Access Type

Open Access Dissertation

Date of Award

January 2021

Degree Type


Degree Name




First Advisor

Janet R. Hankin



Background: Characteristics of drinking alcohol can include drinking contemporaneously; at the same time as others, and concordantly; when individuals exhibit identical traits or characteristics. The purpose of this quantitative study was to examine the association of pre-pregnancy drinking among a unique sample of high-risk women and to investigate the association of their social network members as predictors of alcohol consumption during the 3-month preconceptional period. Analysis was conducted on the patterns of alcohol consumption among study participants who were recruited from the Healthy Families Indiana (HFI) home visiting program; all had been screened as at-risk for child maltreatment, substance abuse, and/or intimate partner violence. Overall, this study examined the association of predictors of pre-pregnancy alcohol consumption among three categories of social network members: 1) Spouse/partner, 2) Close friends/relatives and 3) Anyone in the home who drinks frequently. In the United States, nearly half of all pregnancies are unplanned, and drinking prior to pregnancy can likely extend into pregnancy even before a woman recognizes that she is indeed pregnant, and social network members can be influential in inhibiting or disinhibiting their acquaintances drinking behaviors.Methods: Logistic regression modeling created with SPSS software was used to analyze predictors of pre-pregnancy drinking among the social network categories of spouse/partner, close friends/relatives, and anyone in the home who drinks frequently. Regression analysis models also included sociodemographic control variables as predictors of pre-pregnancy drinking. Tables listing frequencies and percentages were produced and analyzed for types of alcoholic beverages preferred between beer/malt liquor/hard cider, wine, liquor and mixed drinks. Alcohol consumption patterns of participants during the 3 months pre-pregnancy period were also analyzed including amount drank on a typical day including type of vessel commonly drank from; highest amount drank on a drinking day, and number of days during the 3 months prior to pregnancy this highest amount was consumed. Results: Logistic regression analysis revealed close friends/relatives and spouse/partner were significantly associated with women drinking during the 3 months prior to pregnancy. Close friends/relatives were more highly associated with women drinking preconceptionally as compared to spouse/partner. Anyone in the home who drank frequently was not associated with women drinking during the 3 months prior to pregnancy. Among the control variables included in the logistic regression analyses, race and age were found significantly associated with women drinking preconceptionally. Blacks were found to be less likely associated with women drinking prior to pregnancy as compared to non-whites. Older women were found to be significantly associated with pre-pregnancy drinking as compared to younger women. Alcoholic beverage preference analysis showed women reported to preferring more than one type of alcoholic beverage. The most preferred single beverage was mixed drinks (61%, n=85), and most preferred combination of beverages were Beer and Mixed Drinks (35%, n=35) and Beer and Liquor (10.8, 15%). Highest amounts consumed during the 3 months prior to pregnancy were 32 ounces or more of beer, on 41-90 days preconceptionally, 3-5 bottles of wine on 41-90 number of days preconceptionally, a fifth (25 oz.) and a quart (32 oz.) of liquor on 21-90 days preconceptionally, and 16 to- ≥ 40 mixed drinks on 41-90 days preconceptionally. Overall, the total percentage of drinkers among the sample population was relatively low as calculated at between 20-30% of the sample population. Conclusion: Social network members namely close friends/relatives and spouse/partner were shown to be associated with women drinking during the 3 months prior to pregnancy. Given that social network members can be influential in terms of drinking contemporaneously (during the same time) or concordantly (exhibiting identical traits and/or characteristics) as women prior to pregnancy, it is critical that social network members be included in antenatal and prenatal care. Raising awareness that there is no safe threshold of alcohol consumption during pregnancy, and that pre-pregnancy drinking should cease could be more effective if social network members were involved in women’s clinical care and treatment. Key Words: Contemporaneous, concordant, Fetal Alcohol Spectrum Disorders