Postpartum and Alcohol-Related Factors Associated with the Relapse of Risky Drinking * (Report‪)‬

THE CONSUMPTION OF ALCOHOL BY MOTHERS during and after pregnancy can have important effects on the developing child. It is estimated that roughly 1 in 100 children has a fetal alcohol spectrum disorder (May and Gossage, 2001). Because of the potential adverse effects of gestational alcohol on the fetus, the U.S. surgeon general has recommended that women who are pregnant or may become pregnant abstain from alcohol (Office of Surgeon General, 2005). Yet, in the United States, more than half of women who might become pregnant report drinking alcohol (Centers for Disease Control and Prevention, 2002). Although women generally reduce their alcohol consumption once pregnancy is recognized, they typically return to their baseline drinking patterns following the birth of a child (Fried et al., 1985). Maternal drinking can negatively impact families in a variety of ways. Frequent, heavy maternal drinking is associated with poorer family functioning, poorer intellectual stimulation, and increased domestic violence (Jester et al., 2000). Mothers with alcohol dependence are more likely to report punitive behaviors toward their children (Miller et al., 1999). Although not specific to alcohol, a study by Whitaker (2006) documented an increased likelihood of childhood behavior problems among children whose mothers had co-occurring mental-health, substance-use, and domestic-violence conditions. This association persisted even after prenatal exposures and paternal mental health and substance use were controlled for. Furthermore, among women who drink during their pregnancies, the likelihood of having a child with fetal alcohol syndrome increases with subsequent pregnancies (May et al., 2004). Thus, the identification of mothers with risky drinking is a critical step toward the prevention of fetal alcohol spectrum disorders.