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Use of Record Linkage to Examine Alcohol Use in Pregnancy
Lucy Burns 1 , Richard P. Mattick 2 , and Margaret Cooke 3
1
From the National Drug and Alcohol Research Centre, University of New South Wales,
Sydney, Australia ; 2 the National Drug and Alcohol Research Centre, University of New
South Wales, Sydney, Australia and 3 the Faculty of Nursing, Midwifery and Health,
University of Technology, Broadway, Sydney, Australia
Correspondence to Reprint requests: Lucy Burns, MPH, PhD, Lecturer, National Drug and
Alcohol Research Centre, University of New South Wales, Sydney, 2052, Australia; Fax: 61
2 9385 0222; E-mail: [email protected]
This project is funded by HERON (Health Evaluation and Research Outcomes Network), a
collaborative program conducted under the auspices of the Institute for Health Research with
The University of Sydney, The University of New South Wales, University of Technology
Sydney, The Cancer Council NSW and NSW Health through NH&MRC Grant 262121.
KEYWORDS
Pregnancy • Alcohol Abuse • Alcohol Dependence • Neonatal • Perinatal • Linked Data
ABSTRACT
Background: To date, no population-level data have been published examining the obstetric
and neonatal outcomes for women with an alcohol-related hospital admission during
pregnancy compared with the general obstetric population. This information is critical to
planning and implementing appropriate services.
Methods: Antenatal and delivery admissions to New South Wales (NSW) hospitals from the
NSW Inpatient Statistics Collection were linked to birth information from the NSW Midwives
Data Collection over a 5-year period (1998–2002). Birth admissions were flagged as positive
for maternal alcohol use where a birth admission or any pregnancy admission for that birth
involved an alcohol-related International Statistical Classification of Diseases and Related
Health Problems, 10th Revision, Australian Modification (ICD-10-AM) code. Key
demographic, obstetric, and neonatal variables were compared for births to mothers in the
alcohol group with births where no alcohol-related ICD10-AM was recorded.
Results: A total of 416,834 birth records were analyzed over a 5-year period (1998–2002). In
this time, 342 of these were coded as positive for at least 1 alcohol-related ICD-10-AM
diagnosis. Mothers in the alcohol group had a higher number of previous pregnancies,
smoked more heavily, were not privately insured, and were more often indigenous. They
also presented later on in their pregnancy to antenatal services and were more likely to
arrive at hospital unbooked for delivery. Deliveries involved less epidural and local and more
general anesthesia. Cesarean sections were more common to women in the alcohol group
and were performed more often for intrauterine growth retardation. Neonates born to women
in the alcohol group were smaller for gestational age, had lower Apgar scores at 5 minutes,
and were admitted to special care nursery more often.
Conclusions: This study shows that linked population-level administrative data provide a
powerful new source of information for examining the maternal and neonatal outcomes
associated with alcohol use in pregnancy.