Pregnancy appears to be a key motivator in reducing alcohol use disorder, according to the results of a study published in the American Journal of Psychiatry.
Consumption of alcohol during pregnancy is known to increase the risk for miscarriage, stillbirth, and birth defects in offspring. The World Health Organization states that there is no safe level of alcohol use during pregnancy. Nonetheless, a national survey indicated that nearly 10% of pregnant women in the United States use alcohol, and more than 2% reported binge drinking. In the United Kingdom, 28.5% of women reported drinking during pregnancy, whereas Swedish women more closely mirror American women, with 7.2% who reported drinking during pregnancy.
Alexis C Edwards, PhD, of the Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, Virginia, and colleagues used data from longitudinal population-wide Swedish medical, pharmacy, and criminal registries to determine whether or not the rates of alcohol use disorder decreased during pregnancy. They compared data from 322,029 pregnant women born between 1975 and 1992 with data from matched population controls, from nonpregnant female relatives, and from prepregnancy and postpregnancy periods within individuals. They also compared the rates of alcohol use disorder of the pregnant women and their partners.
The investigators found that alcohol use disorder was inversely associated with pregnancy across all analyses (odds ratios, 0.17-0.32). The within-individual analysis found that the rate of alcohol use disorder decreased substantially during pregnancy relative to the prepregnancy period (odds ratios, 0.25-0.26). Furthermore, these rates continued to be lower during the postpartum period (odds ratios, 0.23-0.31).
Interestingly, the partners of pregnant women also demonstrated reductions in alcohol use disorder (odds ratio, 0.45). Moreover, among women who became pregnant at earlier ages and those with a history of criminal behavior, the reduction in alcohol use disorder and its association with pregnancy was particularly strong.
The authors suggest that despite the reduction in the ability to exercise free will associated with substance use disorders and the severity of these disorders, pregnancy appears to have protective effects.
Edwards AC, Ohlsson H, Svikis DS, Sundquist J, Sundquist K, Kendler KS. Protective effects of pregnancy on risk of alcohol use disorder [published online November 29, 2018]. Am J Psychiatry. doi: 10.1176/appi.ajp.2018.18050632