The Cleveland NIAAA prospective alcohol-in-pregnancy study: the first year.

Data from 2,913 antepartum gravidas screened for alcohol problems during the first year of a large prospective study designed to relate antenatal drinking behavior to infant outcome have been analyzed. The Michigan Alcoholism Screening Test (MAST) appears to separate two populations of pregnant patients. Differences between positive and negative MAST responders indicate variables, such as ethnicity, previous pregnancies, nutrition and cigarette smoking, which will require control when infant outcome data are evaluated. Positive MAST responders were found to be more likely to drink alcohol, to drink greater volumes and to drink more frequently than matched negative responders. They obtained a smaller proportion of their alcohol intake from wine and were more likely to drink a combination of beer, wine and/or liquor than the negative responders. The positive responders significantly decreased their alcohol intake as pregnancy progressed, while negative responders did not, suggesting the possibility that abstinence oriented therapy may be helpful. Problems with quantitating alcohol intake by humans and strategies for separating chronic and acute alcohol effects are discussed.