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Wine Consumption by Hazardous Drinkers Before and After Pregnancy Recognition Brittany B. Rayburn, William F. Rayburn, M.D., Chen Meng, M.S., and Nancy S. Handmaker, Ph.D. OBJECTIVE: To investigate patterns of wine consumption among hazardous drinkers before and after pregnancy recognition.
STUDY DESIGN: Using a standard alcohol survey, hazardous drinking was defined as either frequent or binge drinking with related consequences. Patients identified at our clinic during their first prenatal visit as being hazardous drinkers were interviewed during the prenatal and postpartum periods. The numbers of drinking days and drinks per drinking day were sought before and after pregnancy recognition.
RESULTS: A total of 203 of 4,494 women met the criteria as hazardous drinkers before pregnancy recognition and completed the prenatal and postpartum interviews. Wine was consumed by approximately one fourth (49, 24.1%) of these women, usually with other alcoholic beverages (45, 91.8%). Wine alone was not consumed heavily. Nearly half (46.9%) continued their wine consumption after pregnancy confirmation, although the numbers of drinking days and drinks per drinking day became significantly lower than before pregnancy awareness (p<0.01). Thirty-five hazardous drinkers switched to wine after pregnancy recognition.
CONCLUSION: Hazardous drinkers were inclined to drink wine with other alcoholic beverages yet tended to abstain or minimize consumption after pregnancy recognition. (J Reprod Med 2007;52:871–873)
Keywords: alcohol drinking, fetal alcohol syndrome, wine.
 Wine was drunk by many of our
hazardous drinkers before pregnancy recognition but not alone or in a binging manner. Consumption of wine is common among reproductive- age women. Several European studies report wine to be the alcoholic beverage of choice during pregnancy. This preference is affected by a pregnant woman’s perception of its relative safety as compared with other alcoholic beverages.
Fertility is not impaired by wine drinking, and it is possible, therefore, for early gestation to be unexpected.1 Exposure to alcohol is the leading cause of mental retardation in the United States. Fetal behavior can be affected when near-term pregnant women consume as few as 2 glasses of wine (0.25 g of ethanol/kg of maternal body weight).2 Fetal eye movements can be reduced, behavioral state organization disorganized and breathing activity suppressed almost completely.3
The objective of this prospective, clinic-based study was to investigate patterns of wine consumption among pregnant women with hazardous drinking habits. This project was approved by our human research review committee and conducted between February 2000 and July 2003. The investigation was part of a 5-year National Institute of Alcohol Abuse and Alcoholism grant to study the impact of brief interventions on alcohol consumption during and after pregnancy.
Abstinence or a reduction in wine
consumption became evident after pregnancy awareness. The same methodology and the same group of hazardous drinkers used here were also reported on recently when investigating beer consumption.4 The study consisted initially of a survey of all patients at their first prenatal visit to our clinic. The questionnaire related to their drinking habits using 2 standard alcohol screening instruments developed specifically for clinical office settings.4
Those women identified as hazardous drinkers were asked to enroll in this prospective study. The same research assistants met with each consenting participant at enrollment and within 1 month after delivery. Other forms of alcohol consumed were recorded as beer or liquor (distilled spirits). As measures of drinking severity, we determined for each patient the number of drinking days and of drink units per drinking day. This number correlated highly with the amount of alcohol consumed and with binge drinking (≥5 drinks for each day of any of the previous 30 days). Levels of alcohol consumption were categorized as: (1) light: ≤2 drink units per drinking day; (2) moderate: >2 but <5 drink units per drinking day; and (3) heavy: ≥5 drink units per drinking day.4
A total of 203 of the 4,494 patients who completed the initial survey met the criteria for hazardous drinking and completed the prenatal and postpartum interviews. Wine was consumed during pregnancy by 49 (24.1%) of these hazardous drinkers, mostly with other alcoholic beverages (45, 91.8%) rather than alone (4, 8.2%). Demographic characteristics of patients identified before pregnancy awareness as hazardous wine drinkers or as nondrinkers are compared in Table I. Wine drinkers were older (p<0.05) and married (p<0 .01), had higher family incomes (p<0.01) and were more likely to be Caucasian (p<0 .001) than nondrinkers.
 Before pregnancy recognition, hazardous wine drinkers consumed a significantly lower number of drinks per drinking day than those who consumed other alcoholic beverages (5.7±4.1 vs. 7.9±5.5 drinks per drinking day, p<0.05). Wine drinkers consumed alcohol during 39% of the days before pregnancy recognition; that is not significantly different from the 31% of days reported by hazardous drinkers who did not consume wine (p>0.05). Those who drank wine alone before pregnancy were more likely to drink at a moderate than heavy level (75% vs. 25%, p<0.01). Wine was consumed heavily before pregnancy when combined with liquor than alone (58.3% vs. 0%, p<0.001). Hazardous drinkers who consumed wine also used cigarettes (66.7%), marijuana (44.2%), cocaine (25.0%) and stimulants (18.4%) before pregnancy awareness.
Like hazardous drinkers who consumed other alcoholic beverages, 46.9% of wine drinkers continued to drink after pregnancy recognition. Those who continued to consume wine drank on only 5.2% of the days. Fewer drinks of wine were consumed per drinking day than other alcohol beverages (1.1±1.0 vs. 5.3±7.0, p<0.001). The number of drinks of wine per drinking day was higher when wine was consumed with beer or liquor (4.1±4.4, p<0.01). A small proportion of hazardous drinkers switched from wine (2, 4.1%) to another form of alcohol. Thirty-five hazardous drinkers switched to wine drinking, although most continued to also consume beer or liquor.
The findings of this investigation are subject to certain limitations. We interviewed women who were hazardous drinkers rather than those who reported drinking an occasional glass of wine. It was not possible to focus solely on wine since we found that 91.8% of our study population drank other alcoholic beverages in combination with wine before and after pregnancy awareness. Last, we did not maintain records of the type of wine product (regular wine, wine cooler, fortified wine).
In conclusion, wine was drunk by many of our hazardous drinkers before pregnancy recognition but not alone or in a binging manner. Better social acceptance, taste and low cost may explain why wine was favored by certain women. Abstinence or a reduction in wine consumption became evident after pregnancy awareness. Although this observation is encouraging, the obstetrician should inquire about other alcoholic beverages when, at their initial prenatal visit, women acknowledge drinking wine. Since certain women will continue to drink wine despite abstinence-oriented health messages, the obstetrician is urged to encourage cessation and to become familiar with community-based alcohol treatment programs that are sensitive to the needs of pregnant women who are attempting to reduce additional risks to their vulnerable fetuses and to themselves.
References
From the Departments of Obstetrics and Gynecology and of Psychology, University of New Mexico, Albuquerque.
Supported by grant AA12491 from the National Institutes of Health–National Institutes on Alcohol Abuse and Alcoholism. Presented at the 45th Annual Teratology Society Meeting, St. Petersburg, Florida, June 22–25, 2005. Address correspondence to: William F. Rayburn, M.D., Department of Obstetrics and Gynecology, University of New Mexico School of Medicine, MSC 10 5580, 1 University of New Mexico, Albuquerque, NM 87131 (wrayburn@salud.unm.edu). Financial Disclosure: The authors have no connection to any companies or products mentioned in this article.
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