Alcohol consumption during pregnancy by women from southern Brazil: a cross-sectional study

Zottis, Laira Francielle Ferreira; Souza, Mateus Arenhardt de; Hartmann, Jéssica Karine; Gama, Thiago Kenji Kurogi; Rizental, Laís Borges; Maciel, Anita Machado; Gresele, Merialine; Rosa, Ernani Bohrer da; Nunes, Maurício Rouvel; Rocha, Juliana Trevisan da; Telles, Jorge Alberto Bianchi; Cunha, André Campos da; Zen, Paulo Ricardo Gazzola; Rosa, Rafael Fabiano Machado

doi:10.1590/1516-3180.2023.0186.R1.08022024

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Sao Paulo Medical Journal

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ORIGINAL ARTICLE • Sao Paulo Med. J. 142 (5) • 2024 • https://doi.org/10.1590/1516-3180.2023.0186.R1.08022024 copy

Alcohol consumption during pregnancy by women from southern Brazil: a cross-sectional study

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

BACKGROUND:

Some maternal characteristics are related to alcohol intake during pregnancy, which irreversibly compromises the maternal-fetal binomial integrity.

OBJECTIVES:

To identify the frequency, impact, and factors associated with alcohol consumption during pregnancy.

DESIGN AND SETTING:

A cross-sectional study was performed at the Hospital Materno Infantil Presidente Vargas (HMIPV) in Porto Alegre/RS between March and December 2016.

METHODS:

A structured questionnaire was administered along with a medical records review. They refer to the maternal sociodemographic and gestational status, alcohol consumption patterns, and characteristics of the fetus/newborn. In the statistical analysis, P values < 0.05 were considered significant.

RESULTS:

The frequency of alcohol intake was 37.3%; this was characterized by the consumption of fermented beverages (89.3%), especially during the first trimester (79.6%). Risky consumption (high and/or early) occurred for 30.2% of participants. Risk factors associated with maternal alcohol consumption during pregnancy were tobacco use (P < 0.001) and abortion attempt (P = 0.023). Living with a partner (P = 0.002) and planning pregnancy (P = 0.009) were protective factors. Risky consumption was related to all of the aforementioned variables as well as threatened abortion (P = 0.023).

CONCLUSIONS:

Alcohol intake during pregnancy is common and affects nearly one-third of pregnant women. Knowledge of the population at risk and protective factors is essential for the development of campaigns that seek to reduce consumption and, therefore, its consequences for the mother and fetus.

KEY WORDS (MeSH terms):
Alcohol Drinking; Pregnancy; Tobacco Smoking; Risk factors; Pregnancy Outcome

AUTHORS’ KEY WORDS:
Alcohol Intake; Family Planning; Gestation

Variables		Total^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval. (n = 570)	Alcohol use (n = 213)	%	P value	PR	95%CI
Variables		n	n	%	P value	PR	95%CI
Age group	≤ 20 years	183	68	37.2		1
	21 to 34 years	319	123	38.6	0.757	1.04	0.82	1.31
	≥ 35 years	68	22	32.4	0.489	0.87	0.59	1.29
Origin	Porto Alegre	391	155	39.6		1
	Metropolitan area	151	49	32.5	0.132	0.82	0.63	1.06
	Countryside town	28	9	32.1	0.456	0.81	0.47	1.41
Employed (n = 568)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	Yes	228	90	39.5		1
	No	340	123	36.2	0.424	0.92	0.74	1.14
Education	Incomplete elementary education	200	79	39.5		1
	Complete elementary education	188	69	36.7	0.571	0.93	0.72	1.20
	Complete secondary education to higher education	178	62	34.8	0.351	0.88	0.68	1.15
Presence of partner	No	100	52	52.0		1
Presence of partner	Yes	470	161	34.3	0.000	0.66	0.53	0.83
Family income (n = 550)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	Less than R$ 880	112	41	36.6		1
	> R$ 880	438	164	37.4	0.871	1.02	0.78	1.34
Number of residents per house (n = 566)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	< 5 individuals	315	110	34.9		1
	≥ 5 individuals	251	101	40.2	0.193	1.15	0.93	1.43

Variables		Total^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval. (n = 570)	Alcohol use (n = 213)	%	P value	PR	95%CI
Variables		n	n	%	P value	PR	95%CI
Planned pregnancy	No	351	147	41.9		1
Planned pregnancy	Yes	219	66	30.1	0.006	0.72	0.57	0.91
Number of gestations	Multiparous	340	128	37.6		1
Number of gestations	Primiparous	230	85	37.0	0.867	0.98	0.79	1.22
Attempted abortion	No	563	208	36.9		1
Attempted abortion	Yes	7	5	71.4	0.007	1.93	1.20	3.13
Prenatal care	No	12	6	50.0		1
Prenatal care	Yes	558	207	37.1	0.310	0.74	0.42	1.32
Number of consultations (n = 555)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	> = 6 consultations	430	157	36.5		1
	< 6 consultations	125	50	40.0	0.471	1.10	0.85	1.40
Beginning of prenatal care (n = 558)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	1	375	132	35.2		1
	2	166	71	42.8	0.087	1.22	0.97	1.52
	3	17	4	23.5	0.363	0.67	0.28	1.59
zz	No	518	189	36.5		1
zz	Yes	51	24	47.1	0.110	1.29	0.94	1.76

Variables		Total^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval. (n=570)	Alcohol use (n=213)	%	P value	PR	95%CI
Variables		n	n	%	P value	PR	95%CI
Use of illicit drugs during pregnancy	No	547	195	35.6		1
Use of illicit drugs during pregnancy	Yes	23	18	78.3	0.000	2.20	1.72	2.80
Use of illicit drugs during 1st trimester of pregnancy	No	548	196	35.8		1
Use of illicit drugs during 1st trimester of pregnancy	Yes	22	17	77.3	0.000	2.16	1.68	2.78
Tobacco during pregnancy	No	434	132	30.4		1
Tobacco during pregnancy	Yes	136	81	59.6	0.000	1.96	1.61	2.39
Tobacco 1st trimester	No	437	134	30.7		1
Tobacco 1st trimester	Yes	133	79	59.4	0.000	1.94	1.59	2.36
Marijuana	No	550	198	36.0		1
Marijuana	Yes	20	15	75.0	0.000	2.08	1.58	2.75
Marijuana 1st trimester (n = 569)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	No	550	198	36.0		1
	Yes	19	14	73.7	0.000	2.05	1.53	2.74
Cocaine	No	562	205	36.5		1
Cocaine	Yes	8	8	100	0.000	2.74	2.46	3.06
Cocaine 1st trimester (n = 569)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	No	562	205	36.5		1
	Yes	7	7	100	0.000	2.74	2.46	3.06
Crack	No	567	210	37.0		1
Crack	Yes	3	3	100	0.000	2.70	2.43	3.01
Crack 1st trimester (n = 569)^* * Number of valid answers; PR = Crude prevalence ratio; CI = Confidence interval.	No	567	210	37.0		1
	Yes	2	2	100	0.000	2.70	2.43	3.01

Variables		Total^a	Alcohol use	%	P value	PR	95%CI
Variables		n^* * Relative microcephaly corrected for the length of the baby; Apgar 1<7/Apgar 5<7 = values greater or less than 7 in the first and fifth minutes of life; a. Number of fetuses/neonates, considering deaths and valid responses; PR = Crude prevalence ratio; CI = Confidence interval.	n^* * Relative microcephaly corrected for the length of the baby; Apgar 1<7/Apgar 5<7 = values greater or less than 7 in the first and fifth minutes of life; a. Number of fetuses/neonates, considering deaths and valid responses; PR = Crude prevalence ratio; CI = Confidence interval.	%	P value	PR	95%CI
Malformation	No	550	204	37.1
Malformation	Yes	33	13	39.4	0.787	1.06	0.69	1.64
Type of Malformation	Multiple	9	6	66.7		1
Type of Malformation	Isolated	24	7	29.2	0.037	0.44	0.20	0.95
Thoracic	No	580	214	36.9		1
Thoracic	Yes	3	3	100.0	0.000	2.71	2.44	3.01
Skeletal	No	580	215	37.1		1
Skeletal	Yes	3	2	66.7	0.154	1.80	0.80	4.03
Gastrointestinal	No	580	215	37.1		1
Gastrointestinal	Yes	3	2	66.7	0.154	1.80	0.80	4.03
Urinary tract	No	572	212	37.1		1
Urinary tract	Yes	11	5	45.5	0.542	1.23	0.64	2.36
Extremities	No	578	215	37.2		1
Extremities	Yes	5	2	40.0	0.895	1.08	0.37	3.16
Abdomen	No	580	216	37.2		1
Abdomen	Yes	3	1	33.3	0.892	0.90	0.18	4.45
Central nervous system	No	573	215	37.5		1
Central nervous system	Yes	10	2	20.0	0.322	0.53	0.15	1.85
Other	No	578	215	37.2		1
Other	Yes	5	2	40.0	0.895	1.08	0.37	3.16
Prematurity	>=37	502	186	37.1		1
Prematurity	<37	73	28	38.4	0.828	1.04	0.76	1.41
Low birth weight	>=2,500g	506	187	37.0		1
Low birth weight	<2,500g	69	27	39.1	0.723	1.06	0.77	1.45
Absolute microcephaly (n = 489)^a	No	473	175	37.0		1
Absolute microcephaly (n = 489)^a	Yes	16	7	43.8	0.563	1.18	0.67	2.09
Relative microcephaly ^* * Relative microcephaly corrected for the length of the baby; Apgar 1<7/Apgar 5<7 = values greater or less than 7 in the first and fifth minutes of life; a. Number of fetuses/neonates, considering deaths and valid responses; PR = Crude prevalence ratio; CI = Confidence interval. (n = 489)^a	No	482	179	37.1		1
	Yes	42	16	38.1	0.902	1.03	0.68	1.54
Apgar 1 < 7^* * Relative microcephaly corrected for the length of the baby; Apgar 1<7/Apgar 5<7 = values greater or less than 7 in the first and fifth minutes of life; a. Number of fetuses/neonates, considering deaths and valid responses; PR = Crude prevalence ratio; CI = Confidence interval. (n = 569)^a	> = 7	518	185	35.7		1
	< 7	51	25	49.0	0.040	1.37	1.01	1.86
Apgar 5 < 7^* * Relative microcephaly corrected for the length of the baby; Apgar 1<7/Apgar 5<7 = values greater or less than 7 in the first and fifth minutes of life; a. Number of fetuses/neonates, considering deaths and valid responses; PR = Crude prevalence ratio; CI = Confidence interval. (n = 569)^a	> = 7	562	206	36.7		1
	< 7	7	4	57.1	0.181	1.56	0.81	2.99

Variables	P value	PR	95%CI
Marital status = With partner	0.024	0.77	0.61	0.97
Planned pregnancy = Yes	0.013	0.75	0.59	0.94
Attempted abortion = Yes	0.032	1.63	1.04	2.54
Smoking = Yes	0.000	1.90	1.55	2.32

Variables	P value	PR	95%CI
Marital status = with partner	0.002	0.66	0.51	0.86
Planned pregnancy = Yes	0.027	0.74	0.56	0.97
Attempted abortion = Yes	0.009	1.92	1.17	3.13
Threat of abortion = Yes	0.023	1.45	1.05	1.99
Smoking = Yes	0.000	2.10	1.66	2.65

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[1] Address for correspondence: Maurício Rouvel Nunes, Universidade Federal de Ciências da Saúde de Porto Alegre, R. Sarmento Leite, 245/403, Centro — Porto Alegre (RS) — Brasil, CEP 90050-170, Tel. (+55 51) 3303-8771, E-mail: mrouvelnunes@gmail.com