Alcohol and pregnancy: benefits and harms of state-level policies

酒精和怀孕：国家政策的好处和坏处

• 批准号: 10394945
• 负责人: Sarah C.M. Roberts
• 金额: $ 60.18万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-05-15 至 2026-02-28
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10394945
• 关键词: Address; Admission activity; Adopted; Advocacy; Affect; Age; Alcohol consumption; Alcohols; Attention; Birth; Characteristics; Child; Child Abuse and Neglect; Clinical; Data; Data Analyses; Data Set; Data Sources; Disease; Economics; Ensure; Epidemiologic Methods; Epidemiology; Ethnic Origin; Fetal Alcohol Spectrum Disorder; Fetal Alcohol Syndrome; Fetus; General Population; Government; Gynecologist; Health Professional; Hour; Individual; Infrastructure; Laws; Lead; Legal; Low Birth Weight Infant; Marijuana; Maternal and Child Health; Methodological Studies; Minor; Morbidity - disease rate; National Institute on Alcohol Abuse and Alcoholism; Outcome; Pharmaceutical Preparations; Phase; Policies; Policy Research; Population; Population Policies; Pregnancy; Pregnant Women; Premature Birth; Prenatal care; Prevention; Price; Professional Education; Public Health; Public Policy; Race; Reporting; Research; Socioeconomic Status; Substance Use Disorder; Surveys; Taxes; Teratogens; Time; Translating; Woman; adverse birth outcomes; alcohol availability; alcohol policy information system; base; behavioral outcome; binge drinking; drinking; drinking behavior; insurance claims; maternal alcohol use; phase 1 study; public health priorities; public health relevance; public policy on alcohol; reproductive; response

Abstract This project takes a successful and productive R01 – the Drug-Alcohol Pregnancy Policy Study (D-APPS) Phase 1 – to the next phase and further examines impacts of state pregnancy-specific alcohol policies and expands focus to identify general population alcohol policies that reduce harms related to alcohol use during pregnancy. Alcohol is a known teratogen that causes fetal alcohol syndrome and a range of other harms to fetuses. Alcohol use during pregnancy is common, with 15% of pregnant women reporting any alcohol use and 3% of pregnant women reporting binge drinking in the past month. Despite considerable governmental and clinical attention to alcohol use during pregnancy, alcohol use during pregnancy has remained common and essentially stable for decades in the U.S. Thus, assessing which existing pregnancy-specific and general population alcohol policies influence harm from alcohol use during pregnancy is imperative. Since the 1970s, almost all states have enacted one or more policies related to alcohol use during pregnancy. States continue to enact pregnancy-specific alcohol policies. D-APPS Phase 1 found that most pregnancy-specific alcohol policies lead to increases in low birthweight and preterm birth and decreases in prenatal care, which results in thousands of babies born low birthweight or preterm each year. Findings indicate that while alcohol use during pregnancy causes public health harms, so do the policies adopted in response. Before abandoning pregnancy- specific alcohol policies, research is needed to see if there are any positive impacts on more severe outcomes related to alcohol use during pregnancy, such as child morbidities and child maltreatment. Additional research is also needed to identify other possible policies that might reduce harms from drinking during pregnancy. General population alcohol policies that address price and availability of alcohol and criminalization of drinking behavior could also reduce harm related to drinking during pregnancy, but this has not yet been studied comprehensively. In this project, we assess whether existing pregnancy-specific alcohol policies affect other outcomes related to drinking during pregnancy and identify general population alcohol policies that reduce harms related to drinking during pregnancy. We examine whether effects differ by race/ethnicity and socioeconomic status as well as by the other policies in effect at the time. This study uses insurance claims and Treatment Episode Dataset-Admissions data from the 1990s-present, Natality Birth Data and National Alcohol Survey Data from the 1970s-present, NIAAA's Alcohol Policy Information System, and other policy data sources. We will use both epidemiologic and economics-based data analysis approaches to allow for causal interpretation of findings. Findings will inform ongoing policy debates, advocacy and professional education efforts by maternal and child health professionals and obstetricians and gynecologists, and inform policy approaches to reduce harms from drinking during pregnancy.

摘要 该项目采取了成功和富有成效的R 01-药物酒精怀孕政策研究（D-APPS） 阶段1 -到下一阶段，并进一步审查国家怀孕的具体酒精政策的影响， 扩大重点，以确定一般人群的酒精政策，减少与酒精使用有关的危害， 怀孕酒精是一种已知的致畸剂，会导致胎儿酒精综合症和一系列其他危害， 胎儿怀孕期间饮酒很常见，15%的孕妇报告饮酒， 3%的孕妇报告在过去一个月里酗酒。尽管政府和 临床关注怀孕期间饮酒，怀孕期间饮酒仍然很常见， 因此，评估现有的妊娠特异性和一般性 人口酒精政策影响怀孕期间饮酒的危害是必要的。自20世纪70年代以来， 几乎所有州都颁布了一项或多项与怀孕期间饮酒有关的政策。国家继续 制定针对孕妇的酒精政策D-APPS第1阶段发现，大多数妊娠专用酒精 政策导致低出生体重和早产增加，产前护理减少， 每年有数千名婴儿出生时体重不足或早产。研究结果表明，虽然饮酒期间 怀孕对公众健康造成危害，因此采取的应对政策也是如此。在放弃怀孕之前- 具体的酒精政策，需要研究，看看是否有任何积极的影响，更严重的结果 与怀孕期间饮酒有关的问题，如儿童发病率和虐待儿童。额外的研究 还需要确定其他可能减少怀孕期间饮酒危害的政策。 针对一般人群的酒精政策，解决酒精的价格和供应以及饮酒的刑事定罪问题 行为也可以减少怀孕期间饮酒的危害，但这还没有被研究过。 全面地在这个项目中，我们评估现有的怀孕特定的酒精政策是否影响其他 与怀孕期间饮酒有关的结果，并确定一般人群的酒精政策， 怀孕期间饮酒的危害。我们检查了影响是否因种族/民族而异， 社会经济地位以及当时的其他政策。这项研究使用保险索赔 和治疗事件数据集-从20世纪90年代至今的入院数据，出生率出生数据和国家 20世纪70年代至今的酒精调查数据，NIAAA的酒精政策信息系统和其他政策 数据源我们将使用流行病学和基于经济学的数据分析方法， 结果的因果解释。调查结果将为正在进行的政策辩论、宣传和专业工作提供信息。 妇幼保健专业人员、产科医生和妇科医生的教育工作，并提供信息 减少怀孕期间饮酒危害的政策方法。