Number of U.S. Alcohol-exposed Pregnancies and Births May Be Substantially Lower Than Previously Estimated

Pregnant woman wrestling with whether to take a drink

Approximately 731,000 women in the U.S. are at risk for alcohol-exposed pregnancies each month, according to a new estimate published by researchers at the University of California at San Francisco. Although this number still indicates cause for concern, the new estimate is much lower than the estimate of 3.3 million released in 2016 by the U.S. Centers for Disease Control and Prevention (CDC).

Sarah C.M. Roberts, DrPH, at Advancing New Standards in Reproductive Health (ANSIRH) at University of California, San Francisco (UCSF) and Kirsten M. Thompson, MPH, at UCSF used the same data source as the CDC, information about women aged 15-44 from the National Survey of Family Growth. The UCSF researchers modified the approach regarding the chances of becoming pregnant, alcohol exposure once a pregnancy is established, the level of alcohol consumption considered harmful, and the fact that pregnancy outcomes could include miscarriage and abortion as well as births. They estimated the prevalence of alcohol-exposed pregnancies (AEPs) to be 1.2 percent of pregnancies and alcohol-exposed births (AEBs) to be 0.8 percent, or 481,000 births per month. 

Roberts and Thompson explain that their estimate of expected actual numbers of alcohol-exposed pregnancies and births “does not question the importance of alcohol use during pregnancy as a public health problem or deny that public health efforts should be expended” to address it. Their concern is that overestimating the scope of the problem could lead to moral panic and more stigmatizing and punitive approaches to alcohol use during pregnancy, which can in turn lead to less prenatal care use and more adverse birth outcomes. 

“These estimates provide an important alternative to the CDC estimates and the approach we used should inform future efforts to estimate AEPs and AEBs, which may be more relevant public health metrics,” the authors conclude. 

“Public health efforts to address alcohol use during pregnancy must be carefully crafted to avoid discouraging women from seeking care,” said  Amita Vyas, PhD, MHS, an associate professor of prevention and community health at the George Washington University Milken Institute School of Public Health and the Editor-in-Chief of Women’s Health Issues. “This study makes an important contribution to those efforts by providing an estimate based on the best available scientific evidence.”

Estimating the Prevalence of United States Women with Alcohol-exposed Pregnancies and Births” was published online and will appear in the March/April issue of Women’s Health Issues