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Research Report

Alcohol During Pregnancy from 1985 to 2005: Prevalence and High Risk Profile

Published Online:June 20, 2013https://doi.org/10.1024/0939-5911.a000248

Abstract

Aims: This study aimed 1. to examine the prevalence of German children born with prenatal alcohol exposure (PAE) from 1985 to 2005, and asked 2. whether it differed on levels of socioeconomic status (SES) and 3. whether there are differences between abstainers and drinkers during pregnancy in regard to physical, behavioural and sociodemographic features. Methods: 16 978 German mothers, enrolled in the German Health Interview and Examination Survey (KiGGS) were studied. Results: Between 1985 and 2005 13.5 percent of the children were born with PAE. No stable decrease was found over time. Over 20 years, the prevalence of children born with PAE was highest in the upper class. Drinkers differed from abstainers in regard to physical, behavioural and sociodemographic characteristics. High SES women were on a higher risk of alcohol intake during pregnancy. Conclusions: The prevalence of children born with PAE over time indicates that alcohol intake during pregnancy needs further interventions and prevention as no long-lasting decrease was found in the years from 1985 to 2005. Alcohol intake during pregnancy was and still is an issue in women from the upper class. Future research should therefore aim to explain the social gradient.


Alkohol in der Schwangerschaft von 1985 bis 2005: Prävalenz und Hochrisikoprofil

Fragestellung: Diese Studie untersuchte 1.) die Prävalenz von den in Deutschland geborenen Kindern mit pränataler Alkoholexposition (PAE) von 1985 bis 2005, 2.) ob sich diese nach dem sozioökonomischen Status (SES) unterschied und 3.) ob es physische, verhaltensorientierte und soziodemographische Unterschiede zwischen abstinenten und alkoholkonsumierenden Schwangeren gibt. Methodik: Untersucht wurden 16.978 deutsche Mütter, die an dem Kinder- und Jugendgesundheitssurvey (KiGGS) teilnahmen. Alkoholkonsum in der Schwangerschaft wurde mittels Selbstbeantwortungsfragebögen durch die Eltern erfasst. Der SES wurde durch Angaben der Eltern zur schulischen und beruflichen Ausbildung, der Berufsposition und dem Nettoeinkommen ermittelt. Zur statistischen Überprüfung unserer Forschungsfragen wurden Kreuztabellen, Varianzanalysen und multivariate logistische Regressionsanalysen berechnet. Ergebnisse: Von 1985 bis 2005 kamen 13,5 % der Kinder mit PAE zur Welt. Über 20 Jahre hinweg ließ sich kein stabiler Rückgang der Prävalenz verzeichnen. Die Prävalenz von PAE war über den Zeitverlauf in der Oberschicht stets am höchsten. Alkoholkonsumierende Schwangere unterschieden sich von abstinenten Schwangeren in Bezug auf physische, verhaltensorientierte und soziodemographische Charakteristika: Alkoholkonsumierende Schwangere hatten eine höhere Parität, eine geringere Gewichtszunahme in der Schwangerschaft, seltener Schwangerschaftsbluthochdruck und waren bei der Geburt des Kindes älter. Verglichen mit abstinenten Schwangeren rauchten die Alkoholkonsumentinnen häufiger während der Schwangerschaft und der Stillzeit und sie hatten seltener einen Migrationshintergrund. Der SES erwies sich als stärkster Prädiktor mütterlichen Alkoholkonsums in der Schwangerschaft. Im Vergleich zu den Frauen mit hohem SES waren die Risiken des Alkoholkonsums in der Schwangerschaft bei Frauen mit mittlerem SES (Odds Ratio (OR) 0,64; 95 % Konfidenzintervall (KI) 0,58 – 0,71) und niedrigem SES (OR 0,42; 95 % KI 0,37 – 0,49) signifikant geringer. Schlussfolgerungen: Die Prävalenz von PAE im Zeitverlauf von 20 Jahren impliziert, dass Alkohol in der Schwangerschaft weiterer Interventionen und Prävention bedarf, da sich von 1985 bis 2005 kein stabiler Rückgang verzeichnen ließ. Alkohol in der Schwangerschaft war und ist in Deutschland ein Oberschichtproblem und demnach gehören insbesondere Frauen mit hohem SES zur Hochrisikogruppe ein Kind mit PAE zur Welt zu bringen. Zukünftige Forschungen sollten daher eine Erklärung des sozialen Gradienten des Alkoholkonsums in der Schwangerschaft anstreben.

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