Heavy Drinking During Pregnancy Has Nearly Tripled Since 2011, Study Finds

Alcohol Use During Pregnancy Is Rising in the US, New Research Shows

Drinking during pregnancy remains relatively uncommon in the United States, but new federal survey data suggest it has become more common since 2011, and the riskiest drinking patterns are climbing fastest of all.

A study published in JAMA tracked alcohol use among tens of thousands of pregnant women across the United States from 2011 through 2024. Current alcohol use, binge drinking, and heavy drinking all rose significantly over that period. The authors note that no amount of alcohol is established as safe during pregnancy. Binge and heavy drinking carry particularly high risks, and heavy drinking showed the largest relative increase of the three.

Researchers at Columbia University’s Mailman School of Public Health and the University of California San Diego pulled their numbers from the Behavioral Risk Factor Surveillance System, a long-running phone survey run by the CDC. The findings come after several years of changing drinking patterns in the broader US population, including during the COVID-19 pandemic, although this study was not designed to determine what drove the increase among pregnant women specifically.

Pregnant Women Aged 18 to 49 Reported Rising Drinking Rates Across 33,000 Survey Responses

Investigators focused on three specific patterns among pregnant women aged 18 to 49: any current alcohol use in the past month, binge drinking (four or more drinks in one sitting), and heavy drinking (eight or more drinks in a week). These definitions come from CDC surveillance standards used specifically to track alcohol use among women.

More than 33,000 pregnant respondents to the Behavioral Risk Factor Surveillance System provided the data, comparing two-year windows of time starting in 2011-2012 and running through 2023-2024. Non-pregnant women of the same age range served as a comparison group. Researchers adjusted for age, race, and ethnicity to make sure the upward trend held up, and it did, across all three drinking categories.

Alcohol Use During Pregnancy Climbed Sharply, Especially the Riskiest Kind

Current alcohol use among pregnant women climbed from 9.1% in 2011-2012 to a peak of 15.2% in 2021-2022, before easing slightly to 14.5% in 2023-2024, a 59% relative increase overall. Binge drinking followed a similar arc, rising to 4.6% by the end of the study period, a 77% relative jump. Heavy drinking climbed to 2.0%, a 166% relative increase, meaning the rate more than doubled and then some. The recent numbers hint at a possible plateau, though researchers found no clear evidence the trend has reversed.

Demographic patterns added texture to the numbers. Alcohol use during pregnancy was more common among women who were older, more educated, unmarried, and employed, compared with their respective counterparts. Two behavioral health factors stood out sharply: pregnant women who smoked tobacco reported current alcohol use at more than double the rate of nonsmokers (26.3% versus 11.3%), and those with frequent mental distress, defined as 14 or more poor mental health days in the past month, drank at roughly double the rate of those without such distress (22.8% versus 11.1%).

Tobacco’s connection to drinking ran deeper than simple overlap. Among pregnant women who drank at all, 68.1% of those who also smoked reported binge or heavy drinking specifically, compared with 31.3% of drinkers who didn’t smoke. That gap points to tobacco use tracking with the riskiest drinking patterns in particular, not just drinking in general.

Tobacco Use and Mental Distress Point to Where Prevention Efforts Could Focus

Two threads stand out for prevention work, according to the study’s authors. First, the tight link between tobacco and the heaviest drinking patterns suggests these habits are often showing up together, a pattern the authors say could benefit from combined screening and cessation support rather than treating alcohol and tobacco separately. Second, the tie between mental distress and drinking echoes earlier research and points to a need for prevention programs that address behavioral health broadly, not alcohol in isolation.

Several limits shape how far these numbers can be pushed. The survey wasn’t built specifically to capture the finer details of prenatal drinking, so information on timing, dose, and duration during pregnancy was limited. Response rates for phone surveys like this one tend to run low, and self-reported drinking data is generally considered an undercount, particularly during pregnancy, when stigma may push women to underreport further. Binge and heavy drinking estimates carry wider margins of error than the overall alcohol-use figures, simply because fewer women in each two-year window reported those specific patterns.

Thirteen years of data, three ways of measuring drinking, and one consistent pattern: alcohol use during pregnancy increased, with heavy drinking rising fastest.

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