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Prevalence of prenatal drinking assessed at an urban public hospital and a suburban private hospital

Background: Although the prevalence of fetal alcohol syndrome (FAS) varies within the population, few data are available concerning variation in the prevalence of prenatal drinking. Methods: Postpartum women delivering singleton infants at two Atlanta hospitals in 1993 or 1994 were interviewed. Those delivering infants who were small for gestational age (SGA) (n = 638) were over-sampled relative to those delivering infants with birth weights that were appropriate for gestational age (AGA) (n = 247). The prevalence of prenatal drinking was estimated as a weighted average of reports from mothers of SGA and AGA infants. Estimates of the prevalence of FAS come from the Metropolitan Atlanta Congenital Defects Program (MACDP) of the Centers for Disease Control and Prevention. Results: The prevalence of first-trimester drinking was half that reported for the three previous months (private hospital: 72% vs. 35%; public hospital: 52% vs. 28%). Most women (85%) reported abstaining throughout the second trimester. Fewer than 10% of women delivering at the public hospital (7.5%), but one-quarter of those delivering at the private hospital, reported third-trimester drinking. Binge, moderate and heavy drinking in pregnancy were more common among women delivering at the public hospital. Eight infants born at the public hospital during this period, but none of those born at the private hospital, were identified as possibly having FAS; four of the eight were identified as probably having FAS. Conclusions: These results have implications for health education programs. For example, obstetricians in private practice may wish to reaffirm their advice to abstain from drinking in the third trimester. They also suggest that prenatal abstinence programs be targeted at populations identified as most likely to engage in risky drinking.