Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Nov 11;58(6):645-652.
doi: 10.1093/alcalc/agad056.

Pregnancy-specific alcohol policies and admissions to substance use disorder treatment for pregnant people in the USA

Nancy F Berglas  1 , Meenakshi S Subbaraman  2 , Sue Thomas  3 , Sarah C M Roberts  1
Affiliations

Pregnancy-specific alcohol policies and admissions to substance use disorder treatment for pregnant people in the USA

Nancy F Berglas et al. Alcohol Alcohol. .

Abstract

Aims: We examined relationships between pregnancy-specific alcohol policies and admissions to substance use disorder treatment for pregnant people in the USA.

Methods: We merged state-level policy and treatment admissions data for 1992-2019. We aggregated data by state-year to examine effects of nine pregnancy-specific alcohol policies on the number of admissions of pregnant women where alcohol was reported as the primary, secondary, or tertiary substance related to the treatment episode (N = 1331). We fit Poisson models that included all policy variables, state-level controls, fixed effects for state and year, state-specific time trends, and an offset variable of the number of pregnancies in the state-year to account for differences in population size and fertility.

Results: When alcohol was reported as the primary substance, civil commitment [incidence rate ratio (IRR) 1.45, 95% CI: 1.10-1.89] and reporting requirements for assessment and treatment purposes [IRR 1.36, 95% CI: 1.04-1.77] were associated with greater treatment admissions. Findings for alcohol as primary, secondary, or tertiary substance were similar for civil commitment [IRR 1.31, 95% CI: 1.08-1.59] and reporting requirements for assessment and treatment purposes [IRR 1.21, 95% CI: 1.00-1.47], although mandatory warning signs [IRR 0.84, 95% CI: 0.72-0.98] and priority treatment for pregnant women [IRR 0.88, 95% CI: 0.78-0.99] were associated with fewer treatment admissions. Priority treatment findings were not robust in sensitivity analyses. No other policies were associated with treatment admissions.

Conclusions: Pregnancy-specific alcohol policies related to greater treatment admissions tend to mandate treatment rather than make voluntary treatment more accessible, raising questions of ethics and effectiveness.

Keywords: alcohol; policy; pregnancy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Number of U.S. states with pregnancy-specific alcohol policies, 1992–2019.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. American Public Health Association . Public Health Code of Ethics. Washington, DC: American Public Health Association, 2019.
    1. Angelotta C, Weiss CJ, Angelotta JW. et al. A moral or medical problem? The relationship between legal penalties and treatment practices for opioid use disorders in pregnant women. Womens Health Issues 2016;26:595–601. - PubMed
    1. Atkins DN, Durrance CP. State policies that treat prenatal substance use as child abuse or neglect fail to achieve their intended goals. Health Aff (Millwood) 2020;39:756–63. - PubMed
    1. Austin AE, Naumann RB, Simmons E. Association of state child abuse policies and mandated reporting policies with prenatal and postpartum care among women who engaged in substance use during pregnancy. JAMA Pediatr 2022;176:1123–30. - PMC - PubMed
    1. Centers for Disease Control and Prevention (CDC) . Alcohol consumption among pregnant and childbearing-aged women—United States, 1991 and 1995. MMWR Morb Mortal Wkly Rep 1997;46:346–50. - PubMed