Aims The aim of this study was to evaluate the use of a 7‐day Retrospective Diary to assess peri‐conceptual and mid‐pregnancy alcohol consumption. Background Alcohol consumption among women has increased significantly and is of international concern. Heavy episodic (‘binge’) drinking is commonplace and is associated with unintended pregnancy. Pre‐pregnancy drinking is strongly associated with continued drinking in pregnancy. Routine antenatal assessment of alcohol history and current drinking is variable; potentially harmful peri‐conceptual drinking may be missed if a woman reports low or no drinking during pregnancy. Design Cross‐sectional study (n = 510) in two Scottish health board areas. Methods Face‐to‐face Retrospective Diary administration from February to June 2015 assessing alcohol consumption in peri‐conceptual and mid‐pregnancy periods. Women were recruited at the mid‐pregnancy ultrasound clinic. Results Of 510 women, 470 (92·0%) drank alcohol before their pregnancy; 187 (39·9%) drank every week. Retrospective assessment of peri‐conceptual consumption identified heavy episodic drinking (more than six units on one occasion) in 52·2% (n = 266); 19·6% (n = 100) reported drinking more than 14 units per week, mostly at the weekend; ‘mixing’ of drinks was associated with significantly higher consumption. While consumption tailed off following pregnancy recognition, 5·5% (n = 28) still exceeded the recommended daily two‐unit limit in pregnancy. Multivariable logistic regression identified that women who ‘binged’ peri‐conceptually were 3·2 times more likely to do this. Conclusion Statistically significant peri‐conceptual consumption levels suggest a substantial proportion of alcohol‐exposed pregnancies before pregnancy recognition. Not taking a detailed alcohol history, including patterns of consumption, will result in under‐detection of alcohol‐exposed pregnancies. The Retrospective Diary offers practitioners a detailed way of enquiring about alcohol history for this population.

This is the peer reviewed version of the following article: 'Peri-Conceptual and Mid-Pregnancy Alcohol Consumption: A Comparison between Areas of High and Low Deprivation in Scotland', Birth, which has been published in final form at http://dx.doi.org/10.111/birt.12252. This article may be used for noncommercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Peri-conceptual and mid-pregnancy alcohol consumption: a comparison between areas of high and low deprivation in Scotland 2 AbstractBackground. Alcohol-related mortality and morbidity among women has increased over recent

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