1. The Coombe Women’s Hospital (Dublin) study of alcohol use in pregnancy 1987 - 2005 Study funded by the Heath Promotion Unit, Department of Health & Children Dublin, Ireland

2. Irish Research into Alcohol (& Smoking) in Pregnancy

3. 1992 v 2006 1.58% of antenatal women were aware of the potential harmful effects of alcohol in pregnancy & 11% advised by doctor about hazards of alcohol. 2.93% of antenatal women were aware of smoking hazards & 53% advised by doctor about smoking risks. Daly et al (1992), Irish Medical Journal; 85(4): 156-7. 1.Alcohol was consumed by 89% of women in pregnancy & 10% admitted to binge drinking 2.44% were aware of the associated risks of alcohol use in pregnancy 3.28% indicated that they received advice about the alcohol related risk from a health care professional but of these 71% reported that it did not alter their behaviour 4.71% of pregnant smokers were aware of the risks which led to a change in behaviour in 42% McMillan et al (2006), Irish Medical Journal, 99 (9): 283

4. Today’s presentation will focus on... The prevalence and patterns of alcohol use reported by a sample of pregnant women attending a Dublin Maternity Hospital between 1987 and 2005. How alcohol consumption in Irish-born women relates to use in a similar population from other countries also attending this hospital.

5. The Coombe Women’s Hospital Computerised Database Set up in 1986, with the purpose of Generating anonymised data for Annual Report & service planning purposes. Data collection by nursing staff at antenatal booking clinic & in the labour ward Data entry by non-clinical staff “The system” was changed & upgraded in July 1999 & more fields added, and the format of some questions was changed...

6. Size of the data file N = 82,627 (1 January ‘87 – 30 June ’99) 43,318 (July ‘99 – 30 March 2005) Total: 125,945 mothers

7. Annual trends in reported maternal alcohol use (percentages) before pregnancy (1988 - 1998) Never drank Occasional Several days/ alcohol use week 198819.538.741.8 198916.336.747.0 199017.132.850.1 199116.332.451.3 199216.431.352.3 199315.832.351.9 199415.137.347.6 199515.033.451.6 199613.831.854.4 199714.130.555.4 199815.229.355.5

8. Annual trends in reported maternal alcohol use (percentages) before pregnancy (2000 - 2004) Year No alcohol 6 units/ before pregnancy week week 200017.371.511.2 200117.471.211.4 200218.072.89.2 2003 19.770.010.3 200419.171.99.0 The percentage that reported that they did not drink before pregnancy dropped from 1988 until the late 1990s & has risen again..

9. Reported alcohol use by pregnant women (1999 - 2005) No alcohol 11,962 (27.6%) <5units/week 24,300 (56.1%) >6-9 units/week 2,362 (5.5%) >10 units/week 709 (1.6%)* Missing data 3,985 (9.2%) Total 43,318 (100%) *61 pregnant women (0.14%) reported drinking more than 20 units/week.

10. Nationality and reported alcohol use (percentages) in pregnant mothers 1999 - 2005. No 6-9units/ >10 units/ N=35,382 alcoholweek week week Rep of Ireland21.069.3 7.5 2.2 28,454 UK23.966.5 6.9 2.7 1,868 Other EU31.664.7 2.9 0.8 525 Non-EU74.124.8 0.9 0.3 4,505 Irish & UK-born mothers had a lower likelihood of reporting themselves to be non-drinkers in pregnancy. Marked difference between Irish & UK born mothers and the rest of EU & the non-EU mothers when it comes to reported alcohol consumption of more than 6 units/week.

11. Reported maternal alcohol use (percentage) by age, in pregnancy for Irish mothers (1999-2005) Age bands No Alcohol 6-9 units >10 units N=25,312 14-1734.6 59.2 4.4 1.8451 18-2423.7 66.4 6.5 3.4 5,178 25-2923.2 68.2 6.6 2.0 6,034 30-3419.6 70.6 8.0 1.8 8,277 35-3920.4 69.7 8.4 1.5 4,565 40+22.4 67.8 8.4 1.4807 Two-thirds of all pregnant under-18 year olds reported drinking in pregnancy. Highest percentage drinking >10units/week was in the 18-24 year old age band. In most age categories 1:10 women drink more than 6 units/week 0.3% of the 14-17 year olds and the 18-24 year olds reported consuming more than 20 units/week, whereas 0.1% of all of the other age bands reported such usage.

12. Summary Over two-thirds of all pregnant under-18 year olds reported drinking alcohol during pregnancy Irish and UK-born mothers were more likely to report themselves as consuming more than 6 units a week as compared with EU and non- EU nationals The highest percentage category reporting drinking over 10 units per week was the 18 – 24 year olds 7.1% of all pregnant women admitted to drinking more than 6 units of alcohol per week 0.14% pregnant women reported that they drank more than 20 units.

13. Conclusions & actions There is a problem. Progress on tobacco (part of larger study) but not on alcohol. More systematic data collection is needed. An unambiguous public health message is called for…Minister for Health & Children mentioned labelling alcohol products when she launched the Report…

14. Alot done, alot more to do... Siobhán Barry, Clinical Director/Consultant Psychiatrist, Cluain Mhuire Service, Blackrock, Co Dublin & Visiting Consultant Psychiatrist, The Coombe Women’s Hospital, Dublin 8. Aoife Kearney, Research Assistant, Cluain Mhuire Service Seán Daly, Master, The Coombe Women’s Hospital, Dublin 8. Liz Lawlor, Senior Clinical Psychologist, Cluain Mhuire Service Emma McNamee, IT Systems Manager, The Coombe Women’s Hospital Joe Barry, Senior Lecturer in Public Health & Primary Care, Trinity College, Dublin. Acknowledgements: The Coombe Womens’s Hospital Ethics Committee for their approval to proceed. The Health Promotion Unit of the Dept of Health & Children for funding. The Cluain Mhuire Service for their practical support. www.drugsandalcohol.ie/6131/1/Coombe_Women’s_Hospital_Alcohol_etc_Report_1987-2005.pdf