From the, Department of Psychiatry (IT, AEH), School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Psychiatry (TC), Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA.
Alcohol Clin Exp Res. 2020 Aug;44(8):1675-1685. doi: 10.1111/acer.14394. Epub 2020 Jul 23.
Moderate to heavy alcohol use during pregnancy (≥3 drinks/occasion) is linked to a range of adverse offspring outcomes. Prior studies suggest that adolescent and young adult mothers may be particularly vulnerable to these risky drinking behaviors during and after pregnancy. This study used latent class growth analysis (LCGA) to examine changes in risky drinking from prepregnancy to postpregnancy and identified prepregnancy predictors representing cognitive and social factors to inform prevention.
Participants included 432 adolescent and young adult mothers (aged 13 to 24; 78% Black) assessed annually since childhood in the Pittsburgh Girls Study. Participants prospectively reported frequency of risky drinking (≥3 drinks/occasion) in the year of pregnancy and 2 years before and after pregnancy, as well as social-cognitive risk factors for drinking (alcohol expectancies, drinking motives, caregiver, and peer alcohol use).
Approximately 11% of young mothers in this community-based sample engaged in risky drinking at least once a month during the year of pregnancy, with greater frequency observed for young adult (vs. adolescent) mothers. LCGA revealed 4 risky drinking trajectories across the perinatal period, including 3 relatively stable trajectories (low, moderate, and high frequency) and 1 distinct trajectory ("postpartum initiators") characterized by increased risky drinking post-childbirth. Peer alcohol use during and after pregnancy distinguished higher risk from lower risk trajectories, controlling for age, race, and age of drinking onset. Exposure to caregiver alcohol use and prepregnancy coping motives for drinking also elevated risk, but only for mothers who became pregnant in early adulthood (vs. adolescence).
Adolescent and young adult mothers show heterogeneous risky drinking trajectories from prepregnancy to postpregnancy. Pregnant women in the transitional age of early adulthood who report exposure to caregiver alcohol use, more friends who drink, and coping motives for drinking may have elevated risk for moderate-heavy drinking during the perinatal period and may benefit from targeted intervention.
怀孕期间（≥3 杯/次）中到重度饮酒与一系列不良后代结局有关。先前的研究表明，青少年和年轻成年母亲在怀孕期间和怀孕后可能特别容易出现这些危险的饮酒行为。本研究使用潜在类别增长分析（LCGA）来检查从怀孕前到怀孕后的危险饮酒变化，并确定了代表认知和社会因素的怀孕前预测因素，以提供预防信息。
参与者包括 432 名青少年和年轻成年母亲（年龄 13 至 24 岁；78%为黑人），自童年起在匹兹堡女孩研究中每年接受评估。参与者前瞻性地报告了怀孕期间以及怀孕前 2 年和怀孕后 2 年的危险饮酒频率（≥3 杯/次），以及饮酒的社会认知风险因素（酒精期望、饮酒动机、照顾者和同伴饮酒）。
在这个基于社区的样本中，大约 11%的年轻母亲在怀孕期间至少每月有一次危险饮酒，年轻成年母亲（vs. 青少年）的频率更高。LCGA 在围产期期间显示了 4 种危险饮酒轨迹，包括 3 种相对稳定的轨迹（低、中、高频率）和 1 种独特的轨迹（“产后启动者”），特征是产后危险饮酒增加。怀孕期间和怀孕后的同伴饮酒区分了高风险和低风险轨迹，控制了年龄、种族和饮酒起始年龄。暴露于照顾者饮酒和怀孕前的饮酒应对动机也增加了风险，但仅对在成年早期怀孕的母亲（vs. 青少年）。
青少年和年轻成年母亲在怀孕前到怀孕后的危险饮酒轨迹表现出异质性。在成年早期过渡阶段怀孕的孕妇，如果报告接触照顾者饮酒、更多的朋友饮酒和饮酒应对动机，可能在围产期期间有中度至重度饮酒的风险增加，可能受益于有针对性的干预。
