Skip to main content
PMC home page
Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2001 Oct;55(10):738–745. doi: 10.1136/jech.55.10.738

Self reported alcohol intake in pregnancy: comparison between four methods

U Kesmodel 1, S Olsen 1
PMCID: PMC1731783  PMID: 11553658

Abstract

STUDY OBJECTIVE—To assess the agreement between four different measures of alcohol intake in pregnancy.
DESIGN AND SETTING—Danish speaking pregnant women referred to the Midwife Centre in Aarhus, Denmark, for routine antenatal care were contacted at their first visit at approximately 15-16 weeks gestation from October to December 1998. The women were interviewed about current average alcohol intake and intake within the previous week, and subsequently filled in a two week diary on alcohol intake. When booking for delivery at the end of the first trimester the women were also asked to complete a questionnaire including a one item question on current average alcohol intake.
PARTICIPANTS—Participants were 441 pregnant women.
MAIN RESULTS—Per cent agreement ± 1 category ranged between 73 and 82. Mean (SD) intake ranged between 1.09 (1.35) drinks/week for diaries, and 0.69 (0.85) for questionnaires. Mean differences between methods were all close to zero. Three of the four measures yielded comparable distributions of average alcohol intake, but reports of intake within the past seven days seemed to be an inappropriate measure of average intake, yielding three times as many abstainers as expected when combining the methods.
CONCLUSIONS—When assessing the distribution of alcohol intake in pregnancy or when studying adverse pregnancy outcomes that are probably caused mainly by sustained exposure it seems that for pregnant women with low to moderate alcohol intake diaries or an average measure from interviews or a simple one item questionnaire may be applied. A measure of intake for the previous week seems to be a relevant measure only when studying adverse pregnancy outcomes that are most probably caused by binge-like exposure.


Keywords: alcohol; pregnancy

Full Text

The Full Text of this article is available as a PDF (236.3 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Babor T. F., Stephens R. S., Marlatt G. A. Verbal report methods in clinical research on alcoholism: response bias and its minimization. J Stud Alcohol. 1987 Sep;48(5):410–424. doi: 10.15288/jsa.1987.48.410. [DOI] [PubMed] [Google Scholar]
  2. Bellach B. Remarks on the use of Pearson's correlation coefficient and other association measures in assessing validity and reliability of dietary assessment methods. Eur J Clin Nutr. 1993 Oct;47 (Suppl 2):S42–S45. [PubMed] [Google Scholar]
  3. Bland J. M., Altman D. G. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986 Feb 8;1(8476):307–310. [PubMed] [Google Scholar]
  4. Bonthius D. J., Goodlett C. R., West J. R. Blood alcohol concentration and severity of microencephaly in neonatal rats depend on the pattern of alcohol administration. Alcohol. 1988 May-Jun;5(3):209–214. doi: 10.1016/0741-8329(88)90054-7. [DOI] [PubMed] [Google Scholar]
  5. Byers T., Marshall J., Anthony E., Fiedler R., Zielezny M. The reliability of dietary history from the distant past. Am J Epidemiol. 1987 Jun;125(6):999–1011. doi: 10.1093/oxfordjournals.aje.a114638. [DOI] [PubMed] [Google Scholar]
  6. Byers T., Marshall J., Fiedler R., Zielezny M., Graham S. Assessing nutrient intake with an abbreviated dietary interview. Am J Epidemiol. 1985 Jul;122(1):41–50. doi: 10.1093/oxfordjournals.aje.a114085. [DOI] [PubMed] [Google Scholar]
  7. Flegal K. M. Agreement between two dietary methods in reported intake of beer, wine and liquor. J Stud Alcohol. 1991 Mar;52(2):174–179. doi: 10.15288/jsa.1991.52.174. [DOI] [PubMed] [Google Scholar]
  8. Kesmodel U. Alkohol og graviditet. Ugeskr Laeger. 1999 Sep 6;161(36):4989–4994. [PubMed] [Google Scholar]
  9. Kesmodel U., Olsen S. F. Smoking habits among pregnant Danish women: reliability of information recorded after delivery. J Epidemiol Community Health. 1999 Apr;53(4):239–242. doi: 10.1136/jech.53.4.239. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Kline J., Stein Z., Hutzler M. Cigarettes, alcohol and marijuana: varying associations with birthweight. Int J Epidemiol. 1987 Mar;16(1):44–51. doi: 10.1093/ije/16.1.44. [DOI] [PubMed] [Google Scholar]
  11. Lundsberg L. S., Bracken M. B., Saftlas A. F. Low-to-moderate gestational alcohol use and intrauterine growth retardation, low birthweight, and preterm delivery. Ann Epidemiol. 1997 Oct;7(7):498–508. doi: 10.1016/s1047-2797(97)00081-1. [DOI] [PubMed] [Google Scholar]
  12. Maclure M., Willett W. C. Misinterpretation and misuse of the kappa statistic. Am J Epidemiol. 1987 Aug;126(2):161–169. doi: 10.1093/aje/126.2.161. [DOI] [PubMed] [Google Scholar]
  13. Ogston S. A., Parry G. J. EUROMAC. A European concerted action: maternal alcohol consumption and its relation to the outcome of pregnancy and child development at 18 months. Results--strategy of analysis and analysis of pregnancy outcome. Int J Epidemiol. 1992;21 (Suppl 1):S45–S71. doi: 10.1093/ije/21.supplement_1.s45. [DOI] [PubMed] [Google Scholar]
  14. Olsen J., Frische G. Comparison between data obtained through questionnaires and interviews: life-style habits of pregnant women. Scand J Soc Med. 1988;16(1):49–52. doi: 10.1177/140349488801600108. [DOI] [PubMed] [Google Scholar]
  15. Olsen J., Frische G., Kirchheiner H., Poulsen A. O. Alkoholvaner blandt gravide i Odense 1985-1986. Ugeskr Laeger. 1987 May 18;149(21):1420–1422. [PubMed] [Google Scholar]
  16. Passaro K. T., Little R. E., Savitz D. A., Noss J. The effect of maternal drinking before conception and in early pregnancy on infant birthweight. The ALSPAC Study Team. Avon Longitudinal Study of Pregnancy and Childhood. Epidemiology. 1996 Jul;7(4):377–383. doi: 10.1097/00001648-199607000-00007. [DOI] [PubMed] [Google Scholar]
  17. Pennington S., Kalmus G. Brain growth during ethanol-induced hypoplasia. Drug Alcohol Depend. 1987 Nov 30;20(3):279–286. doi: 10.1016/0376-8716(87)90038-x. [DOI] [PubMed] [Google Scholar]
  18. Poikolainen K., Kärkkäinen P. Diary gives more accurate information about alcohol consumption than questionnaire. Drug Alcohol Depend. 1983 Apr;11(2):209–216. doi: 10.1016/0376-8716(83)90080-7. [DOI] [PubMed] [Google Scholar]
  19. Rubin D. H., Krasilnikoff P. A., Leventhal J. M., Berget A., Weil B. Cigarette smoking and alcohol consumption during pregnancy by Danish women and their spouses--a potential source of fetal morbidity. Am J Drug Alcohol Abuse. 1988;14(3):405–417. doi: 10.3109/00952998809001560. [DOI] [PubMed] [Google Scholar]
  20. Sulaiman N. D., Florey C. D., Taylor D. J., Ogston S. A. Alcohol consumption in Dundee primigravidas and its effects on outcome of pregnancy. Br Med J (Clin Res Ed) 1988 May 28;296(6635):1500–1503. doi: 10.1136/bmj.296.6635.1500. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Uchalik D. C. A comparison of questionnaire and self-monitored reports of alcohol intake in a nonalcoholic population. Addict Behav. 1979;4(4):409–413. doi: 10.1016/0306-4603(79)90012-1. [DOI] [PubMed] [Google Scholar]
  22. Verkerk P. H. The impact of alcohol misclassification on the relationship between alcohol and pregnancy outcome. Int J Epidemiol. 1992;21 (Suppl 1):S33–S37. doi: 10.1093/ije/21.supplement_1.s33. [DOI] [PubMed] [Google Scholar]
  23. Windham G. C., Fenster L., Hopkins B., Swan S. H. The association of moderate maternal and paternal alcohol consumption with birthweight and gestational age. Epidemiology. 1995 Nov;6(6):591–597. doi: 10.1097/00001648-199511000-00005. [DOI] [PubMed] [Google Scholar]
  24. Zajac C. S., Abel E. L. Animal models of prenatal alcohol exposure. Int J Epidemiol. 1992;21 (Suppl 1):S24–S32. doi: 10.1093/ije/21.supplement_1.s24. [DOI] [PubMed] [Google Scholar]
  25. da Costa Pereira A., Olsen J., Ogston S. Variability of self reported measures of alcohol consumption: implications for the association between drinking in pregnancy and birth weight. J Epidemiol Community Health. 1993 Aug;47(4):326–330. doi: 10.1136/jech.47.4.326. [DOI] [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of Epidemiology and Community Health are provided here courtesy of BMJ Publishing Group

RESOURCES