The association between alcohol outlet accessibility and adverse birth outcomes: A retrospective cohort study

Article type: Research Article

Authors: Seabrook, J.A.^{a; b; c; d; e; f; *} | Woods, N.^a | Clark, A.^{f; g} | de Vrijer, B.^{d; i} | Penava, D.^{d; i} | Gilliland, J.^{b; c; d; e; f; g}

Affiliations: [a] School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada | [b] Department of Paediatrics, Western University, London, ON, Canada | [c] Department of Epidemiology and Biostatistics, Western University, London, ON, Canada | [d] Children’s Health Research Institute, London, ON, Canada | [e] Lawson Health Research Institute, London, ON, Canada | [f] Human Environments Analysis Laboratory, London, ON, Canada | [g] Department of Geography, Western University, London, ON, Canada | [h] School of Health Studies, Western University, London, ON, Canada | [i] Department of Obstetrics and Gynaecology, Western University, London, ON, Canada

Correspondence: [*] Address for correspondence: Dr. Jamie A. Seabrook, Brescia University College at Western University, 1285 Western Road, London, ON N6G 1H2, Canada. Tel.: +1 519 432 8353/Ext. 28284; Fax: +1 519 858 5137; E-mail: [email protected].

Abstract: BACKGROUND:Alcohol outlet accessibility is positively associated with alcohol consumption, although this relationship has not been thoroughly examined in pregnant women. The present study examines the relationship between proximity and density of alcohol outlets and risk for low birth weight (LBW: <2,500 grams) and preterm birth (PTB: <37 weeks gestational age), and is the first Canadian study to investigate this association. METHODS:Maternal accessibility to alcohol outlets was specified using a gravity-type measure of accessibility, which provides the amount of accessibility that a given household has to liquor stores within 30-minutes of their home. All singleton newborns without congenital anomalies that were born between February 2009 and February 2014 at London Health Sciences Centre in London, Ontario, were included in this cohort. RESULTS:The sample consisted of 25,734 live births, of which 5.8% were LBW and 7.6% were PTB. Only 2.0% of women reported alcohol use during pregnancy. Alcohol outlet gravity was positively correlated with the percentage of mothers living in poverty (rs = 0.33, p < 0.001) and in single-parent families (rs = 0.39, p < 0.001), and who self-identify as visible minorities (rs = 0.45, p < 0.001). Alcohol outlet gravity increased the odds that mothers drank alcohol during pregnancy (OR 1.05; 95% CI: 1.02, 1.07), although the association was weak. Furthermore, alcohol outlet gravity did not increase the likelihood of a LBW or PTB infant. CONCLUSIONS:Women with high accessibility to alcohol outlets are more likely to consume alcohol during pregnancy, but greater alcohol outlet accessibility does not translate into poor birth outcomes.

Keywords: Alcohol outlets, alcohol use, pregnancy, low birth weight, preterm birth

DOI: 10.3233/NPM-181741

Journal: Journal of Neonatal-Perinatal Medicine, vol. 11, no. 1, pp. 71-77, 2018