Week-by-week alcohol consumption in early pregnancy and spontaneous abortion risk: a prospective cohort study

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Publisher: Elsevier B.V.
Document Type: Clinical report
Length: 519 words

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Abstract :

Key words alcohol; miscarriage; pregnancy; prospective cohort; spontaneous abortion Background Half of women use alcohol in the first weeks of gestation, but most stop once pregnancy is detected. The relationship between timing of alcohol use cessation in early pregnancy and spontaneous abortion risk has not been determined. Objective This study aimed to evaluate the association between week-by-week alcohol consumption in early pregnancy and spontaneous abortion. Study Design Participants in Right from the Start, a community-based prospective pregnancy cohort, were recruited from 8 metropolitan areas in the United States (2000--2012). In the first trimester, participants provided information about alcohol consumed in the prior 4 months, including whether they altered alcohol use; date of change in use; and frequency, amount, and type of alcohol consumed before and after change. We assessed the association between spontaneous abortion and week of alcohol use, cumulative weeks exposed, number of drinks per week, beverage type, and binge drinking. Results Among 5353 participants, 49.7% reported using alcohol during early pregnancy and 12.0% miscarried. Median gestational age at change in alcohol use was 29 days (interquartile range, 15--35 days). Alcohol use during weeks 5 through 10 from last menstrual period was associated with increased spontaneous abortion risk, with risk peaking for use in week 9. Each successive week of alcohol use was associated with an 8% increase in spontaneous abortion relative to those who did not drink (adjusted hazard ratio, 1.08; 95% confidence interval, 1.04--1.12). This risk is cumulative. In addition, risk was not related to number of drinks per week, beverage type, or binge drinking. Conclusion Each additional week of alcohol exposure during the first trimester increases risk of spontaneous abortion, even at low levels of consumption and when excluding binge drinking. Author Affiliation: (a) Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN (b) Division of Quantitative Sciences, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN (c) Department of Bioinformatics, Vanderbilt University Medical Center, Nashville, TN (d) Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN * Corresponding author: Katherine E. Hartmann, MD, PhD. Article History: Received 20 November 2019; Revised 28 May 2020; Accepted 7 July 2020 (footnote) The authors report no conflict of interest. (footnote) This work was supported by the Eunice Kennedy Shriver National Institute of Child and Human Development (R01 HD043883, R01 HD049675, and F30 HD094345), the American Water Works Association Research Foundation (2579), the National Institute of General Medical Sciences (T32 GM07347), and the National Center for Advancing Translational Sciences (UL1 TR000445). Funding sources had no role in study design; collection, analysis, or interpretation of data; writing of the report; or the decision to submit the article for publication. (footnote) Cite this article as: Sundermann AC, Velez Edwards DR, Slaughter JC, et al. Week-by-week alcohol consumption in early pregnancy and spontaneous abortion risk: a prospective cohort study. Am J Obstet Gynecol 2021;224:97.e1-16. Byline: Alexandra C. Sundermann, MD, PhD (a), Digna R. Velez Edwards, PhD (a,b,c), James C. Slaughter, DrPH (d), Pingsheng Wu, PhD (d), Sarah H. Jones, MPH (a), Eric S. Torstenson, BS (a), Katherine E. Hartmann, MD, PhD [katherine.hartmann@vumc.org] (a,b,*)

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Gale Document Number: GALE|A648966087