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Prevalence and patterns of alcohol use in pregnancy in remote Western Australian communities: The Lililwan Project

Alcohol use in pregnancy is thought to be common in remote Australian communities, but no population-based data are available.

Authors:
Fitzpatrick JP, Latimer J, Ferreira ML, Carter M, Oscar J, Martiniuk ALC, Watkins, RE... et al.

Authors notes:
Drug Alcohol Rev. 2015;34(3):329-39.

Keywords:
Alcohol consumption, Australian Aboriginal, Fetal alcohol spectrum disorder (FASD), Maternal-fetal relation, Pregnancy

Abstract:
Alcohol use in pregnancy is thought to be common in remote Australian communities, but no population-based data are available.

Aboriginal leaders in remote Western Australia invited researchers to determine the prevalence and patterns of alcohol use in pregnancy within their communities.

Study Design: A population-based survey of caregivers of all children born in 2002/2003 and living in the Fitzroy Valley in 2010/2011 (n=134).
Alcohol use risk was categorised using the Alcohol Use Disorders Identification Test consumption subset (AUDIT-C) tool.
Birth and child outcomes were determined by interview, medical record review and physical examination.

Results: 127/134 (95%) eligible caregivers participated: 78% were birth mothers, 95% were Aboriginal and 55% reported alcohol use in index pregnancies; 88% reported first trimester drinking and 53% drinking in all trimesters.
AUDIT-C scores were calculated for 115/127 women, of whom 60 (52%) reported alcohol use in pregnancy.
Of the 60 women who drank (AUDIT-C score≥1), 12% drank daily/almost daily, 33% drank 2-3 times per week; 71% drank ≥10 standard drinks on a typical occasion; 95% drank at risky or high-risk levels (AUDIT-C score ≥4).
Mean AUDIT-C score was 8.5±2.3 (range 2-12).
The most common drinking pattern was consumption of ≥10 standard drinks either 2-4 times per month (27%) or 2-3 times per week (27%).
 
Conclusions: High-risk alcohol use in pregnancy is common in remote, predominantly Aboriginal communities in north western Australia.
Prevention strategies to reduce prenatal alcohol use are urgently needed.