New Study Finds An Increase In Alcohol Consumption By Pregnant Women In the US

A new study published in JAMA, looked at alcohol consumption during pregnancy among US women aged 18 to 49 from 2021 to 2024.

“We wanted to get a current, national picture of how alcohol use during pregnancy has been changing over time, particularly as alcohol trends in the general population have been shifting a lot recently,” study author Emilie Bruzelius told us. “Prior to this paper, the most recent numbers were only from 2020, so we wanted to get a sense of what the was currently happening, and also what the overall term trend looked like over a longer time frame.”

Going in, Bruzelius noted, there were already several signals in the literature suggesting that alcohol use during pregnancy, especially riskier patterns like binge drinking, might be trending upward. 

“But the picture wasn’t entirely consistent,” Bruzelius told us. “There were different studies, different time windows, and some conflicting takeaways. So we didn’t have a firm expectation of exactly what we’d find, but we suspected the ‘stable since the 1990s’ story that’s often cited might not be the full picture anymore and we found that to be the case. I should also point out that another paper recently came out right around the time our paper was accepted showing similar patterns which adds some confidence to our findings.”

There is really strong evidence on just how damaging alcohol exposure can be during pregnancy, but in practice alcohol often gets less attention than other forms of prenatal substance use like opioid or cannabis use. There’s some evidence that obstetrical screening specifically for alcohol has slipped over time, even as screening for other substances has held steady or drawn more attention. 

“Given that alcohol remains the leading preventable cause of birth defects and neurodevelopmental disability, we feel that it is critically important to have current data, especially in order to inform prevention and intervention efforts,” Bruzelius told us. “We used data from the Behavioral Risk Factor Surveillance System, a large national phone study tracking health behaviors and outcome over time.” 

The research team looked at responses from pregnant people ages 18-49 across seven two-year periods, from 2011-2012 through 2023-2024. For each period, they calculated prevalence rates for three things: any drinking (which is not recommended in pregnancy), binge drinking, and heavy drinking (two especially high-risk patterns). 

“In these calculations, we controlled age and race/ethnicity so we could compare fairly across time,” Bruzelius told us. “We then tested whether the changes across periods reflected a statistically significant trend versus the small fluctuations. We also broke the data down by factors like tobacco use, mental health, education, etc. to see who these patterns were showing up in most.”

The study results revealed increases across the board. Current alcohol use rose from about 9% to 15% over the study period, a 59% relative increase. 

“Binge drinking rose 77%, and heavy drinking rose about 166%, the biggest relative jump, but that’s partly because heavy drinking was so rare to begin with, so even a small absolute increase looks large in percentage terms,” Bruzelius told us. “We also noted a levelling off or slight decline in the most recent 2023-2024 period, which is worth watching but doesn’t yet look like a clear reversal of the broader upward trend.” 

The researchers also saw that tobacco use and frequent mental distress were both linked to higher alcohol use, and tobacco use in particular was closely tied to the riskier binge and heavy drinking patterns specifically.

“What was more useful was finally seeing it play out in a longer, consistent trend rather than a handful of studies that didn’t always agree with each other,” Bruzelius told us. “The levelling off in the most recent 2023-2024 period is something we’ll continue to be watching, though it’s too early to call it a reversal of the broader upward trend that we saw across the whole period.”

From a research perspective, Bruzelius believes the really important question that this and other papers on this topic are raising, is why is alcohol consumption during pregnancy increasing? While Bruzelius believes some of it may track with broader shifts in drinking across the general population, alcohol use patterns have been in flux nationally, especially since the pandemic

“But my reading of the data is that something specific is happening during pregnancy, especially as we don’t consistently see the same patterns occurring for reproductive age women more generally,” Bruzelius told us. “Although there are a lot of explanations that need to be examined, I am particularly interested how broader stress, coping, and behavioral health patterns may be contributing. From a prevention perspective, the findings really point to a need for better public health messaging around pregnancy-related alcohol harms, brief intervention and treatment referral when appropriate, and a shared decision-making approach for alcohol and other substance use that respects patient autonomy while making sure people have accurate information.”

Categories: Addiction , Anxiety , Caregiving | Tags: alcohol, pregnancy, anxiety