Factors associated with recent and discontinued alcohol use by pregnant adolescents.

PURPOSE To determine easily identifiable risk factors that differentiate pregnant adolescents who report recent (past 30 days) alcohol use and those who discontinue use by their first prenatal visit from those who deny consuming alcohol altogether. METHODS A structured interview was completed by 378 adolescents < or = 17 years of age as part of standard care at our institution's adolescent obstetric clinic between July 7, 1992, and December 28, 1994. Using Chi-square or Student's t-tests, unique risk factors associated with recent or discontinued alcohol use in pregnancy were separately identified by comparing demographic, reproductive, behavioral, and environmental factors among recent users (n = 43), discontinued users (n = 48), and adolescents who denied ever using alcohol (n = 108). Significant indicators were then entered into stepwise logistic regression analyses to determine the most efficient models for predicting alcohol use. RESULTS Partner alcohol use and use of alcohol during sexual activities were important risk factors for alcohol use by pregnant adolescents. Recent alcohol users were also more likely to be Mexican-American, to have quit school, and to report recent tobacco use, while adolescents who stopped using alcohol during pregnancy were significantly more likely to have witnessed or been a victim of or known a victim of violence. CONCLUSIONS Screening at the first prenatal visit for these unique and easily assessed factors will help clinicians identify adolescents at greatest risk for alcohol use during pregnancy.