The prevalence and changes of alcohol consumption across three trimesters of pregnancy assessed by ethyl glucuronide concentration in maternal hair and self-reports: a cross-sectional study

Introduction: The teratogenic effect of alcohol is well known, but its prevalence is usually underestimated. This study presents the findings of a cross-sectional study conducted in Poland, which aimed to assess the prevalence and changes in alcohol consumption during pregnancy. The study utilized ethyl glucuronide concentration in maternal hair and self-reports as measures to evaluate alcohol intake across the three trimesters of pregnancy.

Methods: The study involved postpartum women (n=150) and their babies. Hair samples from 135 participants allowed segmental analysis (separately for the three trimesters) and hair from 15 were analysed for the entire 9 moths by gas chromatography tandem mass spectrometry. Survey data included self-reports of health related behaviours and socio-demographic characteristics; medical records - information on the course of a pregnancy and newborns health.

Results: Standard medical interview revealed no cases of alcohol use during pregnancy. The analysis of EtG indicated 50.3% women had been drinking alcohol at any time during pregnancy, including 10% with excessive alcohol consumption. Most participants maintained the same level of alcohol consumption throughout the pregnancy but 8.7% women decreased and 20.7% increased the amount of alcohol consumed between 1st and 2nd or 2nd and 3rd trimester. Gestational consumption of alcohol was not related to sociodemographic characteristics, course of pregnancy and self-reported health behaviours but babies of women who drunk alcohol during pregnancy were more often small for gestation age than babies of abstainers (OR=6.008), with the highest risk observed in case of increased alcohol consumption (OR=12,348).

Conclusions: Maternal hair analysis is useful in detecting pregnancy alcohol use and allows retrospective analysis over a longer period than other biological samples, providing a more comprehensive pattern of use throughout pregnancy. However, there is a need to improve routine methods of interviewing patients about alcohol use and to implement effective preventive strategies regarding alcohol consumption during pregnancy in Poland.