br Introduction The pattern of maternal alcohol

Introduction The pattern of maternal alcohol consumption over the reproductive life course is greatly understudied. Research involving women׳s use of alcohol has tended to focus on short periods of their lives, generally during pregnancy (Anderson et al., 2013; Maloney et al., 2011; Liu, Mumford & Petras, 2014) or old age (Brennan et al., 2011; Molander, Yonker & Krahn, 2010), with little interest in the maternal reproductive life course. The reproductive life course stage for women involves a period of relatively good health but with numerous competing commitments. Childrearing may be the central activity during this period but the formation and maintenance of a dyadic partnership, the histamine-2 receptor antagonist and development of a career, the maintenance and enhancement of social networks, and major transitions involving the death of parents, marital breakdown, and the growing independence of children are all characteristic exposures during the reproductive life course (Mishra, Cooper & Kuh, 2010; Evans, 1985; Neve, Lemmens & Drop, 2000). There is a need to know more about how women transition through this life stage.
Materials and methods
Results
Discussion The maternal cohort was recruited early in pregnancy and followed up over a 21 year period. We found four distinct trajectories of alcohol consumption by women over their reproductive life course. The largest trajectory group comprised low-stable drinkers (58.0%), followed by moderate-escalating drinkers (25.3%), abstainers (11.9%), and heavy-escalating drinkers (4.8%). Our study did not identify the decreasing or curvilinear pattern found in other research (Brennan et al., 2011; Powers & Young, 2008). The four trajectories found in this study exhibit evidence of a high level of stability for abstainers and low-stable drinkers, but changeability for moderate and heavy-escalating drinkers over their reproductive life course. Members of the abstainers and the low-stable group consistently did not consume alcohol, or consumed at a very low level, over 21 years. The biggest reduction is observed during the period of pregnancy and delivery among moderate and heavy drinking mothers, consistent with the findings from previous research (Maloney et al., 2011; Bachman et al., 2013; Tran et al., 2014). However, six months after the birth of the baby, alcohol consumption levels among the moderate-escalating groups started to increase but remained at a moderate level at the 5, 14 and 21 year follow-ups; while alcohol consumption in the heavy-escalating group sharply increased at Year 5 from moderate to heavy (17.1 glasses per week) and remained at this drinking level at the 21-year follow-up (Fig. 2). The pattern of alcohol consumption in the heavy-escalating group suggests the need to focus on prevention and intervention with these women after they have given birth as they breastfeed their baby while apparently consuming moderate levels of alcohol (Tran et al., 2014; Giglia & Binns, 2007). The result also suggests that interventions may be needed during the child-adolescent motherhood period where children may be influenced by their mother׳s drinking behaviour (Van Der Vorst et al., 2009; Cleveland et al., 2014). Examinations of baseline predictors associated with four drinking trajectory groups indicate the differences among profiles of abstainers versus moderate and heavy-escalating drinkers. Predictors associated with abstainers are those who had low family income and being married. The results appear inconsistent with some studies (Huckle, You & Casswell, 2010; Karlamangla et al., 2006) but in line with the work from Cerdá and colleagues (Cerdá, Johnson-Lawrence & Galea, 2011). Frequency of religious participation is a protective factor against alcohol consumption (Krause, 2003). This finding may be limited to Australian society as Australians have a low rate of church attendance (Australian Bureau of Statistics, 2013). Our study shows that women with increasing consumption over time tend to be affluent (except for the heavy-escalating group), are more likely to be unmarried, and less religious—consistent with previous studies (Platt et al., 2010; Karlamangla et al., 2006).