Alcohol use and self-perceived mental health status among pregnant and breastfeeding women in Canada: a secondary data analysis

Objective: To estimate the prevalence of alcohol consumption during pregnancy and while breastfeeding in Canada from 2003 to 2010, and to test the relation between self-perceived mental health status and alcohol consumption during pregnancy and while breastfeeding.

Design: Secondary analysis of four cycles of the Canadian Community Health Survey, a population-based cross-sectional survey.

Setting: Canada.

Sample: A total of 18 612 pregnant and 15 836 breastfeeding women.

Methods: The prevalence of alcohol consumption during pregnancy and while breastfeeding and 95% confidence intervals (CI) were calculated by province and territory, and cycle. The relation between self-perceived mental health status and alcohol consumption during pregnancy and while breastfeeding was explored using quasi-Poisson regression models.

Main outcome measures: Alcohol consumption during pregnancy and while breastfeeding, and self-perceived mental health status.

Results: In Canada, between 2003 and 2010, approximately one in every ten pregnant women (9.9%; 95%CI 9.2-10.5%) and two in every ten breastfeeding women (20.3%; 95%CI 19.4-21.2%) women consumed alcohol. Women with a lower self-perceived mental health status (i.e. 'good') were 1.40 (95%CI 1.18-1.67, P < 0.001) times more likely to have consumed alcohol during pregnancy, compared with women with an 'excellent' self-perceived mental health. There were no notable differences between the categories of mental health status in regard to alcohol consumption while breastfeeding.

Conclusion: Despite public health efforts in Canada, a significant proportion of pregnant and breastfeeding women consume alcohol. It is imperative that a standard screening protocol be initiated among pregnant and breastfeeding women, especially in high-risk populations (e.g. women utilising substance abuse treatment programs).

Tweetable abstract: In Canada in 2003-2010, approximately 10% of pregnant and 20% of breastfeeding women consumed alcohol.