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2002 PRAMS Surveillance Report: Multistate Exhibits
Alcohol Use |
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Data Highlights | References | Tables
Background
Alcohol use during pregnancy can produce a range of physical and mental effects in the fetus.1,2 Because the minimum quantity of alcohol required to produce adverse fetal consequences is unknown, the American Academy of Pediatrics (AAP) recommends abstinence from alcohol use for women who are pregnant or planning to become pregnant.3 While binge drinking (5 or more drinks at one time), heavy drinking (5 or more drinks on one occasion on 5 or more days during a 30-day period), and frequent drinking (7 or more drinks per week) place the fetus at greatest risk,4,5 even low levels of alcohol consumption (2 or fewer drinks per week) are associated with negative effects in children.6
Frequent drinking, including binge drinking, is associated with adverse birth and infant health outcomes, including spontaneous abortions, birth defects, growth deficits, and neurodevelopmental disorders.7 The most severe effects, including fetal alcohol syndrome, seem to result from binge and heavy drinking early in pregnancy. Fetal alcohol syndrome, which usually results from alcohol exposure at 3–8 weeks' gestation, includes facial anomalies; reduced growth in weight, length, or head circumference; and mental retardation.8 However, exposure to alcohol can cause damage to the fetus during all stages of prenatal development.1,9
The effects of alcohol consumption on the fetus may occur before a woman is aware she is pregnant. In 1988, only 20% of women knew they were pregnant before their third week of pregnancy, and almost 20% still did not know they were pregnant by their eighth week.8 Because women are likely to report as first trimester alcohol use the amount they used after they knew they were pregnant, reported alcohol use just before pregnancy may measure use in early pregnancy more accurately than reported alcohol use in the first trimester.10
Pregnant women who report any alcohol use, binge drinking, and frequent drinking are more likely to be older than age 30, employed, and unmarried compared with other pregnant women.11 Data from the 2002 National Survey on Drug Use and Health (NSDUH) indicate that 9% of pregnant women reported alcohol use in the month preceding the survey, 3% reported binge drinking, and less than 1% reported heavy drinking.12 A study using 2000–2001 PRAMS data for eight states highlights the variations in prevalence of alcohol use during pregnancy across states. Prevalence of alcohol use during the last 3 months of pregnancy ranged from 3.4% to 9.9%, and was less than 6% in six of eight states. In seven of eight states, prevalence was highest among pregnant women who were at least 35 years old, were non-Hispanic, had more than a high school education, or had higher incomes. In half of the states, prevalence was highest among white women, while use was highest among American Indian women in three states, and black women in one state.13
PRAMS provides data on weekly alcohol consumption and binge drinking 3 months before pregnancy and during the last 3 months of pregnancy. States can use PRAMS data to monitor alcohol use during early and late pregnancy and to develop and target programs for women most at risk for alcohol use during pregnancy. PRAMS data can also be used to assess the progress made toward achieving the Healthy People 2010 objective (Objective 16–17a) of increasing reported abstinence from alcohol by pregnant women from 86% (1996–1997) to 94%.14
Data Highlights
- In 2002, the prevalence of alcohol use in the 3 months before pregnancy ranged from 21.4% (Utah) to 65.2% (North Dakota).
- During 2000–2002, the prevalence of alcohol use in the 3 months before pregnancy decreased in 1 state (Washington).
- In 2002, the prevalence of alcohol use in the last 3 months of pregnancy ranged from 2.0% (West Virginia) to 11.6% (Vermont).
- During 2000–2002, the prevalence of alcohol use in the last 3 months of pregnancy decreased in 1 state (Oklahoma).
Reference
- Centers for Disease Control and Prevention National Center for Birth Defects and Developmental Disabilities (Web site). Fetal Alcohol Syndrome Fact Sheets: Alcohol Use and Pregnancy. March 2005. Available at http://www.cdc.gov/ncbddd/factsheets/FAS_alcoholuse.pdf.
- Coles CD. Impact of prenatal alcohol exposure on the newborn and the child. Clinical Obstetrics and Gynecology 1993;36(2):255–266.
- American Academy of Pediatrics Committee on Substance Abuse and Committee on Children with Disabilities. Fetal alcohol syndrome and alcohol-related neurodevelopmental disorders. Pediatrics 2000;106(2 Pt 1):358–361.
- U.S. Department of Health and Human Services (HHS). News Release: U.S. Surgeon General Releases Advisory on Alcohol Use in Pregnancy. Washington, DC: HHS; 2005.
- Jacobson JL, Jacobson SW, Sokol RJ, Ager JW Jr. Relation of maternal age and pattern of pregnancy drinking to functionally significant cognitive deficit in infancy. Alcoholism, Clinical and Experimental Research 1998;22(2):345–351.
- Sood B, Delaney-Black V, Covington C, Nordstrom-Klee B, Ager J, Templin T, et al. Prenatal alcohol exposure and childhood behavior at age 6 to 7 years: I. dose-response effect. Pediatrics 2001;108(2):E34.
- Floyd RL, Ebrahim SH, Boyle CA, Gould DW. Observations from the CDC. Preventing alcohol-exposed pregnancies among women of childbearing age: the necessity of a preconceptional approach. Journal of Women's Health and Gender-Based Medicine 1999;8(6):733–736.
- Floyd RL, Decoufle P, Hungerford DW. Alcohol use prior to pregnancy recognition. American Journal of Preventive Medicine 1999;17(2):101–107.
- Jacobson SW. Assessing the impact of maternal drinking during and after pregnancy. Alcohol Health and Research World 1997;21(3):199–203.
- Day NL, Cottreau CM, Richardson GA. The epidemiology of alcohol, marijuana, and cocaine use among women of childbearing age and pregnant women. Clinical Obstetrics and Gynecology 1993;36(2):232–245.
- Sidhu JS, Floyd RL. Alcohol use among women of childbearing age—United States, 1991–1999. MMWR 2002;51(13):273–276.
- Substance Abuse and Mental Health Services Administration (SAMHSA). Results from the 2002 National Survey on Drug Use and Health: National Findings. Rockville, MD: Office of Applied Studies; 2003. NHSDA Series H-22, HHS Publication Number SMA 03–3836.
- Phares TM, Morrow B, Lansky A, Barfield WD, Prince CB, Marchi KS, et al. Surveillance for disparities in maternal health-related behaviors—selected states, Pregnancy Risk Assessment Monitoring System (PRAMS), 2000–2001. MMWR Surveillance Summaries 2004;53(SS-4):1–13.
- U.S. Department of Health and Human Services. Healthy People 2010: Understanding and Improving Health. 2nd Edition. Washington, DC: U.S. Government Printing Office; 2000.
Prevalence of Drinking Alcohol During the 3 Months Before Pregnancy, 2002
| State |
Respondents |
Percent† |
Standard Error |
95% CI‡ |
| Alabama |
1,525 |
38.7 |
1.6 |
35.7–41.8 |
| Alaska |
1,552 |
50.2 |
1.5 |
47.3–53.0 |
| Arkansas |
1,891 |
42.8 |
1.6 |
39.8–45.9 |
| Colorado |
2,234 |
54.2 |
1.4 |
51.5–56.9 |
| Florida |
1,971 |
40.3 |
1.7 |
37.1–43.6 |
| Hawaii |
1,767 |
40.3 |
1.4 |
37.6–43.1 |
| Illinois |
1,883 |
47.5 |
1.2 |
45.1–50.0 |
| Louisiana |
1,627 |
41.7 |
1.4 |
39.0–44.4 |
| Maine |
1,106 |
61.9 |
1.7 |
58.6–65.1 |
| Maryland |
1,437 |
51.8 |
2.0 |
47.9–55.7 |
| Michigan |
1,500 |
56.9 |
1.5 |
54.0–59.8 |
| Minnesotaa |
1,110 |
62.2 |
1.8 |
58.6–65.7 |
| Montana |
1,002 |
64.9 |
1.5 |
61.8–67.9 |
| Nebraska |
1,848 |
57.9 |
1.3 |
55.3–60.4 |
| New Jerseyb |
927 |
46.1 |
1.8 |
42.5–49.7 |
| New Mexico |
1,517 |
45.9 |
1.3 |
43.3–48.5 |
| New Yorkc |
1,195 |
53.7 |
1.8 |
50.0–57.3 |
| North Carolina |
1,519 |
37.0 |
1.5 |
34.1–40.1 |
| North Dakota |
875 |
65.2 |
1.6 |
62.0–68.2 |
| Ohio |
1,330 |
57.4 |
1.7 |
54.0–60.8 |
| Oklahoma |
1,821 |
44.4 |
1.8 |
40.8–48.0 |
| Rhode Island |
1,385 |
53.1 |
1.5 |
50.1–56.1 |
| South Carolina |
1,369 |
41.7 |
2.2 |
37.6–46.0 |
| Utah |
1,556 |
21.4 |
1.4 |
18.8–24.2 |
| Vermont |
1,086 |
64.9 |
1.4 |
62.0–67.6 |
| Washington |
1,498 |
47.9 |
1.8 |
44.3–51.4 |
| West Virginia |
1,629 |
37.0 |
1.7 |
33.7–40.4 |
| All PRAMS states§ |
40,160 |
47.5 |
0.4 |
46.7–48.3 |
† 2002 state range is 21.4–65.2%.
‡ Confidence interval.
§ Aggregate of the 27 PRAMS states.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City. |
Prevalence of Drinking Alcohol During the 3 Months Before Pregnancy, 2002
Prevalence of Drinking Alcohol During the 3 Months Before Pregnancy, 2000–2002
| State |
2000
(%) |
2001
(%) |
2002
(%) |
P value
for trend# |
| Alabama |
37.5 |
37.5 |
38.7 |
0.576 |
| Alaska |
54.1 |
55.3 |
50.2 |
0.064 |
| Arkansas |
38.4 |
42.3 |
42.8 |
0.063 |
| Colorado |
56.2 |
55.1 |
54.2 |
0.319 |
| Florida |
39.0 |
45.5 |
40.3 |
0.595 |
| Hawaii |
41.6 |
42.1 |
40.3 |
0.477 |
| Illinois |
47.8 |
45.4 |
47.5 |
0.847 |
| Louisiana |
43.0 |
41.1 |
41.7 |
0.456 |
| Maine |
60.1 |
57.9 |
61.9 |
0.465 |
| Maryland |
— |
51.5d |
51.8 |
# # |
| Michigan |
— |
56.3e |
56.9 |
# # |
| Minnesota |
— |
— |
62.2a |
# # |
| Montana |
— |
— |
64.9 |
# # |
| Nebraska |
56.5 |
57.3 |
57.9 |
0.463 |
| New Jersey |
— |
— |
46.1b |
# # |
| New Mexico |
46.2 |
48.0 |
45.9 |
0.868 |
| New Yorkc |
54.3 |
54.8 |
53.7 |
0.824 |
| North Carolina |
39.6 |
37.7 |
37.0 |
0.225 |
| North Dakota |
— |
— |
65.2 |
# # |
| Ohio |
53.7 |
54.0 |
57.4 |
0.125 |
| Oklahoma |
43.9 |
45.7 |
44.4 |
0.852 |
| Rhode Island |
— |
— |
53.1 |
# # |
| South Carolina |
38.9 |
34.6 |
41.7 |
0.347 |
| Utah |
22.8 |
22.6 |
21.4 |
0.465 |
| Vermont |
—f |
64.1f |
64.9 |
# # |
| Washington |
53.5 |
52.5 |
47.9 |
0.024* |
| West Virginia |
38.0 |
36.7 |
37.0 |
0.661 |
# Based on a test for linear trend using logistic regression.
* p value is less than 0.05.
# # < 3 years of data available; test for linear trend not applicable.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City.
d Data represent Maryland births from February–December 2001.
e Data represent Michigan births from July–December 2001.
f Data represent Vermont births from October 2000–December 2001. |
Prevalence of Drinking Alcohol During the Last 3 Months of Pregnancy, 2002
| State |
Respondents |
Percent† |
Standard Error |
95% CI‡ |
| Alabama |
1,543 |
3.1 |
0.5 |
2.2–4.4 |
| Alaska |
1,594 |
4.3 |
0.6 |
3.3–5.7 |
| Arkansas |
1,936 |
5.2 |
0.7 |
3.9–6.8 |
| Colorado |
2,247 |
9.5 |
0.8 |
8.0–11.2 |
| Florida |
1,984 |
5.8 |
0.9 |
4.4–7.8 |
| Hawaii |
1,788 |
3.6 |
0.5 |
2.7–4.7 |
| Illinois |
1,895 |
6.0 |
0.6 |
4.9–7.2 |
| Louisiana |
1,652 |
4.8 |
0.6 |
3.7–6.1 |
| Maine |
1,124 |
4.9 |
0.7 |
3.7–6.5 |
| Maryland |
1,448 |
6.6 |
0.9 |
5.0–8.5 |
| Michigan |
1,514 |
4.4 |
0.6 |
3.3–5.7 |
| Minnesotaa |
1,124 |
5.6 |
0.9 |
4.1–7.5 |
| Montana |
1,025 |
6.8 |
0.8 |
5.4–8.6 |
| Nebraska |
1,865 |
4.3 |
0.6 |
3.3–5.6 |
| New Jerseyb |
937 |
8.5 |
1.1 |
6.6–10.9 |
| New Mexico |
1,529 |
4.4 |
0.6 |
3.4–5.6 |
| New Yorkc |
1,211 |
8.2 |
1.0 |
6.5–10.3 |
| North Carolina |
1,530 |
5.5 |
0.7 |
4.3–7.1 |
| North Dakota |
892 |
3.6 |
0.6 |
2.6–5.1 |
| Ohio |
1,348 |
5.1 |
0.8 |
3.8–6.9 |
| Oklahoma |
1,849 |
2.2 |
0.5 |
1.4–3.5 |
| Rhode Island |
1,408 |
6.2 |
0.8 |
4.9–7.9 |
| South Carolina |
1,382 |
3.8 |
0.8 |
2.5–5.8 |
| Utah |
1,564 |
3.0 |
0.6 |
2.1–4.4 |
| Vermont |
1,096 |
11.6 |
0.9 |
9.8–13.5 |
| Washington |
1,512 |
5.5 |
0.9 |
4.0–7.4 |
| West Virginia |
1,672 |
2.0 |
0.5 |
1.3–3.1 |
| All PRAMS states§ |
40,669 |
5.6 |
0.2 |
5.2–6.0 |
† 2002 state range is 2.0–11.6%.
‡ Confidence interval.
§ Aggregate of the 27 PRAMS states.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City. |
Prevalence of Drinking Alcohol During the Last 3 Months of Pregnancy, 2002
Healthy People 2010 Objective 16–17a
Increase abstinence from alcohol among pregnant women to at least 94%. |
Prevalence of Drinking Alcohol During the Last 3 Months of Pregnancy, 2000–2002
| State |
2000
(%) |
2001
(%) |
2002
(%) |
P value
for trend# |
| Alabama |
2.7 |
4.6 |
3.1 |
0.518 |
| Alaska |
5.3 |
5.1 |
4.3 |
0.299 |
| Arkansas |
3.8 |
4.8 |
5.2 |
0.213 |
| Colorado |
9.0 |
10.6 |
9.5 |
0.694 |
| Florida |
4.7 |
4.6 |
5.8 |
0.323 |
| Hawaii |
4.8 |
4.5 |
3.6 |
0.089 |
| Illinois |
6.9 |
5.4 |
6.0 |
0.249 |
| Louisiana |
4.7 |
5.0 |
4.8 |
0.954 |
| Maine |
5.1 |
6.3 |
4.9 |
0.811 |
| Maryland |
— |
8.1d |
6.6 |
# # |
| Michigan |
— |
4.6e |
4.4 |
# # |
| Minnesota |
— |
— |
5.6a |
# # |
| Montana |
— |
— |
6.8 |
# # |
| Nebraska |
3.2 |
3.5 |
4.3 |
0.132 |
| New Jersey |
— |
— |
8.5b |
# # |
| New Mexico |
5.1 |
4.3 |
4.4 |
0.372 |
| New Yorkc |
6.5 |
6.7 |
8.2 |
0.194 |
| North Carolina |
5.0 |
4.5 |
5.5 |
0.592 |
| North Dakota |
— |
— |
3.6 |
# # |
| Ohio |
4.7 |
5.9 |
5.1 |
0.705 |
| Oklahoma |
3.9 |
2.9 |
2.2 |
0.044* |
| Rhode Island |
— |
— |
6.2 |
# # |
| South Carolina |
3.2 |
4.5 |
3.8 |
0.543 |
| Utah |
3.6 |
3.1 |
3.0 |
0.494 |
| Vermont |
—f |
10.9f |
11.6 |
# # |
| Washington |
6.0 |
7.1 |
5.5 |
0.663 |
| West Virginia |
2.1 |
2.0 |
2.0 |
0.900 |
# Based on a test for linear trend using logistic regression.
* p value is less than 0.05.
# # < 3 years of data available; test for linear trend not applicable.
a Data represent Minnesota births from May–December 2002.
b Data represent New Jersey births from July–December 2002.
c Data exclude New York City.
d Data represent Maryland births from February–December 2001.
e Data represent Michigan births from July–December 2001.
f Data represent Vermont births from October 2000–December 2001. |
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Page last reviewed: 5/13/09
Page last modified: 8/23/06
Content source: Division
of Reproductive Health,
National Center for Chronic Disease
Prevention and Health Promotion |
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