Alcohol and smoking among pregnant women in Austria - results of a mixed-methods study

Background:

Prenatal exposure to nicotine or alcohol is an important risk factor for the development of the unborn child. The aim of the study was to assess the prevalence of alcohol consumption and smoking by pregnant women in Vienna, Austria, as well as possible contributing factors and how these topics are dealt with in prenatal care.

Methods:

An online survey of women who had recently given birth (N=888), qualitative interviews with pregnant women in the last trimester (N=32), focus groups with midwives (N=11) and an online survey of gynaecologists and midwives (N=209) were used to explore the topic from different perspectives.

Results:

Twelve per cent of the surveyed women surveyed had smoked at least occasionally during their pregnancy, and around six per cent had drunk alcohol at least occasionally during their pregnancy. Women who had smoked during pregnancy were significantly more likely to be younger than 25, significantly more likely to have a low level of formal education and a migration background. In the case of alcohol consumption, however, these factors had no significant influence on the women's consumption behaviour.

Although the exploration of alcohol consumption and smoking is mandatory for gynaecologists during prenatal care, three out of ten women stated that they had not been asked about their alcohol consumption, while one out of ten women had not been asked about their smoking. This is highly consistent with information provided by gynaecologists: only 80 percent indicated recording alcohol consumption, while 94 percent stated that they record cigarette consumption for every pregnant woman without exception. For gynaecologists and midwives, a lack of knowledge about available support services and the assumption that they could do little to change women's consumption behaviours were the most important barriers to addressing alcohol and cigarette consumption in prenatal care. Other challenges included uncertainty over how to approach the topic, language barriers and the desire not to burden women with this issue.

Conclusions:

The results of the study highlight the relevance of addressing smoking and alcohol during pregnancy in health policies. Target group-specific support programmes for female smokers should be aimed at young women, women with a low level of formal education and women with a migration background. Additional measures for healthcare staff are also required to further reduce the number of alcohol- or nicotine-exposed pregnancies.