Alcohol consumption by reproductive-aged women in the USA: an update on assessment, burden and prevention in the 1990s

Because of alcohol's effects on maternal, fetal and child health, the publi c health implications of alcohol abuse by women are potentially greater tha n those of alcohol abuse by men. This report provides a summary of developm ents in the field of alcohol use and women's health in the 1990s. During th e 1990s, the prevalence of alcohol consumption, including binge drinking, a ppears to have increased among pregnant women, whereas there was little cha nge among non-pregnant women of childbearing age. The prevalence of alcohol use among women under 21 years of age, for whom alcohol should be inaccess ible, is equal to or greater than that in older age groups. Adverse effects have been detected among pregnant women who consume more than three drinks per week on average. Alcohol may impair fertility and increase the risk fo r breast cancer. The national burden from all effects of alcohol on women's health has not been assessed. The available brief screening instruments to detect alcohol use do not detect moderate alcohol consumption or binge dri nking by pregnant women. Brief primary care clinic-based behavioral interve ntions and some medications have been shown to decrease alcohol use and sub sequent problems among women who are problem drinkers. To prevent alcohol-e xposed pregnancies, researchers need to study the feasibility of these inte rventions for pregnant women including moderate drinkers, as well as interv entions that enhance the use of contraception among women who misuse alcoho l and are at risk for pregnancy. Attempts to reduce alcohol-exposed pregnan cies should begin prior to conception. Primary care providers for women, in cluding obstetricians, general practitioners, family planning advisers and school health-care providers can play an important role in the prevention o f all adverse effects of alcohol consumption by women.