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Strengthen the Evidence for Maternal and Child Health Programs

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Evidence Tools
Drinking During Pregnancy

Introduction

This toolkit summarizes content from the Drinking During Pregnancy Evidence Accelerator and the MCHbest database. The peer-reviewed literature supporting this work can be found in the Established Evidence database. Use the resources below as you develop effective evidence-based/informed programs and measures.

From the MCH Block Grant Guidance. Fetal alcohol spectrum disorders (FASDs), which result in life-long physical and cognitive and/or behavioral problems, are caused by drinking during pregnancy.1 Fetal alcohol syndrome (FAS) represents the severe end of FASDs, and is characterized by abnormal facial features (e.g., smooth ridge between nose and upper lip), lower than average height or weight, and central nervous system problems that create deficits in learning, memory, attention, communication, vision, and/or hearing.1 While there is no known safe level of alcohol consumption in pregnancy, binge drinking and regular heavy drinking pose the greatest risks to fetal development.2 In 2018-2020, 13.5% of pregnant adults reported drinking any alcohol in the past 30 days, and 5.2% reported binge drinking.3

Goal. To reduce the percent of infants born with fetal alcohol spectrum disorders.

Note. Access other related measures in this Population Domain through the Toolkits page.

Detail Sheet: Start with the MCH Block Grant Guidance

DEFINITION

Numerators:

A) Number of women who reported having any alcoholic drinks during any trimester of pregnancy

B) Number of women who reported having 4 or more alcoholic drinks in a 2-hour timespan during any trimester of pregnancy

Denominator:

Number of women with a recent live birth

Units: 100

Text: Percent

HEALTHY PEOPLE 2030 OBJECTIVE

Related to Maternal, Infant, and Child Health (MICH) 09: Increase abstinence from alcohol among pregnant women. (Baseline: 89.3% of pregnant females aged 15 to 44 years reported abstaining from alcohol in the past 30 days in 2017-18, Target: 92.2%)

DATA SOURCES

Pregnancy Risk Assessment Monitoring System (PRAMS)

MCH POPULATION DOMAIN

Perinatal/Infant Health

MEASURE DOMAIN

Health Behavior

1. Accelerate with Evidence—Start with the Science

The first step to accelerate effective, evidence-based/informed programs is ensuring that the strategies we implement are meaningful and have high potential to affect desired change. Read more about using evidence-based/informed programs and then use this section to find strategies that you can adopt or adapt for your needs.

Evidence-based/Informed Strategies: MCHbest Database

The following strategies have emerged from studies in the scientific literature as being effective in advancing the measure. Use the links below to read more about each strategy or access the MCHbest database to find additional strategies.

Chart of Evidence-Linked Strategies and Tools

Evidence-Informed

Evidence-Based

Mixed Evidence

Emerging Evidence

Expert Opinion

Moderate Evidence

Scientifically Rigorous

 

Field-Based Strategies: Find promising programs from AMCHP’s Innovation Hub

Cutting Edge:

Emerging:

Promising:

Best:

2. Think Upstream with Planning Tools—Lead with the Need

The second step in developing effective, evidence-based/informed programs challenges us to plan upstream to ensure that our work addresses issues early and is measurable in “turning the curve” on big issues that face MCH populations. Read more about moving from root causes to responsive programs and then use this section to align your work with the data and needs of your populations.

Move from Need to Strategy

Use Root-Cause Analysis (RCA) and Results-Based Accountability (RBA) tools to build upon the science to determine how to address needs.

Planning Tools: Use these tools to move from data to action

3. Work Together with Implementation Tools—Move from Planning to Practice

The third step in developing effective, evidence-based/informed programs calls us to work together to ensure that programs are implementable and moveable within the realities of Title V programs and lead to improved health outcomes for all people. Read more about implementation tools designed for MCH population change and then use this section to develop responsive strategies to bring about change that is responsive to the needs of your populations.

Additional MCH Evidence Center Resources: Access supplemental materials from the literature

Implementation Resources: Use these field-generated resources to affect change

Practice. The following tools can be used to translate evidence to action to advance this SM:

Partnership. The following organizations have developed tools to address drinking during pregnancy:

References

Introductory References: From the MCH Block Grant Guidance

1 Centers for Disease Control and Prevention. Fetal Alcohol Spectrum Disorder (FASDs). 2022 November 4. https://www.cdc.gov/ncbddd/fasd/facts.html
2 National Institute on Alcohol Abuse and Alcoholism. Fetal Alcohol Exposure. 2021 June. https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/fetal-alcohol-exposure
3 Gosdin LK, Deputy NP, Kim SY, Dang EP, Denny CH. Alcohol Consumption and Binge Drinking During Pregnancy Among Adults Aged 18-49 Years - United States, 2018-2020 [published correction appears in MMWR Morb Mortal Wkly Rep. 2022 Jan 28;71(4):156]. MMWR Morb Mortal Wkly Rep. 2022;71(1):10-13. Published 2022 Jan 7. doi:10.15585/mmwr.mm7101a2 https://www.cdc.gov/mmwr/volumes/71/wr/mm7101a2.htm

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U02MC31613, MCH Advanced Education Policy, $3.5 M. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.