Correlates of multigravida women's binge drinking during pregnancy. A longitudinal study.

Objective: To refine our understanding of prenatal psychosocial factors associated with binge drinking during pregnancy and the contribution of binge drinking during pregnancy to the duration of newborn hospitalization.

Design: Prospective cohort.

Setting: A large urban medical center in Wisconsin.

Participants: One hundred thirty-nine women (106 multigravida) who were invited to participate during a prenatal clinic visit early in their third trimester.

Measures: Prenatal measures included social support (Maternal Social Support Index), depression (Center for Epidemiologic Studies Depression Scale), stress (Difficult Life Circumstances), substance use (Monitoring the Future Substance Use Questionnaire and T-ACE Scale [a screen with questions about tolerance, annoyance, cutting down, and using alcohol as an eye-opener), and maternal-fetal attachment (Maternal-Fetal Attachment Scale). After delivery, a mothers' and infants' medical record review form was used.

Results: Multigravida pregnant women (n = 106) were older than primigravida pregnant women (n = 33) (25.8 +/- 0.6 vs. 20.5 +/- 0.5 years; P = .001), with more children at home (2.3 +/- 0.2 vs 1.3 +/- 0.3; P = .01) and less social support (Maternal Social Support Index, 20.1 +/- 0.6 vs 22.9 +/- 1.0; P = .03). All of the binge-drinking women in this sample were in the unmarried multigravida subgroup (17/101 [17%]). Compared with multigravida pregnant women who did not binge drink during pregnancy, binge-drinking pregnant women were older (28.1 +/- 1.3 vs 25.1 +/- 0.6 years; P = .03) and more socially isolated (Maternal Social Support Index, 17.2 +/- 1.3 vs 20.7 +/- 0.7; P = .04) and were more likely to smoke during the pregnancy (82% vs 39%; P = .001). Even after controlling for a number of other important biologic and psychosocial factors (duration of pregnancy, maternal gravidity, racial heritage, education, social support at second trimester, and birth weight), by hierarchical multiple linear regression, binge drinking within the last 2 weeks before the late second-trimester interview continued to explain a significant amount of variance in duration of newborn hospitalization (total R2 = .48, partial R2 = .04; P = .01).

Conclusions: This study suggests that binge drinking during pregnancy is related to longer newborn hospitalizations. Effective prenatal interventions to improve the outcome of pregnancies for women who abuse alcohol during pregnancy should use early screening and provide augmentation of mothers' social support.