Liu Weiwei, Mumford Elizabeth A, Petras Hanno
NORC at the University of Chicago, 4350 East-West Highway, Suite 800, Bethesda, MD, 20814, USA.
American Institutes for Research, Washington, DC, USA.
Matern Child Health J. 2016 Feb;20(2):376-85. doi: 10.1007/s10995-015-1836-5.
Despite potential health risks for women and children, one in five women report alcohol use during pregnancy and a significant proportion of those who quit during pregnancy return to drinking post-delivery. This study seeks to understand the longitudinal patterns of alcohol consumption before, during pregnancy and post-delivery, and the role of maternal characteristics for purposes of informing prevention design.
General growth mixture models were used to describe the average developmental patterns of maternal weekly drinking quantity at six time points, from preconception through child entering kindergarten, as well as heterogeneity in these patterns among 9100 mothers from the Early Childhood Longitudinal Study representing the 2001 US national birth cohort.
Four distinct classes of mothers were defined by their longitudinal alcohol consumption patterns: Low Probability Drinkers (50.3 %), Escalating Risk Drinkers (12.0 %), Escalating Low Risk Drinkers (27.4 %), and Early Parenting Quitters (10.2 %). Heterogeneous covariate associations were observed. For example, mothers who gave birth after age 36 were twice as likely to be Escalating Risk Drinkers and Escalating Low Risk Drinkers (vs Low Probability Drinkers), but not more likely to be Early Parenting Quitters, when compared to mothers who gave birth between the ages of 26 and 35.
There is significant heterogeneity in maternal longitudinal alcohol use patterns during the perinatal period. Baseline maternal characteristics and behavior associated with these heterogeneous patterns provide valuable tools to identify potential risky drinkers during this critical time period and may be synthesized to tailor pre- and postnatal clinical counseling protocols.
尽管饮酒对妇女和儿童存在潜在健康风险，但仍有五分之一的女性报告在孕期饮酒，而且很大一部分在孕期戒酒的女性在产后又恢复了饮酒。本研究旨在了解孕前、孕期和产后酒精消费的纵向模式，以及母亲特征在预防设计中的作用。
使用一般生长混合模型来描述从孕前到孩子进入幼儿园这六个时间点母亲每周饮酒量的平均发展模式，以及来自代表2001年美国全国出生队列的儿童早期纵向研究的9100名母亲在这些模式上的异质性。
根据母亲的纵向饮酒模式定义了四类不同的母亲：低概率饮酒者（50.3%）、风险递增饮酒者（12.0%）、低风险递增饮酒者（27.4%）和早期育儿戒酒者（10.2%）。观察到了异质性协变量关联。例如，与26至35岁生育的母亲相比，36岁以后生育的母亲成为风险递增饮酒者和低风险递增饮酒者的可能性是低概率饮酒者的两倍，但成为早期育儿戒酒者的可能性并不更高。
围产期母亲的纵向饮酒模式存在显著异质性。与这些异质性模式相关的基线母亲特征和行为为在这一关键时期识别潜在的危险饮酒者提供了有价值的工具，并且可以综合起来定制产前和产后临床咨询方案。
