Trangenstein Pamela J, Berglas Nancy F, Subbaraman Meenakshi S, Kerr William C, Roberts Sarah
Alcohol Research Group, Public Health Institute, Emeryville, California.
Advancing New Standards in Reproductive Health, University of California, San Francisco, Oakland, California.
J Stud Alcohol Drugs. 2025 May;86(3):349-357. doi: 10.15288/jsad.23-00414. Epub 2024 Aug 6.
Pregnancy-specific alcohol policies are widely adopted yet have limited effectiveness and established risks. It is unknown whether general population alcohol policies are effective during pregnancy. This study investigated associations between general population policies and alcohol treatment admission rates for pregnant people specifically.
Data are from the Treatment Episodes Data Set-Admissions and state-level policy data for 1992-2019 ( = 1,331 state-years). The primary outcome was treatment admissions where alcohol was the primary substance, and the secondary outcome included admissions where alcohol was any substance. There were five policy predictors: (a) government spirits monopoly, (b) ban on Sunday sales, (c) grocery store sales, (d) gas station sales, and (e) blood alcohol concentration (BAC) laws. Covariates included poverty, unemployment, per capita cigarette consumption, state and year fixed effects, and state-specific time trends.
In models with alcohol as the primary substance, prohibiting spirits sales in grocery stores (vs. allowing heavy beer [>3.2% alcohol by volume] and spirits) had lower treatment admission rates (incidence rate ratio [IRR] = 0.88, 95% CI [0.78, 0.99], = .028). States with BAC laws at .10% (vs. no law) had higher treatment admission rates (IRR = 1.24, 95% CI [1.08, 1.43], = .003). When alcohol was any substance, prohibiting spirits sales in grocery stores (vs. allowing heavy beer and spirits) was again associated with lower treatment admission rates (IRR = 0.89, 95% CI [0.80, 0.98], = .021), but there was no association for BAC laws.
Restrictions on grocery store spirits sales and BAC laws were associated with lower and higher alcohol treatment admission rates among pregnant people, respectively, suggesting that general population alcohol policies are relevant for pregnant people's treatment utilization.
针对孕妇的酒精政策被广泛采用，但效果有限且存在既定风险。尚不清楚一般人群酒精政策在孕期是否有效。本研究专门调查了一般人群政策与孕妇酒精治疗入院率之间的关联。
数据来自1992 - 2019年的治疗事件数据集入院数据和州级政策数据（n = 1331个州年）。主要结局是酒精为主要物质的治疗入院情况，次要结局包括酒精为任何一种物质的入院情况。有五个政策预测因素：（a）政府烈酒专卖，（b）周日销售禁令，（c）杂货店销售，（d）加油站销售，以及（e）血液酒精浓度（BAC）法律。协变量包括贫困、失业、人均香烟消费量、州和年份固定效应以及州特定时间趋势。
在以酒精为主要物质的模型中，禁止在杂货店销售烈酒（相对于允许销售高酒精度啤酒[酒精度体积比>3.2%]和烈酒）的治疗入院率较低（发病率比[IRR] = 0.88，95%置信区间[0.78, 0.99]，P = 0.028）。BAC法律规定为0.10%的州（相对于无法律规定）的治疗入院率较高（IRR = 1.24，95%置信区间[1.08, 1.43]，P = 0.003）。当酒精为任何一种物质时，禁止在杂货店销售烈酒（相对于允许销售高酒精度啤酒和烈酒）再次与较低的治疗入院率相关（IRR = 0.89，95%置信区间[0.80, 0.98]，P = 0.021），但BAC法律与之无关联。
对杂货店烈酒销售的限制和BAC法律分别与孕妇较低和较高的酒精治疗入院率相关，这表明一般人群酒精政策与孕妇的治疗利用情况相关。
