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Pre-pregnancy and Prenatal Alcohol use Among American Indian and Alaska Native and Non-Hispanic White Women: Findings from PRAMS in Five States

Abstract

Introduction

Estimates of prenatal alcohol use among American Indian and Alaska Native (AI/AN) women are limited. This study sought to characterize pre-pregnancy and prenatal alcohol use among AI/AN women in the Pregnancy Risk Assessment Monitoring System (PRAMS) dataset, evaluate variation in alcohol use by state and rural/urban residence, and evaluate associations between potential risk factors and prenatal alcohol use among AI/AN and non-Hispanic white (NHW) women.

Methods

We pooled PRAMS data from five states (Alaska, New Mexico, Oklahoma, South Dakota and Washington) from 2015 to 2017. We estimated the prevalence of pre-pregnancy and pregnancy risk factors, and alcohol use by race and examined alcohol use by state and rural/urban residence among AI/AN women. We conducted bivariate and multivariable logistic regression modelling to estimate the association between each risk factor of interest and the odds of prenatal alcohol use for AI/AN and NHW women.

Results

AI/AN women were less likely to report pre-pregnancy alcohol use compared to NHW women (56% vs. 76%, p < 0.0001). Among women who reported drinking pre-pregnancy, AI/AN women were more likely than NHW women to report drinking 1 or more drinks during pregnancy (4.3% vs. 2.4, p = 0.0049). For AI/AN women, older age and experiencing homelessness (aOR = 2.76; 95% CI 1.16–6.55) increased odds of prenatal alcohol use. For NHW women, having a college education (aOR = 4.06; 95% CI 1.19–13.88) and urban residence (aOR = 1.88; 95% CI 1.40–2.53) increased odds of prenatal alcohol use.

Conclusions

Factors associated with prenatal alcohol use differ between AI/AN women and NHW women, suggesting the need for tailored interventions.

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Acknowledgements

The authors wish to thank the Centers for Disease Control and Prevention and the PRAMS Working Group for the PRAMS data.

Funding

This research is supported by the Native Center for Alcohol Research and Education (NCARE) Pilot Project Grant Program which is funded under the National Institute on Alcohol Abuse and Alcoholism Award Number P60AA026112 (PI:Buchwald).

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Correspondence to Luciana E. Hebert.

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Hebert, L.E., Sarche, M.C. Pre-pregnancy and Prenatal Alcohol use Among American Indian and Alaska Native and Non-Hispanic White Women: Findings from PRAMS in Five States. Matern Child Health J 25, 1392–1401 (2021). https://doi.org/10.1007/s10995-021-03159-7

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  • DOI: https://doi.org/10.1007/s10995-021-03159-7

Keywords

  • PRAMS
  • Pregnancy
  • Prenatal alcohol use
  • American Indian
  • Alaska Native