T-ACE and predictors of self-reported alcohol use during pregnancy in a large, population-based urban cohort

Matthew Hicks, Suzanne C. Tough, David Johnston, Jodi Siever, Margaret Clarke, Reg Sauve, Rollin Brant, Andrew W. Lyon

Abstract


Hicks, M., Tough, S., Johnston, D., Siever, J., Clarke, M., Sauve, R., Brant, R., & Lyon, A. (2014). T-ACE and predictors of self-reported alcohol use during pregnancy in a large, population-based urban cohort. The International Journal Of Alcohol And Drug Research, 3(1), 51-61. doi:10.7895/ijadr.v3i1.117

Aims: To determine 1) the relationship between T-ACE score and maternal self-reported alcohol use prior to and during pregnancy, and 2) the relationship between T-ACE score and maternal demographics, mental health and life circumstances.

Design: Prospective, population-based cohort study.

Setting: Three urban maternity clinics in Calgary, Canada.

Participants: 1,929 pregnant women attended by family physicians at low-risk maternity clinics.

Measures: Women completed three standardized questionnaires over the telephone in the first and third trimesters and eight weeks post-delivery, including the T-ACE and questions about drug and alcohol use, demographics, mental health and life circumstances.

Findings: 43.6% of subjects had a positive T-ACE score at intake (score 2 or greater). A positive T-ACE score was predictive of alcohol use throughout pregnancy, although most women reported no alcohol after the first trimester (93.1%). Multivariate analysis indicated that a positive T-ACE score was significantly associated with being less than 30 years of age; being Caucasian; smoking during pregnancy; having an income of less than $80,000 per annum; having a history of depression; having a history of alcohol use and binge drinking during a previous pregnancy; lower social support; and poor network orientation.

Conclusions: There was a positive association between the T-ACE score and maternal self-report of alcohol use, poor mental health and poor social support. Routine use of the T-ACE to assess for risk of an alcohol-exposed pregnancy may also help identify women with complex needs who could benefit from additional prenatal support.


Keywords


screening questionnaire; prenatal alcohol use; fetal alcohol spectrum disorders; prenatal care

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DOI: http://dx.doi.org/10.7895/ijadr.v3i1.117

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