Alcohol use before and during unwanted pregnancy.
Alcohol use before and during unwanted pregnancy.
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DOI：
10.1111/acer.12544
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发表时间：
2014-11
期刊：
影响因子：
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通讯作者：
Delucchi KL
中科院分区：
文献类型：
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作者：
Roberts SC;Wilsnack SC;Foster DG;Delucchi KL
关于与怀孕有关的酒精使用变化以及导致意外怀孕女性变化的因素的信息很少。这项研究描述了从怀孕前到怀孕期间酒精使用的变化，并确定了意外怀孕妇女酒精使用严重程度的重要预测因素。数据来自Turnaway的研究，该研究对2008年至2010年期间在美国30家机构寻求终止妊娠的956名女性进行了调查，其中一些人被拒绝接受治疗，因为她们超过了招募机构的妊娠限制，在寻求终止妊娠一周后的基线访谈中仍处于怀孕状态。确定了酒精使用严重程度的预测因素(一个潜在变量)。总样本中56%的人报告在怀孕确认前一个月曾饮酒，23%的人报告一次饮酒六次或更多。在总样本中，35%的怀孕前饮酒的人已经戒烟，20%的人在寻求终止妊娠一周后戒酒。在那些拒绝堕胎并仍在怀孕的人中，71%的人已经戒烟，14%的人已经减少。在一个预测酒精严重程度的多变量模型中，年龄较小、仍然怀孕、一次或多次以前出生、怀孕较晚、童年遭受身体虐待以及使用大麻和其他药物与较低的严重程度相关；已完成大学学业、吸烟和最近的身体暴力与较高的严重程度相关。怀孕认定前总样本饮酒比例与全国育龄妇女样本相似，而酗酒比例则显得更高。在被拒绝堕胎的仍在怀孕的妇女中，戒烟的比例与其他怀孕妇女群体相似。需要更多的研究来检验孕妇是否正在用酒精取代大麻和其他药物。关注怀孕期间酒精使用严重程度的干预措施可能也需要关注烟草。
There is little information about pregnancy-related changes in alcohol use and factors contributing to changes among women with unwanted pregnancies. This study describes changes in alcohol use from before pregnancy recognition to during pregnancy and identifies important predictors of alcohol use severity among women with unwanted pregnancies. Data are from the Turnaway Study of 956 women seeking pregnancy termination at 30 U.S. facilities between 2008 and 2010, some of whom were denied care because they were past the gestational limit of the facility where they were recruited and were still pregnant at the baseline interview, one week after termination-seeking. Predictors of alcohol use severity (a latent variable) were identified. 56% of the total sample reported any alcohol use the month before pregnancy recognition, with 23% reporting six or more drinks on an occasion. Among the total sample, 35% of those drinking before pregnancy recognition had quit and 20% had reduced one week after termination seeking. Among those denied terminations and still pregnant, 71% had quit and 14% had reduced. In a multivariate model predicting alcohol severity, younger age, still pregnant, one or more previous births, later gestation, childhood physical abuse, and marijuana and other drug use were associated with lower severity; having completed college, tobacco use, and recent physical violence were associated with higher severity. The proportion of the total sample drinking before pregnancy recognition is similar to national samples of women of childbearing age while the proportion binge drinking appears higher. Of women denied terminations who were still pregnant, the proportion having quit is similar to other populations of pregnant women. More research is needed to examine whether pregnant women may be substituting alcohol for marijuana and other drugs. Interventions focusing on alcohol use severity during pregnancy may need to also focus on tobacco.