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OBJECTIVE: To assess the relationship between unintended pregnancy resulting in a live birth and binge drinking (having 5 or more alcoholic beverages on 1 occasion) in the 3 months before pregnancy (the preconception period) and to characterize women who are of childbearing age and binge drink. METHODS: A case-control study was conducted of women with pregnancies that resulted in a live birth, comparing those with unintended pregnancies with those with intended pregnancies. Data analyzed were from the 15 states that participated in the Pregnancy Risk Assessment Monitoring System from 1996-1999. RESULTS: Of 72 907 respondents, 45% of pregnancies were unintended. Compared with women with intended pregnancy, women with unintended pregnancy were more likely to be young and black and to report preconception binge drinking (16.3% vs 11.9%; odds ratio [OR]: 1.43; 95% confidence interval [CI]: 1.13-1.54). After adjusting for potential confounders, preconception binge drinking was associated with unintended pregnancy for white women (adjusted OR: 1.63; 95% CI: 1.47-1.80) but not for black women (adjusted OR: 0.96, 95% CI: 0.77-1.20). Overall, 14% of women reported preconception binge drinking. Women who binge drank in the preconception period were more likely to be white and unmarried; to smoke and be exposed to violence in the preconception period; and to consume alcohol, binge drink, and smoke during pregnancy. CONCLUSIONS: Binge drinking in the preconception period was associated with unintended pregnancies resulting in a live birth among white women but not among black women. Preconception binge drinkers were more likely to engage in other risky behaviors, including drinking during pregnancy. Comprehensive interventions to reduce binge drinking may reduce unintended pregnancies, as well as other adverse maternal and pediatric health outcomes. [ABSTRACT FROM AUTHOR]

Background: Motor vehicle crashes (MVCs) are a leading cause of death among young people in the United States. We examined the relationship between states' alcohol policy environments and alcohol-related MVC fatalities among children, adolescents, and young adults under the minimum legal drinking age of 21 years., Methods: We used the Alcohol Policy Scale (APS), an assessment of 29 alcohol policies across 50 states and Washington, DC, developed with the assistance of an interdisciplinary Delphi panel. Using the Fatality Analysis Reporting System, we examined APS scores in relation to fatalities of people ≤20 years old from 2000 to 2013 occurring in crashes in which ≥1 involved driver had a blood alcohol content ≥0.08%. Logistic regression was used with a 1-year lag between policies and MVC fatalities and adjusted for potential confounders., Results: Of 84 756 MVC fatalities of those ≤20 years old during the study period, 23 757 (28.0%) were alcohol related, including deaths of 11 006 (46.3%) drivers, 10 212 (43.0%) passengers, and 2539 (10.7%) pedestrians, cyclists, and others. People killed in alcohol-related MVCs were predominantly male (72.7%) and older (65.5% were 18-20 years old), and 51.2% were non-Hispanic white. Restrictive policy environments were associated with fewer fatalities (adjusted odds ratio, 0.91 per 10-percentage-point increase in APS score; 95% confidence interval, 0.89-0.94). The association was observed for drivers and passengers, male and female decendents, and children, adolescents, and young adults., Conclusions: More restrictive alcohol policies are associated with reduced alcohol-related MVC mortality among young people. Studies should scrutinize the relationship between policies and fatalities to highlight mechanisms., (Copyright © 2017 by the American Academy of Pediatrics.)

Background: The relationship between the alcohol policy environment (ie, the combined effectiveness and implementation of multiple existing alcohol policies) and youth drinking in the United States has not been assessed. We hypothesized that stronger alcohol policy environments are inversely associated with youth drinking, and this relationship is partly explained by adult drinking., Methods: Alcohol Policy Scale (APS) scores that characterized the strength of the state-level alcohol policy environments were assessed with repeated cross-sectional Youth Risk Behavior Survey data of representative samples of high school students in grades 9 to 12, from biennial years between 1999 and 2011., Results: In fully adjusted models, a 10 percentage point increase in APS scores (representing stronger policy environments) was associated with an 8% reduction in the odds of youth drinking and a 7% reduction in the odds of youth binge drinking. After we accounted for youth-oriented alcohol policies, the subgroup of population-oriented policies was independently associated with lower odds of youth drinking (adjusted odds ratio 0.94; 95% confidence interval 0.92-0.97) and youth binge drinking (adjusted odds ratio 0.96; 95% confidence interval 0.94-0.99). State-level per capita consumption mediated the relationship between population-oriented alcohol policies and binge drinking among youth., Conclusions: Stronger alcohol policies, including those that do not target youth specifically, are related to a reduced likelihood of youth alcohol consumption. These findings suggest that efforts to reduce youth drinking should incorporate population-based policies to reduce excessive drinking among adults as part of a comprehensive approach to preventing alcohol-related harms. Future research should examine influence of alcohol policy subgroups and discrete policies., (Copyright © 2015 by the American Academy of Pediatrics.)

Objectives: Underage drinking contributes to the 3 leading causes of death (unintentional injury, homicide, and suicide) among persons aged 12 to 20 years. Most adverse health effects from underage drinking stem from acute intoxication resulting from binge drinking. Although binge drinking, typically defined as consuming > or = 5 drinks on an occasion, is a common pattern of alcohol consumption among youth, few population-based studies have focused specifically on the characteristics of underage binge drinkers and their associated health risk behaviors., Methods: We analyzed data on current drinking, binge drinking, and other health risk behaviors from the 2003 National Youth Risk Behavior Survey. Prevalence estimates and 95% confidence intervals were calculated by using SAS and SUDAAN statistical software. Logistic regression was used to examine the associations between different patterns of alcohol consumption and health risk behaviors., Results: Overall, 44.9% of high school students reported drinking alcohol during the past 30 days (28.8% binge drank and 16.1% drank alcohol but did not binge drink). Although girls reported more current drinking with no binge drinking, binge-drinking rates were similar among boys and girls. Binge-drinking rates increased with age and school grade. Students who binge drank were more likely than both nondrinkers and current drinkers who did not binge to report poor school performance and involvement in other health risk behaviors such as riding with a driver who had been drinking, being currently sexually active, smoking cigarettes or cigars, being a victim of dating violence, attempting suicide, and using illicit drugs. A strong dose-response relationship was found between the frequency of binge drinking and the prevalence of other health risk behaviors., Conclusions: Binge drinking is the most common pattern of alcohol consumption among high school youth who drink alcohol and is strongly associated with a wide range of other health risk behaviors. Effective intervention strategies (eg, enforcement of the minimum legal drinking age, screening and brief intervention, and increasing alcohol taxes) should be implemented to prevent underage alcohol consumption and adverse health and social consequences resulting from this behavior.