New data released Thursday suggest the prevalence of drinking during pregnancy increased in recent years.
National survey data published in a Centers for Disease Control and Prevention report show about 15% of adult pregnant women reported current drinking (use in the prior 30 days) between 2021 and 2024. About 13.5% of women reported the same between 2018 and 2020.
The numbers, while lagging behind current trends, point to an ongoing health issue, which experts say gets too little attention because drinking during pregnancy is generally thought of as a thing of the past.
“Alcohol consumption during pregnancy remains a public health concern. Both clinical and community interventions might help,” the report’s authors wrote.
Pregnant women who were unmarried or who experienced frequent “mental distress” were more than twice as likely to report binge drinking and heavy drinking compared to peers without those characteristics, the study says. Binge drinking is defined for women as having four or more drinks in a span of two hours. Having four or more drinks on any given day is classified as heavy drinking.
STAT’s recent reporting on the harms of U.S. alcohol use examined evolving attitudes toward drinking in pregnancy, with even some health care workers adopting a relaxed view of alcohol use. Reporting also revealed that women’s alcohol use, even when problematic, goes unaddressed more often than men’s. Interventions during pregnancy are especially rare.
Providers are often hesitant to refer pregnant patients to substance use disorder treatment, or prescribe medications that could help them cut back on their drinking, studies suggest. That is at least in part due to the fact that pregnant women are excluded by default from clinical trials.
Alcohol use during pregnancy is a key concern because ethanol is a known cause of birth defects. It can affect nearly every stage of fetal development, and is a leading driver of intellectual disability in the U.S. Federal estimates suggest fetal alcohol spectrum disorders may be more common than autism.
All major guidelines on the subject say no amount of alcohol has proven safe for a developing fetus. Women are therefore advised to abstain from all drinking during pregnancy. CDC also recommends anyone who might become pregnant, or who is trying to conceive, stop drinking.
STAT’s analysis of raw CDC data last month showed alcohol use in pregnancy ticked slightly downward in 2024, for the first time in years. CDC’s estimates, which lumped together years of data, did not report this single-year change. It is not yet clear whether the 2024 downtick is a temporary change or a sustained trendline.
Alcohol use spiked across the U.S. population during the Covid pandemic, but has by some measures declined in recent years. Alcohol-related harms, however, have mostly not returned to pre-pandemic levels.
The new CDC data must be understood in context. While people tend to generally underestimate their drinking, which could skew survey results in one direction, some of the women surveyed might have been drinking before they knew they were pregnant. The survey did not ask women which trimester of pregnancy they were in.
Routine screening for alcohol consumption and mental health conditions during pregnancy could help reduce drinking, the CDC report’s authors wrote. So could things like “point-of-sale warning signs or alcohol sales taxes.”
The U.S. has been slow among peer nations to adopt measures that might reduce drinking rates. Attempts to raise taxes on alcohol at the state level are frequently shot down. And alcohol screening, while commonplace in primary care, often varies a great deal in its depth and quality. A majority of people who engage in problematic drinking do not receive counseling or other interventions from their health care providers, studies have found.
STAT’s reporting also found that Trump officials have impeded tracking of alcohol use during and after pregnancy. Several researchers who rely on the Pregnancy Risk Assessment Monitoring System, or PRAMS, say they have received no update on the tool for months. Cuts to CDC staff who ran the system have left it in limbo.
The Department of Health and Human Services has not released the most recent data, from 2023, which includes several measures of alcohol consumption in pregnancy and the postpartum period. The federal PRAMS website advises researchers to contact individual states if they wish to gather the data.
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