New figures from the United States Centers for Disease Control and Prevention (CDC) show that drinking during pregnancy rose between 2021 and 2024. The report, published Thursday, raises serious questions about alcohol consumption during pregnancy that clinicians and policymakers have been slow to answer.

The CDC found that roughly 15% of adult pregnant women reported current alcohol use in the 2021 to 2024 period. That compares with 13.5% between 2018 and 2020. The authors were direct: “Alcohol consumption during pregnancy remains a public health concern. Both clinical and community interventions might help.”

Vulnerable Groups at Heightened Risk From Drinking During Pregnancy

The data show that risk is not evenly distributed. Unmarried women, and those who experienced frequent mental distress, were more than twice as likely to report binge drinking or heavy drinking. For women, binge drinking means four or more drinks within two hours. Heavy drinking means four or more drinks on any single day.

These figures make the case for early, targeted intervention. Women facing social or psychological pressures are clearly more exposed to the harms of alcohol consumption during pregnancy. Existing systems are not reaching them in time.

Why Alcohol Consumption During Pregnancy Carries Serious Risk

Ethanol is a recognised cause of birth defects. It can affect virtually every stage of foetal development and is one of the leading preventable drivers of intellectual disability in the United States. Federal estimates suggest foetal alcohol spectrum disorders may be more common than autism. Every major clinical guideline holds the same position: no level of alcohol use has been shown safe for a developing foetus. Women are advised to stop drinking entirely. The CDC also recommends that anyone trying to conceive, or who may become pregnant, abstain from alcohol.

Despite that guidance, alcohol use in pregnancy often goes unaddressed. Providers frequently hesitate to refer pregnant patients for substance use disorder support. This reluctance links partly to the longstanding exclusion of pregnant women from clinical trials, leaving a significant evidence gap. A majority of people with problematic drinking patterns do not receive counselling from healthcare providers, studies have found. Screening during pregnancy varies considerably in its depth and reach.

Post-Pandemic Trends and the Scale of the Problem

Alcohol use rose across the wider population during the Covid pandemic. Alcohol-related harms have largely remained above pre-pandemic levels even where overall drinking has dipped. Against this backdrop, rising alcohol consumption during pregnancy follows a consistent pattern.

STAT News analysis of raw CDC data showed that drinking during pregnancy fell slightly in 2024, the first such decline in several years. The CDC’s published estimates combine multiple years of data and did not capture that single-year shift. Whether 2024 marks a genuine turning point or a short-term variation is not yet clear.

The new data carry important limitations. People tend to underreport alcohol use in surveys. Some respondents may also have been drinking before they knew they were pregnant. The survey did not ask which trimester participants were in.

Tracking Systems Under Pressure

Surveillance of alcohol consumption during pregnancy has weakened at a critical moment. Researchers who rely on the Pregnancy Risk Assessment Monitoring System, known as PRAMS, report receiving no updates for several months. Reductions in CDC staffing have left the system uncertain. The most recent data from 2023, covering several measures of alcohol use in pregnancy and the postpartum period, has not been released by the Department of Health and Human Services.

The CDC report points to routine antenatal screening for alcohol use and mental health as practical steps forward. Point of sale warning signage and alcohol taxation have also been identified as useful policy tools. Progress on both fronts has been slow. Alcohol tax increases are frequently blocked at the state level. Even where screening programmes exist, their quality and reach remain inconsistent.

The gap between what is known about drinking during pregnancy and what is done to prevent it remains wide.

Source: statnews