Associations of education and work status with alcohol use and cessation among pregnant women in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

Abstract Background: There is inconsistent evidence on the associations of education and work status with alcohol use during pregnancy. We aimed to examine the associations of education and work status with alcohol use in early and middle pregnancy and alcohol cessation between early and middle pregnancy in Japan.Methods: This prospective study was part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. Pregnant women were recruited at approximately 50 obstetric clinics and hospitals in Miyagi Prefecture in Japan. We analyzed 11592 pregnant women who completed the questionnaires administered in early pregnancy and middle pregnancy. Women were dichotomized as current drinkers or non-drinkers in both early and middle pregnancy. Multivariable logistic regression analyses were conducted to examine associations of education and work status with alcohol use in early and middle pregnancy, adjusting for age, income, psychological distress, and work status/education. Associations with alcohol cessation between early pregnancy and middle pregnancy were also examined.Results: Prevalence of alcohol use in early and middle pregnancy was 20.9% and 6.4%, respectively. Higher education was associated with alcohol use in early pregnancy and alcohol cessation during pregnancy; the odds ratios (ORs) of ≥university education compared with ≤high school education were 1.47 (95% confidence interval [CI], 1.30–1.66) and 1.31 (95% CI, 1.00–1.71), respectively. Work status was associated with alcohol use in both periods and alcohol cessation during pregnancy; for alcohol cessation, the OR of working in early pregnancy only compared with not working in both periods was 1.72 (95% CI, 1.03–2.88).Conclusions: Women with higher education were more likely to consume alcohol in early pregnancy and to cease between early pregnancy and middle pregnancy. Working women were more likely to consume alcohol throughout pregnancy in Japan.