Perinatal Alcohol and Tobacco Use
Date Posted: 07/30/2009
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'The Pregnancy Risk Assessment Monitoring System (PRAMS) is a population-based risk factor surveillance system designed to identify and monitor behaviors and experiences of women before, during, and after pregnancy. Colorado continues to have one of the highest low birth weight rates in the nation for total births and for births in all major racial and ethnic groups. PRAMS provides a method for the collection and analysis of perinatal data to better understand not only low birth weight rates, but also maternal behaviors, access to prenatal care, pregnancy intendedness, and health care delivery to women and infants in Colorado.
'The PRAMS questionnaire is mailed to a sample of Colorado women each month and telephone follow-up is conducted with women who do not return the survey by mail. The written questionnaires and telephone interviews can both be completed in English or Spanish. Approximately 240 women in Colorado receive the survey each month, with an expected response rate of at least 70% (Colorado Health Information Dataset).'
Where large increases are evident, it is important to note that the sample size is rather small, therefore these increases may be insignificant. See data tables for actual numbers and percentages.
What this chart shows: Maternal Report of Alcohol Use During Pregnancy

Data Source: Colorado Health Information Dataset-Pregnancy Risk Assessment Monitoring System
What these data tell us:
During the interview (see above for study method), mothers were asked: 'Did you drink alcohol during the last 3 months of your pregnancy?' Colorado and Larimer County mothers differed slightly in the percent who reported that they did drink during that time. The figure was 10.3% for Colorado mothers and 11.4% for Larimer County mothers. From 2004 to 2006, there was a rise in the percentage of Larimer County mothers who consumed alcohol during the last 3 months of their pregnancy, from 7.2% to 12.9%. One possible explanation is that the raw numbers in Larimer County are relatively low so even slight deviations equate to higher percentage changes. (See data table)
Nationally, one out of every 30 women who knew they were pregnant report 'risk drinking' (7 or more drinks per week, or 5 or more drinks on any one occasion). Additionally, one in seven women of childbearing age (18 to 44 years) report 'risk drinking'; these alcohol levels can pose a threat to the fetus should a woman be pregnant and not know it (Centers for Disease Control).
What this chart shows: Maternal Tobacco Use at Stages of Pregnancy

Data Source: Colorado Health Information Dataset-Pregnancy Risk Assessment Monitoring System
What this chart shows: Maternal Consent to Smoking in a Room with an Infant Present

Data Source: Colorado Health Information Dataset-Pregnancy Risk Assessment Monitoring System
What these data tell us:
During the interview (see above for study method), mothers were asked: 'Did you smoke during the 3 months before you got pregnant?', 'Did you smoke during the last 3 months of your pregnancy?', and 'Do you smoke now (when the survey was completed)?' As of November 2006, national figures for pregnant women who smoke, ages 15 to 44, were 18%, compared with 30% of nonpregnant women who were the same age. The five-year average (2003-2007) of survey respondents who reported smoking while pregnant was 12.6% in Colorado and 10.7% in Larimer County, significantly lower than the Healthy People 2010 Objective of 30%.Overall, smoking among females was associated with lower income, younger age (<25 years), having less than or equal to a high school education, and race - smoking was most prevalent in Native American or Alaskan Native women (Centers for Disease Control).
Colorado mothers completing the PRAMS interview were also asked: 'Is your new baby ever left in a room with someone smoking?' The five-year average for Colorado was 3.9% while that for Larimer County was 4.1%, significantly lower than the Healthy People 2010 Objective of 10%. The percentage of Larimer County mothers who allowed smoking with their baby in the room decreased from 6.6% in 2006 to 1.8% in 2007. However, as noted above, the sample size in Larimer County is too small to make this increase significant (See data table).
Numerous studies indicate that smoking by pregnant women, or being regularly exposed to environmental tobacco smoke (secondhand smoke), dramatically increases the risk of health problems both to themselves and their babies. Potential problems include the following: spontaneous abortions, other birth and delivery problems, fetal brain damage, growth retardation/low birth weight, and sudden infant death syndrome (Smoking While Pregnant, Colorado Department of Health and Environment).
Additional Information:
On Compass-
- Adult Alcohol Use
- Adult Tobacco Use
- Birth Defects
- Cardiovascular Disease & Stroke Mortality
- Infant Mortality
- Low Birthweight Babies
- Lung Cancer Incidence & Mortality
- Prenatal Care
- Teen Fertility Rates
- Women's Health (breast, cervical, uterine cancer incidence and mortality)
Outside Compass-
- Fetal Alcohol Syndrome, National Center on Birth Defects & Developmental Disabilities, Centers for Disease Control
- March of Dimes
- Mothers Who Smoke While Pregnant, Child Trends Databank
- National Organization on Fetal Alcohol Syndrome
- National Survey on Drug Use and Health (NSDUH) Report, Alcohol Use Among Pregnant Women and Recent Mothers: 2002 to 2007 (September 2008)
- Prevalence of Fetal Alcohol Syndrome in Colorado, Centers for Disease Control
- Safe Motherhood: Facts for Life
- Safe Motherhood: Promoting Health for Women Before, During and After Pregnancy 2008
- Women Benefit More from Quitting Smoking than Men, National Institutes of Health
Industry Standards or Targets:
16-17a. Increase alcohol abstinence during past month to 94%
16-17c. Increase cigarette smoking cessation during pregnancy to 99%
- 27-6. Increase smoking cessation during pregnancy to 30%.
- 27-9. Reduce the proportion of children who are regularly exposed to tobacco smoke at home to 10%.
Maternal Report of Alcohol Use During Pregnancy
|
Colorado Number 'Yes' |
Colorado Percentage |
Larimer County Number 'Yes' |
Larimer County Percentage |
|
|
2003 |
191 | 8.7% | 10 | 7.0% |
|
2004 |
187 | 10.1% | 11 | 7.2% |
|
2005 |
207 | 11.1% | 12 | 9.8% |
|
2006 |
187 | 11.2% | 16 | 12.9% |
|
2007 |
182 | 10.3% | 13 | 11.4% |
Maternal Tobacco Use and Pregnancy, 2003-2007 Five-Year Average
|
|
'Yes' N |
'Yes' % |
'No' N |
'No' % |
|
|
Smoking Before Pregnant
|
Colorado |
2,233 | 22.6% | 7,635 | 77.4% |
|
Larimer County |
143 | 21.6% | 520 | 78.4% | |
|
Smoking During Pregnancy
|
Colorado |
1,253 | 12.6% | 8,664 | 87.4% |
|
Larimer County |
71 | 10.7% | 593 | 89.3% | |
|
Smoking Now (After Pregnancy)
|
Colorado |
1,688 | 17.0% | 8,227 | 83.0% |
|
Larimer County |
98 | 14.7% | 567 | 85.3% | |
Maternal Consent of Smoking in a Room with an Infant Present
|
Colorado Number 'Yes' |
Colorado Percentage |
Larimer County Number 'Yes' |
Larimer County Percentage |
|
|
2003 |
103 | 4.6% | 6 | 4.9% |
|
2004 |
93 | 4.1% | 6 | 4.7% |
|
2005 |
88 | 4.0% | 2 | 2.4% |
|
2006 |
90 | 4.3% | 7 | 6.6% |
|
2007 |
42 | 2.5% | 2 | 1.8% |