Maternal alcohol use statistics show that drinking during pregnancy remains a measurable U.S. public-health concern. The available figures cover self-reported drinking, binge drinking, alcohol screening, clinical interventions, and estimates connected with fetal alcohol spectrum disorders (FASDs). Because the studies use different years, populations, and methods, each percentage should be read in its stated context.
Contents
- Current drinking and binge drinking
- Differences by age and social characteristics
- Recent trend estimates
- Alcohol screening during pregnancy
- What clinicians report doing
- Fetal alcohol spectrum disorder estimates
Current drinking and binge drinking
In the CDC’s 2018–2020 data, 13.5% of pregnant adults reported current drinking and 5.2% reported binge drinking. These are self-reported measures for that three-year period, not estimates of every pregnancy in the United States. The CDC published the findings in a 2022 Morbidity and Mortality Weekly Report (CDC MMWR 2022).
The earlier 2015–2017 CDC period produced lower reported levels: 11.5% of pregnant women reported current drinking, while 3.9% reported binge drinking (CDC MMWR 2019). The two periods should not be treated as a simple like-for-like trend without considering differences in survey population, wording, and analysis.
| Measure | 2015–2017 | 2018–2020 |
|---|---|---|
| Current drinking | 11.5% | 13.5% |
| Binge drinking | 3.9% | 5.2% |
The 2018–2020 CDC analysis also identified associations with mental distress and access to care. Pregnant adults reporting frequent mental distress were 2.3 times as likely to report current drinking and 3.4 times as likely to report binge drinking. Pregnant adults without a usual health care provider were 1.7 times as likely to report current drinking. These are relative comparisons reported by the CDC, not proof that one factor caused another (CDC MMWR 2022).
A separate CDC analysis of 2017 and 2019 Behavioral Risk Factor Surveillance System Alcohol Screening and Brief Intervention jurisdictions found that 13.3% of pregnant persons reported current drinking and 6.9% reported binge drinking. The jurisdiction-specific results are not necessarily nationally representative (CDC MMWR 2023).
Differences by age and social characteristics
The CDC’s 2015–2017 estimates show that reported current drinking varied by age. Among pregnant women aged 18–24, 11.4% reported current drinking and 5.8% reported binge drinking. Among those aged 25–34, the corresponding figures were 9.6% and 3.7%. Among those aged 35–44, 14.1% reported current drinking and 3.1% reported binge drinking (CDC MMWR 2019).
Race and ethnicity categories also showed different reported levels in that period. White non-Hispanic pregnant women reported 10.7% current drinking and 3.4% binge drinking. Black non-Hispanic pregnant women reported 14.0% current drinking; a binge-drinking figure was not supplied here. Hispanic pregnant women reported 8.9% current drinking and 3.5% binge drinking. Other non-Hispanic pregnant women reported 18.5% current drinking and 5.1% binge drinking (CDC MMWR 2019).
Education, employment, and marital status were also examined:
- Pregnant women with a high school diploma or less reported 10.4% current drinking and 4.1% binge drinking.
- Those with some college reported 11.6% current drinking and 3.9% binge drinking.
- Those with a college degree reported 12.7% current drinking and 3.6% binge drinking.
- Employed pregnant women reported 12.6% current drinking and 4.3% binge drinking.
- Not-employed pregnant women reported 10.0% current drinking and 3.3% binge drinking.
- Married pregnant women reported 8.6% current drinking and 2.2% binge drinking.
- Not-married pregnant women reported 15.2% current drinking and 6.1% binge drinking.
These subgroup percentages describe survey responses in 2015–2017. They should not be used to label an individual’s behavior or risk based on age, race, education, employment, or marital status (CDC MMWR 2019).
Recent trend estimates
A JAMA Network Open 2022 study compared pregnant and nonpregnant women from 2011 through 2020. Among pregnant women, reported binge drinking rose from 2.5% in 2011 to 6.1% in 2020. Among nonpregnant women, binge drinking fell from 18.6% in 2011 to 17.6% in 2020 (JAMA Network Open 2022).
The study also reported adjusted average annual percent changes. For pregnant women, the adjusted average annual percent change in binge drinking was 8.9%, compared with 0.7% for nonpregnant women. For heavy alcohol consumption, the corresponding adjusted average annual percent changes were 11.6% among pregnant women and 2.3% among nonpregnant women (JAMA Network Open 2022).
These figures are model-based trend summaries across the study period. They are not the same as a percentage-point increase, and they do not establish why the reported patterns changed. The 2020 endpoint also belongs to the study’s defined survey period; it should not be presented as a current-year estimate.
Alcohol screening during pregnancy
In the CDC’s 2017 and 2019 BRFSS ASBI jurisdictions, 80.1% of pregnant persons reported alcohol screening at their last visit. For comparison within those jurisdictions, 86.0% of nonpregnant reproductive-aged women reported screening at their last visit. The same comparison found current drinking of 13.3% and binge drinking of 6.9% among pregnant persons, versus 56.4% and 20.2%, respectively, among nonpregnant reproductive-aged women (CDC MMWR 2023).
Screening prevalence among pregnant persons varied across reported characteristics. It was 78.8% for ages 18–24, 79.6% for ages 25–34, and 83.4% for ages 35–49. It was 79.7% among Black non-Hispanic persons, 79.0% among Hispanic persons, 83.2% among White non-Hispanic persons, and 69.6% among other non-Hispanic persons (CDC MMWR 2023).
Education-related screening estimates were 53.5% for pregnant persons who did not graduate high school, 83.4% for those who graduated high school, and 84.5% for those with some college or more. Screening was reported by 82.2% of employed pregnant persons and 77.3% of those not employed.
The CDC report also listed screening estimates for health and access indicators. Screening was 86.5% among pregnant persons reporting a disability and 79.3% among those with no reported disability. It was 89.6% among those with frequent mental distress and 83.6% among those with a chronic condition. Among those with any health insurance, screening was 80.4%; among those without health insurance, it was 77.0%. Screening was 79.8% among those with a usual health care provider and 80.7% among those without one. It was 78.8% in Medicaid expansion states and 82.1% in states without Medicaid expansion (CDC MMWR 2023).
What clinicians report doing
A 2019 clinician survey published by CDC Preventing Chronic Disease found that 94.6% of clinicians reported screening pregnant patients for alcohol use. In frequency categories, 67.2% said they always screened, 15.9% screened often, 11.5% screened sometimes, and 5.4% never screened (CDC Preventing Chronic Disease 2023).
The same survey found that 94.9% reported brief interventions with pregnant patients. Specifically, 66.0% said they always conducted brief interventions, 18.8% often did so, 10.1% sometimes did so, and 5.1% never did so. Confidence was lower than participation: 46.5% felt very confident screening for excessive alcohol use, while 34.9% felt very confident conducting brief interventions.
Regarding tools and documentation, 64.0% reported using a U.S. Preventive Services Task Force-recommended screening tool. Brief interventions were documented in EHR notes by 51.7% and in a designated EHR space by 50.7%. The reported number of screening tools used was one or two for 44.0% of clinicians and three or four for 43.7%.
Specific tools or approaches included a single-question screen about days per week with at least one alcoholic drink, used by 60.7%; CAGE, 58.6%; SASQ, 44.6%; AUDIT or AUDIT-C, 19.4%; T-ACE or TWEAK, 6.3%; 4P’s, 4P’s Plus, or 5P’s, 4.5%; NIDA Quick Screen, 3.0%; and ASSIST or ASSIST-FC, 2.5% (CDC Preventing Chronic Disease 2023).
Reported practice differed by clinician type. Always-screening was reported by 72.7% of nurse practitioners and 80.8% of OB/GYNs. Always conducting brief interventions was reported by 74.3% of nurse practitioners and 68.6% of OB/GYNs. Among physician assistants, 10.2% reported never screening and 8.4% reported never conducting brief interventions (CDC Preventing Chronic Disease 2023).
Fetal alcohol spectrum disorder estimates
CDC FASDs Data and Statistics materials provide several estimates, with different populations and measurement approaches. The CDC estimates that about 1 in 20 U.S. school-aged children may have an FASD. Experts estimate that the full range of FASDs may be 1 to 5 per 100 school-aged children. These are estimates, not a count of diagnosed children.
Earlier CDC studies identified about 1 infant with fetal alcohol syndrome (FAS) for every 1,000 live births in certain U.S. areas. The most recent CDC study cited in the supplied materials found FAS in 0.3 out of 1,000 children aged 7 to 9 years. School-based studies reported FAS prevalence of 6 to 9 per 1,000 children (CDC FASDs Data and Statistics).
The figures differ because they refer to FASD as a broad group or FAS as one diagnosis, and because the studies examined different ages, locations, and case-finding methods. The estimates should therefore remain labeled with their source and population rather than being combined into one national rate.
The CDC materials also report historical economic estimates. The lifetime cost of care for one individual with FAS was estimated at $2 million in 2002. The cost to the United States for FAS alone was estimated to exceed $4 billion annually (CDC FASDs Data and Statistics). These are historical estimates and are not updated cost figures for 2026.