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Eliason SHY, Miller AR, Gibbard WB, Salh G, Lanphear N. Asking difficult questions about fetal alcohol spectrum disorder in the context of the child, the mother, and the systems in which they live. THE LANCET. CHILD & ADOLESCENT HEALTH 2024:S2352-4642(24)00188-3. [PMID: 39299258 DOI: 10.1016/s2352-4642(24)00188-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 07/07/2024] [Accepted: 07/08/2024] [Indexed: 09/22/2024]
Abstract
Alcohol is a known teratogen and prenatal alcohol exposure remains a major ongoing public health concern. Fetal alcohol spectrum disorder has become the diagnosis for describing individuals who have been affected by prenatal alcohol exposure. In this Viewpoint, we raise major concerns about its continued use as a diagnostic term in how it perpetuates a misleading and outdated narrative about child development and maternal health. We argue that the term fetal alcohol spectrum disorder has contributed to a culture of racism and discrimination for many who are diagnosed with it. The term fetal alcohol spectrum disorder fails to capture the progress made in our collective understanding of neurodevelopment through advancements in the field of genetics and in understanding the effects of trauma and adversity. We call for urgent international collaborative action to review the use of it as a diagnostic term and, more broadly, to reconsider the practice of diagnosing disabilities as medical illnesses. We suggest that this practice fails to recognise that outcomes of functioning and participation in individuals are not only the results of health conditions, but are also the products of complex interactions and experiences of individuals within the families and societies in which they live.
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Affiliation(s)
- Sabrina H Y Eliason
- Division of Developmental Pediatrics, Department of Pediatrics, University of Alberta, Edmonton, AB, Canada; Glenrose Rehabilitation Hospital, Edmonton, AB, Canada.
| | - Anton R Miller
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Sunny Hill Health Centre at BC Children's Hospital, Vancouver, BC, Canada
| | - W Ben Gibbard
- Section of Developmental Pediatrics, Department of Pediatrics, University of Calgary, Calgary, AB, Canada; Alberta Children's Hospital, Calgary, AB, Canada
| | - Gurpreet Salh
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Sunny Hill Health Centre at BC Children's Hospital, Vancouver, BC, Canada
| | - Nancy Lanphear
- Division of Developmental Pediatrics, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada; Sunny Hill Health Centre at BC Children's Hospital, Vancouver, BC, Canada
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Basel A, Bhadsavle SS, Scaturro KZ, Parkey GK, Gaytan MN, Patel JJ, Thomas KN, Golding MC. Parental Alcohol Exposures Associate with Lasting Mitochondrial Dysfunction and Accelerated Aging in a Mouse Model. Aging Dis 2024:AD.2024.0722. [PMID: 39122451 DOI: 10.14336/ad.2024.0722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 07/20/2024] [Indexed: 08/12/2024] Open
Abstract
Although detrimental changes in mitochondrial morphology and function are widely described symptoms of fetal alcohol exposure, no studies have followed these mitochondrial deficits into adult life or determined if they predispose individuals with fetal alcohol spectrum disorders (FASDs) to accelerated biological aging. Here, we used a multiplex preclinical mouse model to compare markers of cellular senescence and age-related outcomes induced by maternal, paternal, and dual-parental alcohol exposures. We find that even in middle life (postnatal day 300), the adult offspring of alcohol-exposed parents exhibited significant increases in markers of stress-induced premature cellular senescence in the brain and liver, including an upregulation of cell cycle inhibitory proteins and increased senescence-associated β-galactosidase activity. Strikingly, in the male offspring, we observe an interaction between maternal and paternal alcohol use, with histological indicators of accelerated age-related liver disease in the dual-parental offspring exceeding those induced by either maternal or paternal alcohol use alone. Our studies indicate that chronic parental alcohol use causes enduring mitochondrial dysfunction in offspring, resulting in a reduced NAD+/NAHD ratio and altered expression of the NAD+-dependent deacetylases SIRT1 and SIRT3. These observations suggest that some aspects of FASDs may be linked to accelerated aging due to programmed changes in the regulation of mitochondrial function and cellular bioenergetics.
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Lee PM, Xu X, Du JB, Li J. Paternal Preconceptional Alcohol Use Disorder With the Offspring's Mortality Risk. Am J Prev Med 2024; 67:105-113. [PMID: 38430947 DOI: 10.1016/j.amepre.2024.02.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/05/2024]
Abstract
INTRODUCTION Paternal preconceptional alcohol use may contribute to early pregnancy loss. However, the link between paternal preconceptional alcohol use disorder and long-term offspring's mortality risk remains unclear. This study examined the association of paternal preconceptional alcohol use disorder and recency of diagnosis with offspring's mortality and further stratified the mortality after the first year of birth by age. METHODS This is a nationwide cohort study with 1,973,174 Danish births (1980-2012), with follow-up from birth until death; emigration; or December 31, 2016. Paternal conceptional alcohol use disorder was identified from Danish National Patient Register and Prescription Registry, categorizing recency of diagnosis into <1 year, 1 to <4 years, 4 to <8 years, and ≥8 years. Logistic regression estimated the ORs and 95% CIs for offspring mortality risk. All data were analyzed in 2023. RESULTS Paternal preconceptional alcohol use disorder was associated with a 28% increased mortality after 1 year of birth (95% CI=1.09, 1.51), 23% increased infant mortality (95% CI=1.07, 1.42), and 23% increased odds of stillbirth (95% CI=1.06, 1.43). Paternal alcohol use disorder diagnosed <1 year before conception was associated with an 85%-111% increased risk of mortality in offspring aged 15-40 years. More recent alcohol use disorder diagnosis (i.e., 1 year before conception) had a higher risks of death from infectious and circulatory diseases in offsprings. CONCLUSIONS Offspring of fathers with alcohol use disorder before conception had higher mortality risk from birth to early adulthood, especially when alcohol use disorder diagnosis is close to conception. Current awareness regarding paternal preconceptional alcohol dependence use is insufficient. Promoting alcohol dependence avoidance, including educating men on the impact of alcohol on child health during prepregnancy examination, may help reduce or prevent long-term offspring mortality.
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Affiliation(s)
- Priscilla My Lee
- Department of Clinical Medicine-Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
| | - Xin Xu
- Center for Global Health, Department of Maternal, Child, and Adolescent Health, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jiang B Du
- State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China; Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jiong Li
- Department of Clinical Medicine-Department of Clinical Medicine-Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark; State Key Laboratory of Reproductive Medicine, Nanjing Medical University, Nanjing, China; Department of Epidemiology, School of Public Health, Nanjing Medical University, Nanjing, China
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Jansen E, Marceau K, Sellers R, Chen T, Garfield CF, Leve LD, Neiderhiser JM, Spotts EL, Roary M. The role of fathers in child development from preconception to postnatal influences: Opportunities for the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) program. Dev Psychobiol 2024; 66:e22451. [PMID: 38388196 PMCID: PMC10902630 DOI: 10.1002/dev.22451] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/21/2023] [Accepted: 12/04/2023] [Indexed: 02/24/2024]
Abstract
A growing body of literature highlights the important role of paternal health and socioemotional characteristics in child development, from preconception through adolescence. Much of this research addresses the indirect effects of fathers, for instance, their influence on maternal behaviors during the prenatal period or via the relationship with their partner. However, emerging evidence also recognizes the direct role of paternal health and behavior for child health and adjustment across development. This critical review presents evidence of biological and sociocultural influences of fathers on preconception, prenatal, and postnatal contributions to child development. The National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) program incorporates in its central conceptualization the impact of fathers on family and child outcomes. This critical synthesis of the literature focuses on three specific child outcomes in the ECHO program: health outcomes (e.g., obesity), neurodevelopmental outcomes (e.g., emotional, behavioral, psychopathological development), and positive health. We highlight the unique insights gained from the literature to date and provide next steps for future studies on paternal influences.
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Affiliation(s)
- Elena Jansen
- Division of Child & Adolescent Psychiatry, Department of Psychiatry & Behavioral Sciences , Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Kristine Marceau
- Department of Human Development and Family Science, Purdue University, West Lafayette, Indiana, USA
| | - Ruth Sellers
- Faculty of Education, University of Cambridge, Cambridge, UK
| | - Tong Chen
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Craig F Garfield
- Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Leslie D Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, USA
| | - Jenae M Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Erica L Spotts
- Office of Behavioral and Social Sciences Research, National Institutes of Health, Bethesda, Maryland, USA
| | - Mary Roary
- Substance Abuse and Mental Health Service Administration, United States Department of Health and Human Services, Rockville, Maryland, USA
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5
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Daly M, Kipping RR, Tinner LE, Sanders J, White JW. Preconception exposures and adverse pregnancy, birth and postpartum outcomes: Umbrella review of systematic reviews. Paediatr Perinat Epidemiol 2022; 36:288-299. [PMID: 34970757 DOI: 10.1111/ppe.12855] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/10/2021] [Accepted: 12/12/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Preconception exposures have been associated with adverse pregnancy, birth and postpartum outcomes. However, the reports, statements and guidelines of national and international health organisations vary in what they recommend individuals should monitor, avoid, reduce or practise in the preconception period. OBJECTIVES To synthesise and evaluate the evidence across systematic reviews for associations between exposures before conception and adverse pregnancy, birth and postpartum outcomes. DATA SOURCES MEDLINE, Embase, Epistemonikos (to May 2020) and reference lists of included reviews, without language or date restrictions. STUDY SELECTION, DATA EXTRACTION AND SYNTHESIS Systematic literature reviews of observational and/or interventional studies reporting associations between preconception exposures in women and/or men of reproductive age and pregnancy, birth or postpartum health outcomes were included. The methodological quality of reviews and the certainty of the evidence underlying each exposure-outcome association were assessed using AMSTAR 2 and the GRADE approach. RESULTS We identified 53 eligible reviews reporting 205 unique exposure-outcome associations. Methodological quality was generally low with only two reviews rated as 'high' quality and two as 'moderate'. We found high-certainty, randomised trial evidence that maternal folate supplementation reduces the risk of neural tube defects and anomaly-related terminations. Moderate-certainty, observational evidence was found that maternal physical activity is associated with reduced risk of pre-eclampsia and gestational diabetes, and that paternal age of ≥40 years and maternal body mass index (BMI) and interpregnancy weight gain are associated with increased risk of various adverse pregnancy and birth outcomes. Low- and very low-certainty evidence was found for other associations. CONCLUSIONS Clinicians and policymakers can be confident that maternal folate supplementation should be encouraged during the preconception period. There is moderate certainty in the evidence base that maternal physical activity, BMI and interpregnancy weight gain and advanced paternal age are important preconception considerations. High-quality research is required to better understand other exposure-outcome associations.
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Lemon D, Swan-Castine J, Connor E, van Dooren F, Pauli J, Boffa J, Fitzpatrick J, Pedruzzi RA. Vision, future, cycle and effect: A community life course approach to prevent prenatal alcohol exposure in central Australia. Health Promot J Austr 2021; 33:788-796. [PMID: 34716966 PMCID: PMC9541745 DOI: 10.1002/hpja.547] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 09/29/2021] [Accepted: 10/13/2021] [Indexed: 11/13/2022] Open
Abstract
Issue addressed Prevention approaches specific to prenatal alcohol exposure (PAE) and foetal alcohol spectrum disorder (FASD) have been identified as urgently needed in Australia, including in Aboriginal and Torres Strait Islander communities. However, very little work has aimed to describe and evaluate health promotion initiatives, especially those developed in rural and remote areas. Methods A series of television commercial scripts (scripts) were developed with health promotion staff at an aboriginal and Torres Strait Islander Community Controlled Health Service and piloted with 35 community members across six yarning sessions. Results Scripts evoked responses in line with two predominant themes: “Strength” and “Community resonance.” This process led to the development of a four‐part television and radio campaign focusing on a life course approach to prevent prenatal alcohol exposure (PAE) – “Vision,” “Future,” “Cycle” and “Effect.” Conclusions Intergenerational influences on PAE were key elements of scripts positively received by community members. Strengths of this work included a flexible approach to development, local aboriginal men and women coordinating the yarning sessions, and the use of local actors and familiar settings. So what? Preventing PAE is extraordinarily complex. Initiatives that are culturally responsive and focus on collective responsibility and community action may be crucial to shifting prominent alcohol norms. Future work is necessary to determine the impact of this campaign.
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Affiliation(s)
- Donna Lemon
- Central Australian Aboriginal Congress Aboriginal Corporation, Alice Springs, Northern Territory, Australia
| | - Justine Swan-Castine
- Central Australian Aboriginal Congress Aboriginal Corporation, Alice Springs, Northern Territory, Australia
| | | | | | - Jenna Pauli
- Central Australian Aboriginal Congress Aboriginal Corporation, Alice Springs, Northern Territory, Australia
| | - John Boffa
- Central Australian Aboriginal Congress Aboriginal Corporation, Alice Springs, Northern Territory, Australia.,National Drug Research Institute, Curtin University, Perth, Western Australia, Australia
| | - James Fitzpatrick
- Telethon Kids Institute, Nedlands, Western Australia, Australia.,School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
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Reid N, Schölin L, Erng MN, Montag A, Hanson J, Smith L. Preconception interventions to reduce the risk of alcohol-exposed pregnancies: A systematic review. Alcohol Clin Exp Res 2021; 45:2414-2429. [PMID: 34590331 DOI: 10.1111/acer.14725] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/31/2021] [Accepted: 09/23/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND The preconception period provides a unique opportunity to optimize the health of women and children. High rates of alcohol use and unintended pregnancies are common across many Western societies, and alcohol-exposed pregnancies (AEPs) are a possible unintended outcome. The aim of the current study was to evaluate preconception interventions for the prevention of AEPs. METHODS A systematic search of four electronic databases (PubMed, Embase, CINAHL, and PsycINFO) was undertaken for relevant peer-reviewed articles published from 1970 onward. Studies were included if they enrolled women and/or their support networks during the preconception period. RESULTS Nineteen studies met the inclusion criteria. The majority of studies (n = 14) evaluated CHOICES-based interventions, which incorporate motivational interviewing approaches to change alcohol and/or contraceptive behavior. The other five interventions included a range of different approaches and modes of delivery. The majority of interventions were successful in reducing AEP risk. Changes in AEP risk were more often driven by changes in contraceptive behavior, although some approaches led to changes in both alcohol and contraceptive behavior. CONCLUSIONS The review indicated that many interventions were efficacious at reducing AEP risk during the preconception period through preventing unplanned pregnancy. The effectiveness estimated from these clinical trials may be greater than that seen in interventions when implemented in practice where there is a lack of blinding and greater attrition of participants during follow-up. Further research investigating the real-world effectiveness of these intervention approaches implemented across a wide range of clinical settings would be beneficial.
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Affiliation(s)
- Natasha Reid
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Lisa Schölin
- Centre for Pesticide Suicide Prevention, University of Edinburgh, Edinburgh, UK
| | - May Na Erng
- Child Health Research Centre, University of Queensland, Brisbane, Queensland, Australia
| | - Annika Montag
- Department of Pediatrics, University of California San Diego, La Jolla, California, USA
| | - Jessica Hanson
- Department of Applied Health Sciences, University of Minnesota Duluth, Duluth, Minnesota, USA
| | - Lesley Smith
- Faculty of Health Sciences, Institute of Clinical Applied Health Research, University of Hull, Hull, Yorkshire, UK
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Mavoa S, Keevers D, Kane SC, Wake M, Tham R, Lycett K, Wong YT, Chong K. Parental Preconception Exposures to Outdoor Neighbourhood Environments and Adverse Birth Outcomes: A Protocol for a Scoping Review and Evidence Map. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178943. [PMID: 34501533 PMCID: PMC8431720 DOI: 10.3390/ijerph18178943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/22/2021] [Accepted: 08/23/2021] [Indexed: 11/19/2022]
Abstract
Parental preconception exposures to built and natural outdoor environments could influence pregnancy and birth outcomes either directly, or via a range of health-related behaviours and conditions. However, there is no existing review summarising the evidence linking natural and built characteristics, such as air and noise pollution, walkability, greenness with pregnancy and birth outcomes. Therefore, the planned scoping review aims to collate and map the published literature on parental preconception exposures to built and natural outdoor environments and adverse pregnancy and birth outcomes. We will search electronic databases (MEDLINE, EMBASE, Scopus) to identify studies for inclusion. Studies will be included if they empirically assess the relationship between maternal and paternal preconception exposures to physical natural and built environment features that occur outdoors in the residential neighbourhood and adverse pregnancy and birth outcomes. Two reviewers will independently screen titles and abstracts, and then the full text. Data extraction and assessment of study quality will be performed by one researcher and checked by a second researcher. Results will be summarised in a narrative synthesis, with additional summaries presented as tables and figures. The scoping review will be disseminated via a peer-reviewed publication, at academic conferences, and published on a website.
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Affiliation(s)
- Suzanne Mavoa
- Melbourne School of Population & Global Health, University of Melbourne, Parkville, VIC 3010, Australia
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (M.W.); (K.L.)
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia;
- Correspondence: ; Tel.: +61-3-9035-9720
| | - Daniel Keevers
- Melbourne Medical School, University of Melbourne, Parkville, VIC 3010, Australia;
| | - Stefan C. Kane
- Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, VIC 3010, Australia;
- Department of Maternal Fetal Medicine, Royal Women’s Hospital, Parkville, VIC 3052, Australia
| | - Melissa Wake
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (M.W.); (K.L.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3010, Australia
- Liggins Institute, University of Auckland, Grafton, Auckland 1023, New Zealand
| | - Rachel Tham
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC 3000, Australia;
| | - Kate Lycett
- Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia; (M.W.); (K.L.)
- Department of Paediatrics, University of Melbourne, Parkville, VIC 3010, Australia
- School of Psychology, Faculty of Health, Deakin University, Burwood, VIC 3125, Australia
| | - Yen Ting Wong
- IMPACT Institute, School of Medicine, Deakin University, Waurn Ponds, VIC 3216, Australia;
| | - Katherine Chong
- Ingram School of Nursing, McGill University, Montreal, QC H3A 2M7, Canada;
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Leggat G, Livingston M, Kuntsche S, Callinan S. Changes in alcohol consumption during pregnancy and over the transition towards parenthood. Drug Alcohol Depend 2021; 225:108745. [PMID: 34051548 DOI: 10.1016/j.drugalcdep.2021.108745] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 03/18/2021] [Accepted: 03/22/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To examine pre- to postnatal changes in drinking for women and men and assess the role of education level in these changes. BACKGROUND The transition towards parenthood can contribute to significant shifts in alcohol consumption for women and men. Research has generally focused on pregnancy and short-term changes following childbirth, usually for mothers only. Socio-economic variation in the impact of childbirth and return to drinking postnatally is similarly understudied. METHOD Longitudinal alcohol consumption data for 2470 individuals (1248 female) who were pregnant, or the partner of a pregnant woman, were obtained from a representative, Australian survey for three years prior and following birth. Piecewise regression models, including an education-x-time interaction, assessed changes in drinking quantity and frequency. RESULTS Female usual quantity and frequency significantly declined during pregnancy, followed by significant postnatal increases in quantity, approaching pre-pregnancy levels, with similar trends across education levels. Male usual quantity increased following childbirth, save for those men with a high-school education. Having an undergraduate degree was associated with a significant postnatal increase in drinking frequency. CONCLUSION Further awareness of the risks associated with male-partner drinking could provide substantial public health benefits. Successful facilitation and implementation of interventions and harm reduction strategies for harmful drinking over the pre- to postnatal period could benefit from further consideration of socioeconomic status and education level, particularly for men.
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Affiliation(s)
- Geoffrey Leggat
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia.
| | - Michael Livingston
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia; National Drug Research Institute, Curtin University, Australia; Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden.
| | - Sandra Kuntsche
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia.
| | - Sarah Callinan
- Centre for Alcohol Policy Research (CAPR), La Trobe University, Australia.
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Lyall V, Wolfson L, Reid N, Poole N, Moritz KM, Egert S, Browne AJ, Askew DA. "The Problem Is that We Hear a Bit of Everything…": A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3445. [PMID: 33810338 PMCID: PMC8037183 DOI: 10.3390/ijerph18073445] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 01/09/2023]
Abstract
Understanding the factors that contribute to women's alcohol use in pregnancy is critical to supporting women's health and wellness and preventing Fetal Alcohol Spectrum Disorder. A systematic review of qualitative studies involving pregnant and recently postpartum women was undertaken to understand the barriers and facilitators that influence alcohol use in pregnancy (PROSPERO: CRD42018098831). Twenty-seven (n = 27) articles were identified through EMBASE, CINAHL, PsycINFO, PubMed and Web of Science. The included articles were thematically analyzed using NVivo12. The analysis was informed by Canada's Action Framework for Building an Inclusive Health System to articulate the ways in which stigma and related barriers are enacted at the individual, interpersonal, institutional and population levels. Five themes impacting women's alcohol use, abstention and reduction were identified: (1) social relationships and norms; (2) stigma; (3) trauma and other stressors; (4) alcohol information and messaging; and (5) access to trusted equitable care and essential resources. The impact of structural and systemic factors on prenatal alcohol use was largely absent in the included studies, instead focusing on individual choice. This silence risks perpetuating stigma and highlights the criticality of addressing intersecting structural and systemic factors in supporting maternal and fetal health.
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Affiliation(s)
- Vivian Lyall
- Primary Care Clinical Unit, University of Queensland, Brisbane, QLD 4006, Australia; (V.L.); (D.A.A.)
| | - Lindsay Wolfson
- Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada;
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC V5R OA4, Canada
| | - Natasha Reid
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia; (N.R.); (K.M.M.)
| | - Nancy Poole
- Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada;
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC V5R OA4, Canada
| | - Karen M. Moritz
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia; (N.R.); (K.M.M.)
- School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Sonya Egert
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD 4077, Australia;
| | - Annette J. Browne
- School of Nursing, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Deborah A. Askew
- Primary Care Clinical Unit, University of Queensland, Brisbane, QLD 4006, Australia; (V.L.); (D.A.A.)
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD 4077, Australia;
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11
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Montagnoli C, Ruggeri S, Cinelli G, Tozzi AE, Bovo C, Bortolus R, Zanconato G. Anything New about Paternal Contribution to Reproductive Outcomes? A Review of the Evidence. World J Mens Health 2021; 39:626-644. [PMID: 33474842 PMCID: PMC8443996 DOI: 10.5534/wjmh.200147] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 10/13/2020] [Accepted: 11/08/2020] [Indexed: 11/15/2022] Open
Abstract
Paternal health and behavioral lifestyles affect reproductive and neonatal outcomes and yet the magnitude of these effects remain underestimated. Even though these impacts have been formally recognized as a central aspect of reproductive health, health care services in Europe often neglect the involvement of fathers in their reproductive programs. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines for systematic reviews, a literature search was carried out to assess the possible impact of paternal health on reproductive outcomes. The comprehensive strategy included cohort studies and meta-analysis available on PubMed, Web of Science, CINAHL, and Google scholar. Cross-referencing of bibliographies of the selected papers ensured wider study capture. Paternal factors were grouped into two categories respectively identified with the terms "Biological Paternal Factors" and "Lifestyle Paternal Factors". Advanced age may impair male fertility and affect early pregnancy stages. Increased body mass index, smoking, alcohol and recreational drugs, all alter seminal fluid parameters. Hazardous alcohol use correlates with low birthweight in pregnancy and harmful behavioral lifestyles have been linked to congenital heart defects, metabolic and neurodevelopmental disorders in the offspring. Measures targeting paternal health and lifestyle within the first 1,000 days' timeframe need to be implemented in couples undergoing reproductive decisions. Health professionals, as well as future fathers, must be aware of the benefits for the offspring associated with correct paternal behaviors. More research is needed to build guidelines and to implement specific programs aiming at reproductive health promotion.
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Affiliation(s)
- Caterina Montagnoli
- Department of Medical Direction, Verona University Hospital, Verona, Italy.,Department of Midwifery, Geneva School of Health Sciences, HES-SO University of Applied Sciences and Arts of Western Switzerland, Geneva, Switzerland
| | | | - Giulia Cinelli
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto E Tozzi
- Predictive and Preventive Medicine Research Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Chiara Bovo
- Department of Medical Direction, Verona University Hospital, Verona, Italy
| | - Renata Bortolus
- Directorate General for Preventive Health - Office 9, Ministry of Health, Rome, Italy
| | - Giovanni Zanconato
- Department of Surgery, Odontostomatology and Maternal and Child Health, University of Verona, Verona, Italy
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Finlay-Jones A, Symons M, Tsang W, Mullan R, Jones H, McKenzie A, Reibel, Cannon L, Birda B, Reynolds N, Sargent P, Gailes H, Mayers D, Elliott EJ, Bower C. Community Priority setting for Fetal Alcohol Spectrum Disorder Research in Australia. Int J Popul Data Sci 2020; 5:1359. [PMID: 34036178 PMCID: PMC8130797 DOI: 10.23889/ijpds.v5i1.1359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder caused by prenatal alcohol exposure (PAE). FASD research is a rapidly growing field that crosses multiple disciplines. To ensure research is relevant and meaningful for people living with FASD, their families, and the broader public there is a need to engage community members in setting priorities for research. OBJECTIVES Our primary objective was to formally identify the views of people living with FASD, their parents/caregivers, service providers, and the general community on the research priorities for FASD and alcohol use in pregnancy in Australia. Our secondary objective was to provide an overview of current research in the highest priority areas identified. METHODS The approach for this study involved two community surveys and a consensus workshop, followed by a rapid literature review. Survey responses (n = 146) were collected and grouped using qualitative thematic analysis. The themes identified were then ranked in a second survey (n = 45). The 22 highest ranked themes were considered in a workshop with 21 community members, and consensus on the top ten priority areas was sought. The priority areas were grouped into conceptually similar topics and rapid literature reviews were undertaken on each. RESULTS A diverse range of priorities was identified within key areas of prevention, diagnosis, and therapy. On request from participants, separate priority lists were developed by Aboriginal and non-Aboriginal participants. CONCLUSION There is need for a national network of researchers to take forward the research commenced by the Centre of Research Excellence, FASD Research Australia, in addressing community priorities. KEY WORDS Community, priorities, FASD, rapid review, Australia.
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Affiliation(s)
- A Finlay-Jones
- Telethon Kids Institute, NHMRC FASD Research Australia Centre of Research Excellence, Nedlands, Western Australia, Australia
| | - M Symons
- Telethon Kids Institute, NHMRC FASD Research Australia Centre of Research Excellence, Nedlands, Western Australia, Australia
| | - W Tsang
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - R Mullan
- Telethon Kids Institute, NHMRC FASD Research Australia Centre of Research Excellence, Nedlands, Western Australia, Australia
| | - H Jones
- Telethon Kids Institute, NHMRC FASD Research Australia Centre of Research Excellence, Nedlands, Western Australia, Australia
| | - A McKenzie
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - Reibel
- Ngangk Yira Research Centre for Aboriginal Health and Social Equity, Murdoch University, Perth, Western Australia, Australia
| | - L Cannon
- Telethon Kids Institute, NHMRC FASD Research Australia Centre of Research Excellence, Nedlands, Western Australia, Australia
| | | | | | | | | | | | - EJ Elliott
- Faculty of Medicine and Health and Discipline of Child and Adolescent Health, University of Sydney, Sydney, New South Wales, Australia
| | - C Bower
- Telethon Kids Institute, NHMRC FASD Research Australia Centre of Research Excellence, Nedlands, Western Australia, Australia
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Neri Mini F, Saltzman JA, Simione M, Luo M, Perkins ME, Roche B, Blake-Lamb T, Kotelchuck M, Arauz-Boudreau A, Davison K, Taveras EM. Expectant Fathers' Social Determinants of Health in Early Pregnancy. Glob Pediatr Health 2020; 7:2333794X20975628. [PMID: 33294495 PMCID: PMC7705787 DOI: 10.1177/2333794x20975628] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/15/2020] [Accepted: 11/02/2020] [Indexed: 11/18/2022] Open
Abstract
This cross-sectional, descriptive study examined unmet social and economic needs and health information requests of low-income, expecting fathers who participated in the First 1000 Days program. The First 1000 Days is a systems-level intervention aiming to prevent obesity among low-income mothers and infants across 3 community health centers in Greater Boston, MA, USA. Fathers who attended their partner's first prenatal care visit were invited to complete a program survey during early pregnancy. Among 131 fathers surveyed, 45% were white, 21% were Hispanic/Latino, 55% were foreign-born, and 69% reported an annual income under $50 000. Fathers reported elevated levels of food insecurity (18%) and 33% were unaware of someone that could provide a $50 loan; however, over 85% of fathers knew someone that could provide non-financial social support. Fathers requested information about pregnancy, birth preparation, and fatherhood. Findings support addressing fathers' unmet needs during pregnancy and providing father-specific perinatal information.
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Affiliation(s)
| | - Jaclyn A. Saltzman
- Massachusetts General Hospital, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Meg Simione
- Massachusetts General Hospital, Boston, MA, USA
| | - Man Luo
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | | | | | | | | | - Elsie M. Taveras
- Massachusetts General Hospital, Boston, MA, USA
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Erng MN, Smirnov A, Reid N. Prevention of Alcohol-Exposed Pregnancies and Fetal Alcohol Spectrum Disorder Among Pregnant and Postpartum Women: A Systematic Review. Alcohol Clin Exp Res 2020; 44:2431-2448. [PMID: 33119893 DOI: 10.1111/acer.14489] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 10/18/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Prenatal alcohol exposure can result in a wide range of adverse health outcomes, including in some cases fetal alcohol spectrum disorder (FASD), a lifelong neurodevelopmental disorder. Thus, there is pressing need for effective interventions to prevent alcohol-exposed pregnancies (AEPs). METHODS A systematic review was undertaken to provide an up-to-date analysis of the current prevention literature. PubMed, Embase, CINAHL, and PsycINFO were searched for relevant English-language articles published from 1970 onward. Studies were eligible for the current systematic review if the interventions included pregnant and postpartum women and/or their support networks to prevent AEPs and FASD. Outcomes of interest included alcohol consumption, knowledge, contraceptive use, neonatal outcomes, family well-being or functioning, economics, and healthcare utilization outcomes. RESULTS Thirty-four peer-reviewed studies met the inclusion criteria. Fifteen studies employed brief intervention (BI) methods, 6 used long-term/intensive strategies, and 5 were educational interventions. A further 3 studies assessed counseling approaches, 2 evaluated multicomponent interventions, and 3 assessed nutritional supplementation interventions. CONCLUSIONS The current review identified variable results from available interventions to prevent alcohol use among pregnant and postpartum women. Preliminary evidence demonstrated that BIs may be effective among subgroups of pregnant women with higher initial alcohol consumption, those with partner involvement, and those who used alcohol and other substances concurrently. Some preliminary evidence relating to long-term interventions with pregnant women with polysubstance use emerged, specifically case management that not only focused on reduction in substance use, but also on addressing the complex interplay between health and social well-being of families. Overall, additional research is required to improve the effectiveness of preventative approaches during pregnancy and the postpartum period.
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Affiliation(s)
- May Na Erng
- From the, Child Health Research Centre, (MNE, NR), The University of Queensland, South Brisbane, QLD, Australia
| | - Andrew Smirnov
- School of Public Health, (AS), The University of Queensland, Herston, QLD, Australia
| | - Natasha Reid
- From the, Child Health Research Centre, (MNE, NR), The University of Queensland, South Brisbane, QLD, Australia
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Parental Alcohol Use and the Alcohol Misuse of their Offspring in a Finnish Birth Cohort: Investigation of Developmental Timing. J Youth Adolesc 2020; 49:1702-1715. [PMID: 32378014 DOI: 10.1007/s10964-020-01239-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 04/02/2020] [Indexed: 12/30/2022]
Abstract
There is a positive association between parental alcohol use and the alcohol use of their offspring. It is less clear whether this relation exists at different developmental periods. The purpose of the current study was to examine the associations between parental alcohol use at two developmental periods (prenatal and adolescence) and the alcohol misuse of their offspring at two developmental periods (adolescence and young adulthood). Data from the Northern Finland Birth Cohort 1986 (NFBC1986; n = 6963; 51% of offspring were girls) were used. The NFBC1986 is a population-based study of individuals born during a 1-year period in Finland. Multi-informant (parent, teacher, and youth) and multi-method (surveys and population registers) data were collected at four developmental periods (prenatal, childhood, adolescence, and young adulthood). The findings indicated that parents' alcohol use was stable from the prenatal period to adolescence. Mothers' and fathers' (based on mothers' perceptions) alcohol use during the prenatal period and adolescence were directly related to adolescents' heavy drinking. Prenatal alcohol use by mothers and fathers were related to young adults' alcohol use disorder indirectly (but not directly) through mothers' and fathers' alcohol use during adolescence and then through adolescents' heavy drinking. The results suggest that early and ongoing screening for alcohol use by mothers and fathers could help identify individuals at risk for heavy drinking and alcohol-related problems during adolescence and young adulthood.
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My partner and my neighbourhood: The built environment and social networks’ impact on alcohol consumption during early pregnancy. Health Place 2020; 61:102239. [DOI: 10.1016/j.healthplace.2019.102239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 11/17/2022]
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Fetal Alcohol Spectrum Disorder: What does Public Awareness Tell Us about Prevention Programming? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16214229. [PMID: 31683594 PMCID: PMC6862449 DOI: 10.3390/ijerph16214229] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 11/17/2022]
Abstract
The prevalence of Fetal Alcohol Spectrum Disorder (FASD) does not appear to be diminishing over time. Indeed, recent data suggests that the disorder may be more prevalent than previously thought. A variety of public education programs developed over the last 20 years have promoted alcohol abstention during pregnancy, yet FASD remains a serious public health concern. This paper reports on a secondary data analysis of public awareness in one Canadian province looking at possible creative pathways to consider for future prevention efforts. The data indicates that the focus on women of childbearing age continues to make sense. The data also suggests that targeting formal (health care providers for examples) and informal support (partner, spouse, family, and friends) might also be valuable. They are seen as sources of encouragement, so ensuring they understand the risks, as well as effective ways to encourage abstinence or harm reduction, may be beneficial for both the woman and the pregnancy. Educating people who might support a woman in pregnancy may be as important as programs targeted towards women who may become or are pregnant. The data also suggests that there is already a significant level of awareness of FASD, thus highlighting the need to explore the effectiveness and value of current prevention approaches.
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Finnbogadóttir H, Persson EK. Lifestyle factors, self-reported health and sense of coherence among fathers/partners in relation to risk for depression and anxiety in early pregnancy. Scand J Caring Sci 2018; 33:436-445. [PMID: 30575068 DOI: 10.1111/scs.12641] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 11/20/2018] [Indexed: 01/06/2023]
Abstract
BACKGROUND Father's health is important for mothers and unborn/newborn children and knowledge about expectant fathers' health in relation to lifestyle and psychosocial aspects is essential. AIMS To determine sociodemographic and lifestyle factors, self-reported health and sense of coherence among fathers and partners in relation to their risk for depression and anxiety in early pregnancy. METHODS A cross-sectional design, descriptive statistics, chi-squared analysis, T-test, binary logistic regression, multiple logistic regression with OR and 95% CI were used. RESULTS A total of 532 prospective fathers/partners constituted the cohort (mean age 31.55, SD 5.47 years). Nearly, one in ten (9.8%) had a statistically high risk for depression; mainly those who were unemployed (p = 0.043), had financial distress (0.001), reported 'very or fairly bad' health (p = 0.002), had a 'very or fairly bad' sexual satisfaction (p = 0.006) and scored low on the SOC scale (p < 0.001). They smoked more often (p = 0.003) were hazardous users of alcohol (p = 0.001) and slept with difficulties (p = 0.001). Those with sleeping difficulties were 5.7 times more likely to have several symptoms of depression (p = 0.001). Hazardous users of alcohol and smokers had 3.1 respectively 3.0 times higher risk for depression (p = 0.001 respectively 0.003). The single strongest risk factor was a low score on the SOC-scale which gave 10.6 (AOR 10.6; 95% CI 5.4-20.6) higher risk for depression. High-anxiety 'just now' was reported by 8.9% and 'in general' by 7.9%, and those who had sleeping difficulties reported 'very or fairly bad' health (p < 0.001). CONCLUSIONS Allocating more resources and introducing more family-focused care with depression and anxiety screening in early pregnancy for both expecting parents at antenatal care should be strongly considered by actors and policymakers, as this is a step in maintaining a family's well-being.
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Affiliation(s)
- Hafrún Finnbogadóttir
- Faculty of Health and Society, Department of Care Science, Malmö University, Malmö, Sweden
| | - Eva K Persson
- Department of Health Sciences, Medical Faculty, Lund University, Lund, Sweden
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Roozen S, Peters GJY, Kok G, Townend D, Nijhuis J, Koek G, Curfs L. Systematic literature review on which maternal alcohol behaviours are related to fetal alcohol spectrum disorders (FASD). BMJ Open 2018; 8:e022578. [PMID: 30573481 PMCID: PMC6303602 DOI: 10.1136/bmjopen-2018-022578] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Revised: 11/20/2018] [Accepted: 11/26/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Fetal alcohol spectrum disorders (FASD) is a worldwide problem. Maternal alcohol consumption is an important risk factor for FASD. It remains unknown which alcohol consumption patterns most strongly predict FASD. The objective of this study was to identify these. DESIGN Systematic literature review. METHODS We searched in PubMed, PsychINFO, PsycARTICLES, ERIC, CINAHL, Embase and MEDLINE up to August 2018. The query consisted of keywords and their synonyms related to FASD, pregnancy and behaviour. Studies were excluded when not published in English, were reviews or involved non-human subjects. Substantial heterogeneity precluded aggregation or meta-analysis of the data. Instead, data were qualitatively inspected. RESULTS In total, 21 studies were eligible for further data analysis. All studies that measured both maternal alcohol drinking behaviours and FASD reported retrospective data on maternal drinking patterns, employing both continuous and categorical measures and exhibiting substantial heterogeneity in measures of alcohol consumption (eg, timing of exposure, quantification of alcohol measure and definition of a standard drink). Study quality improved over time and appeared higher for studies based on active case ascertainment, especially when conducted in schools and when behaviour was assessed through interviews. CONCLUSIONS We aimed to identify specific maternal drinking behaviour(s) related to FASD. The state of the literature precludes such conclusions. Evidence-based preventive measures necessitate identifying which prenatal alcohol drinking behaviour(s) are most in need of intervention. Therefore, we formulate three recommendations for future research. First, future studies can optimise the value of the collected dataset through specifying measurements and reporting of maternal drinking behaviours and avoiding categorised measures (nominal or ordinal) whenever possible. Second, samples should not be selected based on FASD status, but instead, FASD status as well as maternal alcohol consumption should both be measured in a general population sample. Finally, we provide 10 reporting guidelines for FASD research.
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Affiliation(s)
- Sylvia Roozen
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - Gjalt-Jorn Ygram Peters
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
- Faculty of Psychology and Education Science, Open University of The Netherlands, Heerlen, The Netherlands
| | - Gerjo Kok
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Work and Social Psychology, Maastricht University, Maastricht, The Netherlands
| | - David Townend
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Health, Ethics & Society, Maastricht University, Maastricht, The Netherlands
| | - Jan Nijhuis
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Obstretrics and Gynaecology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ger Koek
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Leopold Curfs
- Governor Kremers Centre, Maastricht University Medical Centre, Maastricht, The Netherlands
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Gender Stereotypes and Preconception Health: Men’s and Women’s Expectations of Responsibility and Intentions to Engage in Preventive Behaviors. Matern Child Health J 2018; 23:459-469. [DOI: 10.1007/s10995-018-2654-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Symons M, Pedruzzi RA, Bruce K, Milne E. A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. BMC Public Health 2018; 18:1227. [PMID: 30390661 PMCID: PMC6215602 DOI: 10.1186/s12889-018-6139-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/22/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work. METHOD The MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO, SocINDEX, and Informit databases were searched from inception to 22/08/2017 for all prevention and intervention papers published in peer-reviewed scientific journals, with results, targeting prenatal alcohol exposure and FASD in Indigenous populations. This review was limited to studies published in English and excluded interventions focusing on the workforce. All steps were completed independently by two reviewers with discrepancies resolved via consensus with the senior author. RESULTS There was significant heterogeneity in the ten included studies. Populations targeted included non-pregnant women of child-bearing age, pregnant women, school children and the general public. Study designs included one randomised controlled trial, five cohort studies with pre-post design, one cross-sectional study with different pre- and post-intervention groups, and four studies collected post-intervention data. Studies assessed changes in knowledge, and/or changes in risk for prenatal alcohol exposure including self-reported alcohol consumption, use of birth control or a combination of both. One study was conducted in Australia and nine in the US. The methodological quality of all studies was rated as 'Poor' using the systematic review assessment tools developed by The National Heart, Lung and Blood Institute. Studies were subject to substantial bias due to issues such as high loss to follow-up, lack of control groups and the reliance on self-report measures to assess the main outcome. CONCLUSION Overall, there is little evidence that previous interventions aiming to reduce the risk of prenatal alcohol exposure or FASD in Indigenous populations have been effective. Future intervention studies should address the cultural factors and historical context that are fundamental to successful work with Indigenous populations, and be designed, implemented and evaluated using rigorous methods. This systematic review was registered with PROSPERO, CRD42018086212.
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Affiliation(s)
- Martyn Symons
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Australia
| | - Rebecca Anne Pedruzzi
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Kaashifah Bruce
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
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Robinson M, Wilkinson RB, Fletcher R, Bruno R, Baker AL, Maher L, Wroe J, Dunlop AJ. Alcohol Text Messages: A Developmental Study. Int J Ment Health Addict 2017; 16:1125-1139. [PMID: 30416401 PMCID: PMC6208711 DOI: 10.1007/s11469-017-9835-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Risky paternal alcohol use is associated with maternal alcohol use during pregnancy, poor fetal and infant outcomes, domestic violence and depression. This study developed 30 SMS text messages about alcohol for fathers who drink at risky levels. The text messages were developed using two motivational styles: messages presented in a second person voice and the same messages presented in a child's voice. Fifty-one fathers were recruited through social media to complete an online survey rating the SMS text messages for message importance and likelihood of seeking further information and measuring risky alcohol use and psychosocial distress. Seventeen participants then participated in a semi-structured qualitative interview. Fathers rated the text messages presented in the child's voice as more important than messages presented in the second person. Qualitative data supported survey results that motivational SMS text messages could provide an acceptable way to raise awareness of risky alcohol consumption for future fathers.
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Affiliation(s)
- Maryanne Robinson
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
- 12 Alfred Street, Newcastle East, New South Wales 2300 Australia
| | - R. B. Wilkinson
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, New South Wales Australia
| | - R. Fletcher
- Family Action Centre, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - R. Bruno
- School of Medicine, University of Tasmania, Hobart, Australia
| | - A. L. Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - L. Maher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales Australia
| | - J. Wroe
- Family Action Centre, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - A. J. Dunlop
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, New Lambton, New South Wales Australia
- Centre for Brain and Mental Health, University of Newcastle, Callaghan, New South Wales Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
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