Of Pregnancy Blues and Drinking Clues

Negativity during pregnancy linked to greater risk of light and binge drinking

(RxWiki News) The recommendations not to drink alcohol while pregnant are clear from obstetric medical organizations in the US. Yet pregnant women feeling depressed may be at risk for ignoring this advice.

A recent study found that having higher levels of "negativity" increased the likelihood that a pregnant woman would drink alcohol.

Pregnant women who reported higher levels of negative emotions on a depression and anxiety survey were more likely to drink lightly and to binge drink.

The greatest risk with these women was for binge drinking during the second trimester.

Women experiencing depression, anxiety, or other feelings of negativity should discuss these emotions with their care provider.

"Tell your OB/GYN if you're feeling negative and down."

The study, led by Kim Stene-Larsen, of the Department of Psychosomatics and Health Behaviors at the Norwegian Institute of Public Health, aimed to find out whether feelings of negativity were related to pregnant women's drinking alcohol.

The researchers included in the study 66,111 women who were pregnant at some point during the study period, 1999 to 2008.

In analyzing pregnant women's use of alcohol, the researchers defined "light alcohol use" as 0.5 to 2 units of alcohol, one to four times a month.

A unit of alcohol was defined as one-third of a liter of beer or one sherry glass of wine or one shot glass of a liquor.

"Binge drinking" was defined as five or more units of alcohol drunk during the same period of time.

The women filled out questionnaires when they were 17 and 30 weeks pregnant, and the fathers of their children filled out questionnaires for the same time periods.

The women's levels of negativity — their tendency to view things from a negative perspective — were measured based on their responses to questions on an anxiety and depression symptom checklist.

Past research has shown that the questions on this symptom checklist match up with levels of negativity in individuals.

The researchers found that for each additional unit of greater negativity reported by the women on the anxiety/depression assessment, the likelihood of her drinking lightly during pregnancy increased by 27 percent during her first trimester and 28 percent during her second trimester.

Then, for each extra unit of negativity the women reported, the likelihood she would binge drink in the first trimester increased by 55 percent.

Negativity was even more strongly linked to binge drinking in the second trimester. A woman was more than twice as likely (114 percent higher odds) to binge drink during her second trimester for each unit increase on her anxiety/depression survey.

"Negative affectivity is associated with both light alcohol use and binge drinking during pregnancy," the researchers wrote.

They suggested that additional care and follow-up be offered to pregnant women who show clear signs of negativity.

Andre Hall, MD, an OBGYN at Birth and Women's Care, PA in Fayetteville, NC, noted that using alcohol to self-medicate is not uncommon.

"Alcohol is used by many people, whether pregnant or not, to escape reality and deal with negative feelings and depression," Dr. Hall said. "This clearly is not a healthy form of escape as it often leads to decreased inhibitions and poor decision making."

But he said that those effects become compounded in pregnant women because of possible effects on the unborn baby.

"While fetal alcohol syndrome is clearly more common with 'binge' drinking, no safe amount of alcohol during pregnancy has been established — hence the recommendation that women avoid all alcohol during pregnancy," Dr. Hall said.

"Using alcohol as a way of addressing negative feelings in the non-pregnant state unfortunately often leads to using alcohol to address these same feelings in pregnancy," he said. "Therefore, its best to develop healthier ways to address these concerns early in life and avoid these negative habits altogether."

The study was published October 15 in the journal Acta Obstetricia et Gynecologica Scandinavica. The authors declared no conflicts of interest.

The research was funded by the Norwegian Research Council, the Norwegian Ministry of Health, the National Institutes of Health and the Danish Council for Independent Research.

Review Date: 
October 23, 2013