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Current Australian guidelines advise that it is safest for pregnant women to completely refrain from drinking alcohol [ 1, 14 ]. This approach has been adopted around the world and public health campaigns encourage women to drink no alcohol during pregnancy [ 15 ]. However, given the low rate of PAE in the general population, along with the lack of Australian data on maternal alcohol use, pregnant women themselves may not be aware of the prevalence of PAE in the population or its harms in relation to child development. Our cohort study presents the first comprehensive examination of drinking patterns during pregnancy in Melbourne, Australia. We observed that 29% of women abstained from alcohol in the three months before pregnancy, 43% drank moderately (one to two drinks) and 28% drank moderately throughout pregnancy. Eleven per cent drank heavily (three or more drinks) in pregnancy, and 48% of women reported binge drinking in the three months prior to pregnancy (median of 3 drinks on one occasion, inter-quartile range 2 to 5).
The AQUA study sought to address these issues by exploring exposure to alcohol in pregnancy from the perspective of pregnant women themselves. To this end, all women were given questionnaires at three time points throughout pregnancy, the last after 36 weeks gestation. The first questionnaire was administered at their first antenatal visit, the second and third were given about three and six weeks later, respectively.
The focus of our research program has been the design of alcohol, cigarettes, and other substance use “Checklists” to be used in the earliest stages of intake by new clients undergoing a substance abuse assessment. These Checklists are able to identify whether or not the client is at the beginning, middle or end of their substance use patterns. The first Checklist was designed in the mid-1990s by Dr. Patricia McDermott and her team at the California Institute of Human Development. A total of 42 men and 78 women ranging in age from 17 to 25 were asked to rate the intensity, frequency, and duration of their Alcohol, Cigarettes and Other Substance Use on a scale from 0-10. It was found that the Checklists were useful in identifying the different substance use patterns from beginner, middle and advanced to moderate to heavy use of substances. The Checklists were used in many countries. They have been revised to the substance, such as cannabis, and to the age group being studied (adolescents, young adults and adults). These Checklists now cover: Alcohol, Cigarettes, Other Substances, Dependence, Treatment, Safety in Hazardous Accidents, Social/Isolation, Alternative Lifestyles, Life Stressors, Emotional Problems, Physical Problems, Anxiety, Depression and Suicide. The Checklists have been published in the U.S. by the Substance Abuse and Mental Health Services Administration ( SAMSHA), the UK by the Health and Safety Executive ( HSE) and are published in Australia by the Industrial Health and Safety Commission ( IHSC).
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