PloS one · 2025
Relationships between state-level general population alcohol policies and birth outcomes: Results from 1972-2019 vital statistics.
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Subbaraman Meenakshi S, Berglas Nancy F, Kerr William C, Roberts Sarah C M
Аннотация
BACKGROUND: Research has found that policies that single out pregnant people's alcohol consumption are mostly ineffective. Identifying alternative approaches - for example, general population alcohol policies - that can reduce adverse effects of pregnant people's alcohol consumption is essential. Here, we examine how U.S. state-level alcohol policies regarding grocery store and gas station sales, Sunday sales, Blood Alcohol Concentration limits for driving, and government monopolies relate to birth outcomes.
METHODS: Outcome data came from the 1972-2019 U.S. Vital Statistics System birth certificates (N = 160,538,939 live singleton births). Primary outcomes were low birthweight (<2,500 grams) and preterm birth (<37 weeks). Fully adjusted models included state and year fixed effects, state-specific time trends, and maternal- and state-level covariates with standard errors clustered by state.
RESULTS: The only significant, robust associations between policies and outcomes were for government monopolies. In fully adjusted models, having a government monopoly on spirits or on both spirits and wine retail sales (vs. none) were each related to lower odds of low birthweight births (aOR=0.94, 95% CI: 0.93, 0.95; aOR=0.95, 95% CI: 0.92, 0.98 respectively). Having a government monopoly on spirits sales was also significantly related to lower odds of preterm births (aOR=0.97, 95% CI: 0.95, 1.00).
CONCLUSIONS: Government monopolies on spirits and wine relate to better birth outcomes. Findings underscore the importance of maintaining state government monopolies on spirits and wine as a strategy for protecting against adverse effects of pregnant people's drinking.
METHODS: Outcome data came from the 1972-2019 U.S. Vital Statistics System birth certificates (N = 160,538,939 live singleton births). Primary outcomes were low birthweight (<2,500 grams) and preterm birth (<37 weeks). Fully adjusted models included state and year fixed effects, state-specific time trends, and maternal- and state-level covariates with standard errors clustered by state.
RESULTS: The only significant, robust associations between policies and outcomes were for government monopolies. In fully adjusted models, having a government monopoly on spirits or on both spirits and wine retail sales (vs. none) were each related to lower odds of low birthweight births (aOR=0.94, 95% CI: 0.93, 0.95; aOR=0.95, 95% CI: 0.92, 0.98 respectively). Having a government monopoly on spirits sales was also significantly related to lower odds of preterm births (aOR=0.97, 95% CI: 0.95, 1.00).
CONCLUSIONS: Government monopolies on spirits and wine relate to better birth outcomes. Findings underscore the importance of maintaining state government monopolies on spirits and wine as a strategy for protecting against adverse effects of pregnant people's drinking.