. This information may help clinicians develop and target interventions prior to conception.