First time’s a charm: Maternal problem drinking around the birth of a child in primiparous and multiparous women at risk for child maltreatment

Objective: The birth of a child may represent a turning point in alcohol and other drug (AOD) use trajectories, particularly for families exposed to cumulative early adversity. This prospective longitudinal study aimed to examine differences in the problem drinking trajectories of primiparous and multiparous mothers around the birth of a child. A history of AOD problems was examined as a predictor of change in problem drinking.

Method: Primiparous (n = 245) and multiparous (n = 243) women were recruited on the basis of risk for child maltreatment. Past-year maternal problem drinking was assessed with the CAGE screener (cut down, annoyed, guilty, eye opener) at childbirth and child ages 12, 24, and 36 months. Latent growth modeling was used to estimate changes in CAGE scores over the four time points.

Results: Although maternal CAGE symptoms decreased linearly from the year before the child's birth to age 36 months at the sample level, substantial differences emerged when trajectories of primiparous and multiparous mothers were examined separately. CAGE trajectories of primiparous mothers decreased sharply from the year before the child's birth to age 12 months, whereas no change was observed among multiparous mothers. Of note, an equal proportion of primiparous and multiparous women consumed any alcohol during pregnancy. In addition, a history of AOD problems predicted a slower decline in CAGE symptoms across the transition to parenthood for primiparous mothers.

Conclusions: Parity may be an important dimension of maternal identity for AOD-focused health professionals to consider in working with mothers at risk for child maltreatment because of their problem drinking.