{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T14:31:25Z","timestamp":1783002685103,"version":"3.54.5"},"reference-count":31,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T00:00:00Z","timestamp":1662595200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Alcohol consumption during pregnancy is related to severe birth complications such as low birthweight, preterm birth and birth defects. During the last decade, the Alcohol Use Disorders Identification Test (AUDIT) has been used as a screening tool in Swedish maternal healthcare units to identify hazardous, pre\u2010pregnancy alcohol use. However, evaluation of the screening with AUDIT, as well as adverse maternal or neonatal outcomes, has not been assessed at a national level.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>This was a population\u2010based cohort study of 530\u2009458 births from 2013 to 2018 using demographic, reproductive and maternal health data from the Swedish Pregnancy Register. Self\u2010reported alcohol consumption in the year before pregnancy, measured as AUDIT scores, was categorized into moderate (6\u201313 points) and high\u2010risk (14\u201340 points) consumption, with low\u2010risk (0\u20135 points) consumption as the reference group. Associations with pregnancy\u2010 and birth outcomes were explored with logistic regressions using generalized estimating equation models, adjusting for maternal and socioeconomic characteristics. Estimates are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>High\u2010risk and moderate pre\u2010pregnancy alcohol consumption was associated with preeclampsia, preterm birth and birth of an infant small for gestational age (SGA), but these associations were nonsignificant after adjustments. Prior moderate\u2010risk (aOR 1.29, 95% CI 1.17\u20131.42) and high\u2010risk consumption (aOR 1.62, 95% CI 1.17\u20132.25) increased the likelihood of intrapartum and neonatal infections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Apart from identifying hazardous alcohol consumption prior to pregnancy and the offer of counseling, screening with the AUDIT in early pregnancy indicates a high risk of inflammatory\u2010\/placenta\u2010mediated pregnancy and birth outcomes. For most outcomes, AUDIT was not an independent contributor when adjusting for confounding factors. Hazardous alcohol use prior to pregnancy was independently linked to intrapartum and neonatal infections; conditions associated with morbidity and long\u2010term sequalae. These associations may be explained by alcohol\u2010induced changes in the maternal or fetal immune system in early pregnancy or persistent alcohol intake during pregnancy, or may depend on unidentified confounding factors.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14451","type":"journal-article","created":{"date-parts":[[2022,9,8]],"date-time":"2022-09-08T08:56:35Z","timestamp":1662627395000},"page":"1386-1394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Alcohol exposure prior to pregnancy\u2014does hazardous consumption affect placenta\u2010 and inflammatory\u2010mediated pregnancy outcomes? A Swedish population\u2010based cohort study"],"prefix":"10.1111","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1567-4940","authenticated-orcid":false,"given":"Joline","family":"Asp","sequence":"first","affiliation":[{"name":"Center for Clinical Research S\u00f6rmland Uppsala University  Eskilstuna Sweden"},{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5202-9428","authenticated-orcid":false,"given":"Lina","family":"Bergman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"},{"name":"Department of Obstetrics and Gynecology Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Obstetrics and Gynecology Stellenbosch University  Stellenbosch South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3556-065X","authenticated-orcid":false,"given":"Susanne","family":"Lager","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ove","family":"Axelsson","sequence":"additional","affiliation":[{"name":"Center for Clinical Research S\u00f6rmland Uppsala University  Eskilstuna Sweden"},{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna\u2010Karin","family":"Wikstr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Hesselman","sequence":"additional","affiliation":[{"name":"Department of Women's and Children's Health Uppsala University  Uppsala Sweden"},{"name":"Center for Clinical Research Dalarna  Falun Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,9,8]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(73)91092-1"},{"key":"e_1_2_12_3_1","volume-title":"Guidelines for the identification and management of substance use and substance use disorders in pregnancy","author":"World Health Organization","year":"2014"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2011.03050.x"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3182a6b226"},{"key":"e_1_2_12_6_1","unstructured":"Welfare SNBoHa."},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2015.09.001"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11481-016-9691-8"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1530-0277.2009.01106.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-8329(00)00076-8"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2018.05.004"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1203\/00006450-198106000-00005"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.13148"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1753-4887.2007.tb00362.x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.575197"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-020-66971-1"},{"key":"e_1_2_12_17_1","unstructured":"Gr\u00f6nqvistE Nor\u00e9nA Sj\u00f6grenA SvalerydH editors.Sober mom healthy baby? 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