The association of lowered alcohol prices with birth outcomes and abortions: A population-based natural experiment
Research report
When alcohol becomes cheaper, abortions and negative birth outcomes increase, new research shows
When Finnish policymakers cut taxes on alcohol and made importing alcohol easier, rates of abortion, pre-term birth, and low birthweight all rose, according to a new study published in the scientific journal Addiction.
Expanding the supply of cheap alcohol was followed by negative pregnancy outcomes mainly among low-income women. Both abortions and adverse birth outcomes reverted to their previous levels after several months, according to the University of Helsinki press release.
The short-term increase of adverse birth outcomes and abortions after the price cut implies that the price cut was followed by a period of increased alcohol use, after which the women at risk returned to the initial levels or patterns of consumption.
Explanation for study findings
- When alcohol becomes more affordable to people with monetary constraints, they consume more alcohol, and are thus exposed to more alcohol harms.
- A population-level rise in alcohol use would cause a rise in prenatal exposure to alcohol and a corresponding rise in negative birth outcomes.
- Similarly, reduced alcohol taxes leads to lower alcohol prices, which increases alcohol use and thus increases alcohol harms, such as an increase in unintentional pregnancies, causing a corresponding rise in abortions.
The study made by University of Helsinki looked at 32,400 abortions and almost 170,000 live births over the two years before and one year after a tax cut that lowered the price of off-premises alcohol by 33%.
Lowered alcohol prices were linked with a 0.84 percentage point increase in abortions immediately after the price cut. Furthermore, there was a 1.5 percentage point higher probability of low birth weight, and a 1.98 percentage point increased probability of preterm birth among low-income women after the price cut.
Abstract
Background and Aims
Alcohol use during pregnancy remains an important risk factor for adverse birth outcomes, but little is known regarding how alcohol prices affect pregnancy outcomes on the population level.
The researchers assessed the links between decreased alcohol prices with birth outcomes and abortions.
Design
Using national registers, the researchers used interrupted time-series modelling to compare outcomes of pregnancies conceived before and after a tax cut, resulting in 33% mean decrease of off-premise alcohol prices on 1 March 2004.
The researchers also addressed possible heterogeneity of the associations by maternal age and household income.
Setting
Finland.
Participants
All registered pregnancies starting two years before and one year after the alcohol price cut (analysis sample consisted of 169,735 live births and 32,441 abortions).
Measurements
The outcomes were:
- birth weight,
- gestational age,
- the probability of low birth weight (< 2500 g at birth),
- preterm birth (< 37 weeks of gestation),
- any congenital malformations, and
- share of registered abortions of pregnancies.
Findings
On the population level, lowered alcohol prices were linked with an increase in abortions immediately after the price cut (+0.84 percentage points).
For birth outcomes, negative associations were observed among women in the lowest income quintile; for example, increased probabilities of low birth weight (+1.5 percentage points) and preterm birth (+1.98 percentage points).
All changes were strongest immediately after the price cut and attenuated during the course of the following year.
Conclusions
Lowered alcohol prices in Finland were linked with a short-term increase in adverse birth outcomes among low-income mothers and an overall increase in abortions.