Derseh Behailu, Dadi Abel, Phan Hoang, Unger Holger W, Brown Kiarna, Belay Demeke Mesfin, Guthridge Steven
Centre for Child Development and Education, Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
Department of Public Health, Asrat Woldeyes Health Science Campus, Debre Berhan University, Debre Berhan, Ethiopia.
BMC Pregnancy Childbirth. 2025 Oct 17;25(1):1110. doi: 10.1186/s12884-025-08216-5.
Prenatal Alcohol Use (PAU) has detrimental effects on mothers and their children. Robust estimates of the prevalence of PAU and associated risk factors are critical for informing interventions to reduce adverse health impacts. This study aimed to estimate the prevalence and risk factors of PAU among Aboriginal and non-Aboriginal mothers in the Northern Territory of Australia.
We used linked individual-level records from the NT perinatal register, hospital admissions, and emergency department presentations to estimate the prevalence of PAU for all 19,588 births to NT-resident women from 2013 to 2017. Permutation analysis was used to create four PAU categories: no PAU, early PAU (alcohol use in early pregnancy only), continued PAU (alcohol use in early and late pregnancy), and extreme PAU (hospital admissions/ presentations for alcohol-related diagnosis during pregnancy). Multinomial logit models explored the associations between sociodemographic and clinical factors and degrees of PAU. A relative risk ratio (RRR) with a 95% confidence interval (CI) was used to measure associations.
There were 19,588 births to 16,199 women during the study period (6,310 births to 5,207 Aboriginal women). The mean gestational age at birth for Aboriginal women was 37.8 (95% CI: 37.7, 37.9) weeks and 38.7 (38.6, 38.8) weeks for non-Aboriginal women. The overall PAU prevalence for births to Aboriginal women was 13.1% (95% CI: 12.2, 14.0), including 5.9% (95% CI: 5.2, 6.5) early PAU, 4.3% (95% CI: 3.8, 4.8) continued PAU, and 2.8% (95% CI: 2.4, 3.3) "extreme" PAU. The overall prevalence for non-Aboriginal women was 2.3% (95% CI: 2.1, 2.6), including 1.7% (95% CI: 1.5, 1.9), 0.53% (95% CI: 0.4, 0.7) and 0.1% (95% CI: 0.02, 0.1) for each category, respectively. Age, smoking, and substance misuse-related hospitalisation were associated with an increased risk of PAU among both populations. Being a victim of violence was an additional risk among Aboriginal women. More than five antenatal care (ANC) visits were associated with less PAU. However, 17.9% (n = 3520) of births had missing records related to PAU.
The study provides refined prevalence estimates for PAU across groups with increasing risk of harm. Early identification and effective engagement with women at risk of PAU are critical for improving outcomes for mothers and their children. Targeted interventions like enhanced services that support cessation of alcohol and other drugs (AOD), strengthening families, and sustained engagement with culturally safe, trauma-informed maternity care may aid in reducing PAU. The study also highlights the critical need to enhance both the quality and completeness of the routine recording of alcohol use during pregnancy.
孕期饮酒（PAU）对母亲及其子女有不利影响。对孕期饮酒的流行率及其相关风险因素进行可靠估计，对于制定减少不良健康影响的干预措施至关重要。本研究旨在估计澳大利亚北领地原住民和非原住民母亲中孕期饮酒的流行率及其风险因素。
我们使用了北领地围产期登记册、医院入院记录和急诊科就诊记录中的个体层面关联数据，以估计2013年至2017年期间北领地常住妇女所生的19,588例婴儿中孕期饮酒的流行率。采用排列分析创建了四个孕期饮酒类别：无孕期饮酒、早期孕期饮酒（仅在妊娠早期饮酒）、持续孕期饮酒（在妊娠早期和晚期饮酒）以及极端孕期饮酒（孕期因与酒精相关的诊断而入院/就诊）。多项logit模型探讨了社会人口统计学和临床因素与孕期饮酒程度之间的关联。使用具有95%置信区间（CI）的相对风险比（RRR）来衡量关联。
研究期间，16,199名妇女共分娩19,588例婴儿（5,207名原住民妇女分娩6,310例婴儿）。原住民妇女的平均出生孕周为37.8周（95%CI：37.7，37.9），非原住民妇女为38.7周（38.6，38.8）。原住民妇女所生婴儿的总体孕期饮酒流行率为13.1%（95%CI：12.2，14.0），其中早期孕期饮酒为5.9%（95%CI：5.2，6.5），持续孕期饮酒为4.3%（95%CI：3.8，4.8），“极端”孕期饮酒为2.8%（95%CI：2.4，3.3）。非原住民妇女的总体流行率为2.3%（95%CI：2.1，2.6），各类别分别为1.7%（95%CI：1.5，1.9）、0.53%（95%CI：0.4，0.7）和0.1%（95%CI：0.02，0.1）。年龄、吸烟以及与药物滥用相关的住院治疗与这两个人群孕期饮酒风险增加有关。遭受暴力是原住民妇女的另一个风险因素。超过五次产前检查（ANC）与孕期饮酒减少有关。然而，17.9%（n = 3520）的分娩记录中缺少与孕期饮酒相关的信息。
该研究提供了不同危害风险组孕期饮酒流行率的精确估计。早期识别和有效干预有孕期饮酒风险的妇女对于改善母亲及其子女的结局至关重要。有针对性的干预措施，如加强支持戒酒和戒毒（AOD）的服务、强化家庭以及持续提供具有文化安全性、考虑创伤因素的产科护理，可能有助于减少孕期饮酒。该研究还强调了提高孕期饮酒常规记录质量和完整性的迫切需求。
