What Do We Know About Prevalence and Management of Intoxicated Women During Labor and Delivery?

Objective. To review the published literature on women who were intoxicated at delivery and outcomes for their infants. Methods. A systematic literature review was utilized to identify articles meeting our inclusion criteria. After screening using titles and abstracts, we identified 34 articles requiring full-text review. Each of these were reviewed by at least 2 of the authors. We identified 12 articles that met our inclusion criteria. Results. We identified case reports of 16 mothers who delivered with a blood alcohol concentration (BAC) ranging from 42.1 to 473 mg/dL. Three of the pregnancies (18.8%) ended with a stillbirth, 5 (31.3%) were infant deaths, 6 (37.5%) lived, and 2 (12.5%) had no fetal or infant outcome reported. The BAC for the stillborn infants ranged from 120 to 460 mg/dL. The BAC among the infant deaths ranged from 96 to 715 mg/dL. Among surviving infants, the BAC ranged from 38.4 to 246.5 mg/dL. Conclusion. We identified no deaths with a BAC <96 mg/dL. However, it is not clear if this represents the lower level of BAC where mortality risk increases. In this article, we present 9 suggestions to improve detection and management of these mothers and their infants.