Background: Alcohol use during pregnancy is a modifiable health behavior that causes a range of health problems in infants, including impaired growth, stillbirth, and fetal alcohol spectrum disorder. However, there is lack of comprehensive information on alcohol use and associated factors during pregnancy using a population-based dataset in Ethiopia. Therefore, this study aimed to assess the prevalence of alcohol use during pregnancy and associated factors using a national, population-based survey.Methods: The study utilized data from the 2011 and 2016 Ethiopian Demographic and Health Survey, a cross-sectional survey conducted on a nationally representative sample. The survey employed a multistage cluster sampling method to generate representative national and sub-national health and health related indicators. A total of 2,341 pregnant women were included in the analysis. Factors associated with alcohol use were identified using multivariable logistic regression model. Adjusted odds ratios (AOR) with 95% confidence interval (CI) were computed to quantify the degree of association between independent variables and alcohol use.Results: In Ethiopia, the prevalence of alcohol use among pregnant women was 30.2% (95% CI: 28.4%-32.2%). The study identified that being employed (AOR: 2.07; 95%CI: 1.55-2.77), ever attempted termination of pregnancy (AOR: 2.21; 95% CI: 1.60-3.05), having two (AOR: 2.56; 95% CI: 1.76-3.72), or three (AOR: 2.98; 95% CI: 1.40-6.35) sexual partners in lifetime and chat chewing (AOR: 8.91; 95% CI: 4.61-17.23) had increased the odds of alcohol use during pregnancy.Conclusion: In this study, the prevalence of alcohol use during pregnancy among Ethiopian mothers was high. Working status, ever used something to terminate the pregnancy, more than one lifetime partner, and chat chewing were factors associated with alcohol use during pregnancy. Thus, prevention interventions and strategies can draw on the identified modifiable health behaviors.
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