National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2026, Australia.
Alcohol Clin Exp Res. 2011 Jul;35(7):1230-7. doi: 10.1111/j.1530-0277.2011.01457.x. Epub 2011 Apr 4.
To date, no studies have used population-level data to investigate whether maternal location of residence (metropolitan vs. regional/remote populations) is associated with alcohol use in pregnancy. This information has important implications for appropriate service provision.
Information on all live births in New South Wales, Australia, was linked to records of alcohol-related admissions for mothers of these births over a 6-year period (2000 to 2006). Cases were women who had at least 1 alcohol-related hospital admission during pregnancy or at birth. Controls were women who had at least 1 live birth over that same time period but no alcohol-related hospital admissions during that time. Admissions were considered to be alcohol-related based on the International Statistical Classification of Diseases and Related Health Problems, 10th Revision, Australian Modification (ICD-10-AM) code. Demographic, obstetric, and neonatal variables were compared.
A total of 417,464 singleton birth records were analyzed, 488 of which were coded positive for at least 1 alcohol-related ICD-10-AM diagnosis. Characteristics associated with alcohol-related admissions in pregnancy were residence in a remote/very remote area, being Australian-born, having had a previous pregnancy, smoking in the current pregnancy, and presenting late to antenatal care. Alcohol-exposed pregnancies were associated with a range of poor obstetric and neonatal outcomes, with no geographic differences noted. However, women in regional/remote areas were less likely to attend specialist obstetric hospitals.
This study shows the need for standardized screening programs for alcohol use in pregnancy and where problematic use is detected, for clear clinical guidelines on management and referral.
迄今为止，尚无研究利用人群水平数据调查产妇居住地（城市与地区/偏远地区）与孕期饮酒之间的关系。这一信息对于提供适当的服务具有重要意义。
将澳大利亚新南威尔士州的所有活产信息与母亲在 6 年期间（2000 年至 2006 年）因酒精相关问题住院的记录相链接。病例组为至少有 1 次孕期或分娩时因酒精相关问题住院的女性；对照组为同期至少有 1 次活产但无酒精相关住院的女性。基于国际疾病分类和相关健康问题第十次修订版（澳大利亚修订版）（ICD-10-AM）编码，将住院归因于酒精相关问题。比较了人口统计学、产科和新生儿变量。
共分析了 417464 例单胎分娩记录，其中 488 例被编码为至少有 1 次酒精相关 ICD-10-AM 诊断。与孕期酒精相关住院相关的特征包括居住在偏远/非常偏远地区、澳大利亚出生、曾有过妊娠、当前妊娠时吸烟以及晚期接受产前保健。暴露于酒精的妊娠与一系列不良产科和新生儿结局相关，但未发现地理差异。然而，地区/偏远地区的女性较少到专科产科医院就诊。
本研究表明需要针对孕期饮酒开展标准化筛查项目，一旦发现有问题的饮酒行为，应制定明确的管理和转诊临床指南。
