# Alcohol and pregnancy: benefits and harms of state-level policies

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2021 · $532,805

## Abstract

Abstract
This project takes a successful and productive R01 – the Drug-Alcohol Pregnancy Policy Study (D-APPS)
Phase 1 – to the next phase and further examines impacts of state pregnancy-specific alcohol policies and
expands focus to identify general population alcohol policies that reduce harms related to alcohol use during
pregnancy. Alcohol is a known teratogen that causes fetal alcohol syndrome and a range of other harms to
fetuses. Alcohol use during pregnancy is common, with 15% of pregnant women reporting any alcohol use and
3% of pregnant women reporting binge drinking in the past month. Despite considerable governmental and
clinical attention to alcohol use during pregnancy, alcohol use during pregnancy has remained common and
essentially stable for decades in the U.S. Thus, assessing which existing pregnancy-specific and general
population alcohol policies influence harm from alcohol use during pregnancy is imperative. Since the 1970s,
almost all states have enacted one or more policies related to alcohol use during pregnancy. States continue to
enact pregnancy-specific alcohol policies. D-APPS Phase 1 found that most pregnancy-specific alcohol
policies lead to increases in low birthweight and preterm birth and decreases in prenatal care, which results in
thousands of babies born low birthweight or preterm each year. Findings indicate that while alcohol use during
pregnancy causes public health harms, so do the policies adopted in response. Before abandoning pregnancy-
specific alcohol policies, research is needed to see if there are any positive impacts on more severe outcomes
related to alcohol use during pregnancy, such as child morbidities and child maltreatment. Additional research
is also needed to identify other possible policies that might reduce harms from drinking during pregnancy.
General population alcohol policies that address price and availability of alcohol and criminalization of drinking
behavior could also reduce harm related to drinking during pregnancy, but this has not yet been studied
comprehensively. In this project, we assess whether existing pregnancy-specific alcohol policies affect other
outcomes related to drinking during pregnancy and identify general population alcohol policies that reduce
harms related to drinking during pregnancy. We examine whether effects differ by race/ethnicity and
socioeconomic status as well as by the other policies in effect at the time. This study uses insurance claims
and Treatment Episode Dataset-Admissions data from the 1990s-present, Natality Birth Data and National
Alcohol Survey Data from the 1970s-present, NIAAA's Alcohol Policy Information System, and other policy
data sources. We will use both epidemiologic and economics-based data analysis approaches to allow for
causal interpretation of findings. Findings will inform ongoing policy debates, advocacy and professional
education efforts by maternal and child health professionals and obstetricians and gynecologists, and inf...

## Key facts

- **NIH application ID:** 10209868
- **Project number:** 2R01AA023267-04A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Sarah C.M. Roberts
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $532,805
- **Award type:** 2
- **Project period:** 2015-05-15 → 2026-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10209868

## Citation

> US National Institutes of Health, RePORTER application 10209868, Alcohol and pregnancy: benefits and harms of state-level policies (2R01AA023267-04A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10209868. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*