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Associations Between State-Level Policies Regarding Alcohol Use Among Pregnant Women, Adverse Birth Outcomes, and Prenatal Care Utilization: Results from 1972 to 2013 Vital Statistics
- Source :
- Alcoholism: Clinical and Experimental Research. 42:1511-1517
- Publication Year :
- 2018
- Publisher :
- Wiley, 2018.
-
Abstract
- Author(s): Subbaraman, Meenakshi S; Thomas, Sue; Treffers, Ryan; Delucchi, Kevin; Kerr, William C; Martinez, Priscilla; Roberts, Sarah CM | Abstract: BackgroundPolicies regarding alcohol use during pregnancy continue to be enacted and debated in the United States. However, no study to date has examined whether these policies are related to birth outcomes-the outcomes they ultimately aim to improve. Here, we assessed whether state-level policies targeting alcohol use during pregnancy are related to birth outcomes, which has not been done comprehensively before.MethodsThe study involved secondary analyses of birth certificate data from 148,048,208 U.S. singleton births between 1972 and 2013. Exposures were indicators of whether the following 8 policies were in effect during gestation: Mandatory Warning Signs (MWS), Priority Treatment for Pregnant Women, Priority Treatment for Pregnant Women/Women with Children, Reporting Requirements for Data and Treatment Purposes, Prohibitions Against Criminal Prosecution, Civil Commitment, Reporting Requirements for Child Protective Services Purposes, and Child Abuse/Child Neglect. Outcomes were low birthweight (l2,500ng), premature birth (l37nweeks), any prenatal care utilization (PCU), late PCU, inadequate PCU, and normal (≥7) APGAR score. Multivariable fixed-effect logistic regressions controlling for both maternal- and state-level covariates were used for statistical analyses.ResultsOf the 8 policies, 6 were significantly related to worse outcomes and 2 were not significantly related to any outcomes. The policy requiring MWS was related to the most outcomes: specifically, living in a state with MWS was related to 7% higher odds of low birthweight (pnln0.001); 4% higher odds of premature birth (pnln0.004); 18% lower odds of any PCU (pnln0.001); 12% higher odds of late PCU (pnln0.002); and 10% lower odds of a normal APGAR score (pnln0.001) compared to living in a state without MWS.ConclusionsMost policies targeting alcohol use during pregnancy do not have their intended effects and are related to worse birth outcomes and less PCU.
- Subjects :
- Child abuse
Pregnancy
business.industry
030508 substance abuse
Medicine (miscellaneous)
Prenatal care
Birth certificate
Toxicology
medicine.disease
Article
Odds
03 medical and health sciences
Psychiatry and Mental health
0302 clinical medicine
Premature birth
medicine
Apgar score
030212 general & internal medicine
0305 other medical science
business
Child neglect
Demography
Subjects
Details
- ISSN :
- 01456008
- Volume :
- 42
- Database :
- OpenAIRE
- Journal :
- Alcoholism: Clinical and Experimental Research
- Accession number :
- edsair.doi.dedup.....e978d933a6e28c2f115db7bb578adab5