# A Population-Based Study on Women Who Used Alcohol during Pregnancy and Their Neonates in Ontario, Canada

## TL;DR

This study examines the effects of alcohol use during pregnancy on maternal and neonatal outcomes in Ontario, finding significant risks for both mothers and babies.

## Contribution

The study provides population-based evidence linking prenatal alcohol use and mental health/substance use history to adverse neonatal outcomes.

## Key findings

- Prenatal heavy alcohol use was associated with a 2.5 times higher risk of neonatal abstinence syndrome.
- Women with mental health/substance use problems had significantly higher odds of heavy alcohol use during pregnancy.
- Exposure to alcohol and other substances increased the risk of preterm birth and NICU admission.

## Abstract

Background: Data from birth registries can be studied to assess the prevalence of prenatal alcohol use and associated maternal and neonatal outcomes. Methods: Linked maternal and neonatal data (2015–2018) for alcohol-exposed pregnancies were obtained from the Better Outcomes Registry and Network (BORN) Ontario. Descriptive statistics were generated for maternal demographics, prenatal substance use, mental health/substance use history, and neonatal outcomes. Logistic regression models were performed to assess the odds of prenatal heavy (binge or weekly) alcohol and other substance use based on mental health/substance use history and other maternal demographics, and the impacts of heavy alcohol use and other prenatal substance exposures on neonatal outcomes. Results: A total of 10,172 (2.4%) women reported alcohol use during pregnancy. One-third had pre-existing or current mental health and/or substance use problems, which was associated with significantly higher odds of heavy alcohol use during pregnancy. Prenatal exposure to heavy alcohol use was associated with increased odds of neonatal abstinence syndrome (2.5 times); respiratory distress syndrome (2.3 times); neonatal intensive care unit (NICU) admission (58%); and hyperbilirubinemia (57%). Prenatal exposure to one or more substances in addition to alcohol was associated with significantly higher odds of fetal/maternal/placental pregnancy complications; preterm birth; NICU admission; low APGAR scores; one or more confirmed congenital anomalies at birth; respiratory distress syndrome; and intrauterine growth restriction. Conclusions: It is crucial to routinely screen childbearing-age and pregnant women for alcohol and other substance use as well as mental health problems in order to prevent adverse maternal and neonatal outcomes.