Postpartum and alcohol-related factors associated with the relapse of risky drinking

The purposes of this investigation were (1) to describe postpartum drinking patterns among women who were frequent drinkers before pregnancy and (2) to identify factors correlated with postpartum "risky" drinking among women who were frequent drinkers before pregnancy.

Information was gathered through a self-administered questionnaire completed at the postpartum visit and a subsequent face-to-face interview of 381 women, recruited from 35 obstetric/gynecologic clinics throughout Wisconsin, who reported frequent drinking before pregnancy. Multivariate analyses were used to identify correlates of postpartum risky drinking, defined as consuming four or more drinks per occasion (heavy episodic drinking) at least twice in the past 28 days or drinking an average of seven or more drinks per week.

Overall, 37.8% (n = 144) of women reported postpartum risky drinking. Eighteen percent reported heavy episodic drinking only, 5% reported frequent drinking only, and 15% reported both behaviors. Postpartum risky drinkers were more likely than other women to have had a partner who engaged in risky drinking (odds ratio [OR] = 2.6, 95% confidence interval [CI]: 1.5-4.5), to have been unemployed (OR = 3.0, 95% CI: 1.2-7.7), to have smoked following pregnancy (OR = 1.9, 95% CI: 1.0-3.5), and to have consumed alcohol after the recognition of pregnancy (OR = 4.8, 95% CI: 2.2-10.6). Women who breast-fed their child were less likely to report risky drinking (OR = 0.3, 95% CI: 0.2-0.5).

In the postpartum period, health care providers may want to focus alcohol screening efforts on former frequent drinkers who are smokers, are unemployed, have a partner who is a risky drinker, or are not breast-feeding.