Maternal Alcohol Use, Adverse Neonatal Outcomes and Pregnancy Complications in British Columbia, Canada: A Population-based Study

Svetlana Popova, Centre for Addiction and Mental Health
Danijela Dozet, Centre for Addiction and Mental Health
Graham O’Hanlon, Centre for Addiction and Mental Health
Valerie Temple, Surrey Place
Jurgen Rehm, Centre for Addiction and Mental Health

Abstract
Background
The current study aimed to estimate the prevalence of alcohol use identified as a risk factor during pregnancies by the antenatal care providers, resulting in live births in British Columbia (BC) and to examine associations between alcohol use, adverse neonatal outcomes, and pregnancy complications.

Methods
This population-based cross-sectional study utilized linked obstetrical and neonatal records within the BC Perinatal Data Registry (BCDPR), for deliveries that were discharged between January 1, 2015 and March 31, 2018. The main outcome measures were alcohol use identified as a risk factor during pregnancy, associated maternal characteristics, pregnancy complications, and adverse neonatal outcomes. Estimates for the period and fiscal year prevalence were calculated. Chi-square tests were used to compare adverse neonatal outcomes and pregnancy complications by alcohol use during pregnancy. Logistic regression was used to examine the association between alcohol use during pregnancy and adverse neonatal outcomes and pregnancy complications, after adjusting for identified risk factors.

Results
A total of 144,779 linked records within the BCDPR were examined. The period prevalence of alcohol use during pregnancy identified as a risk factor was estimated to be 1.1% and yearly prevalence was 1.1%, 1.1%, 1.3%, and 0.9% from the 2014/2015 fiscal year to 2017/2018, respectively.

Indicated alcohol use was associated with younger maternal age, fewer antenatal visits, being
nulliparous, a history of mental illness, substance use, and smoking. Alcohol-exposed neonates had greater odds of being diagnosed with low birth weight (aOR = 1.25; 95% CI: 1.01, 1.53), other respiration distress of newborn (aOR = 2.57; 95% CI: 1.52, 4.07), neonatal difficulty in breastfeeding (aOR = 1.97; 95% CI: 1.27, 2.92) and unspecified feeding problems (aOR = 2.06; 95% CI: 1.31, 3.09)

Conclusions
The prevalence of alcohol use during pregnancy identified as a risk factor, estimated in this study, was comparable to the previous estimates within BCDPR. Prenatal alcohol exposure was associated with notable differences in maternal and neonatal characteristics and adverse neonatal outcomes. More consistent and thorough screening and prevention efforts targeting alcohol use in pregnancy are urgently needed in Canada.

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