Knowledge of FAS and the Risks of Heavy Drinking during Pregnancy, 1985 and 1990

This Epidemiologic Bulletin examines changes in respondents' attitudes toward the risks of heavy drinking during pregnancy, their awareness of fetal alcohol syndrome (FAS), and their knowledge of what FAS is. Although the respondents are women and men ages 18 to 44 years, the detailed analyses presented here focus on women only. Data were extracted from the Health Promotion and Disease Prevention (HPDP) supplements of both the 1985 and the 1990 National Health Interview Survey (NHIS). BACKGROUND One of the important contributions of biomedical research in the past century is the demonstration that personal lifestyle choices make a significant difference in the measure of health and quality of life. Accordingly, a national agenda aimed at considerably reducing preventable death and disability and enhancing quality of life by the year 2000 has been initiated. Healthy People 2000 (U.S. Department of Health and Human Services 1991) is a substantial effort involving health professionals and citizens, public agencies, and private organizations from all over the United States. Work on the objectives began in 1987 with the creation of a consortium that now includes nearly 300 national membership organizations as well as all State health departments. More than 300 specific objectives in 22 priority areas were identified in Healthy People 2000 as goals targeted for achievement by the year 2000. One of these objectives is to reduce the incidence of FAS to no more than 0.12 per 1.000 live births. A step toward attaining this level would be to ensure that all prospective mothers know what FAS is. Although increased knowledge and awareness do not necessarily lead to changes in behavior, it is unlikely that changes such as decreasing or eliminating alcohol consumption during pregnancy will occur in the absence of knowledge of the risks of not doing so. Therefore, three important questions have to be addressed: How much do women in the United States today know about the risks to the fetus that are associated with alcohol consumption during pregnancy, particularly FAS? How have knowledge levels of FAS changed over time? What are the implications of such findings with regard to achieving the Healthy People 2000 goal for FAS? The purpose of this study is threefold. First, it will examine changes since 1985 in the percentage of men and women ages 18 to 44 years who believe that heavy drinking during pregnancy increases the chances of miscarriage, mental retardation, low birth weight, and birth defects; who have heard of FAS; and who can correctly describe FAS. Second, it will examine whether differences in these areas of belief, awareness, and knowledge exist among all women, current drinkers, and risk drinkers. Third, it will examine whether differences exist among demographic subgroups in the population of women of childbearing age. METHODS SOURCES OF DATA Data for this study were derived from HPDP supplements in the 1985 and the 1990 NHIS. These questionnaires were first developed to monitor progress on national health objectives for the year 1990 and, later, for the year 2000. In the section involving risks of heavy drinking during pregnancy, awareness of FAS, and knowledge of FAS, survey respondents between the ages of 18 and 44 years were asked a series of questions about their agreement as to whether heavy drinking during pregnancy increases the chances of miscarriage, mental retardation, low birth weight, and birth defects. Heavy drinking was respondent defined; that is, each respondent used his or her own criteria of heavy drinking. Thus, different respondents may have interpreted the questions in many different ways. Respondents were asked to indicate whether heavy drinking during pregnancy "definitely increases," "probably increases," "probably does not increase," or "definitely does not increase" the chances of these complications. A response of "don't know" also was valid. …