Reducing the Prevalence of Alcohol-Exposed Pregnancies in the United States: A Simulation Modeling Study

Reza Yaesoubi, Maya Mahin, Geoffrey Martin, A. David Paltiel and Mona Sharifi
Additional contact information
Reza Yaesoubi: Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
Maya Mahin: Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
Geoffrey Martin: Yale-NUS College, Singapore
A. David Paltiel: Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
Mona Sharifi: Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA

Medical Decision Making, 2022, vol. 42, issue 2, 217-227

Abstract: Background Public health efforts to prevent alcohol-exposed pregnancies (AEPs) primarily focus on promoting abstinence from alcohol among women if pregnant or seeking pregnancy and using effective contraception to prevent unintended pregnancies if consuming alcohol. Little is known about how programs to improve adherence to these recommendations would affect the prevalence of AEPs. Methods We developed an individual-based simulation model of US women of reproductive age to project the prevalence of AEPs under different public health strategies. The model varies each woman’s risk of an AEP over time depending on fertility, contraceptive use, awareness of pregnancy, sexual activity, and drinking patterns. We used the 2013–2015 National Survey on Family Growth data set to parameterize the model. Results We estimate that 54% (95% uncertainty interval: 48%–59%) of pregnancies that result in a live birth in the United States are exposed to alcohol, 12% (10%–15%) are ever exposed to ≥5 alcoholic drinks in a week, and 3.0% (1.3%–4.2%) to ≥9 drinks. Unintended pregnancies (either due to contraceptive failure or sex without contraceptives) account for 80% (75%–87%) of pregnancies unknowingly exposed to alcohol. We project that public health efforts that focus only on promoting alcohol abstinence among women who are aware of their pregnancy or seeking pregnancy could reduce the prevalence of AEPs by at most 42% (36%–48%). Augmenting this strategy with efforts to avert unintended pregnancies could yield an 80% (73%–86%) reduction in the prevalence of AEPs. Conclusions Promoting alcohol abstinence among women who are aware of their pregnancy or seeking pregnancy offers limited potential to reduce the prevalence of AEPs. Programs to avert unintended pregnancies are essential to achieve more substantial reductions in AEPs in the United States.

Keywords: alcohol consumption; alcohol exposure; pregnancy; risk; simulation (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X211023203 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:42:y:2022:i:2:p:217-227

DOI: 10.1177/0272989X211023203

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().