1
|
Popova S, Dozet D, Temple V, Riddell C, Yang C. A Population-Based Study on Women Who Used Alcohol during Pregnancy and Their Neonates in Ontario, Canada. CHILDREN (BASEL, SWITZERLAND) 2024; 11:993. [PMID: 39201928 PMCID: PMC11352585 DOI: 10.3390/children11080993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2024] [Revised: 08/12/2024] [Accepted: 08/13/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND Data from birth registries can be studied to assess the prevalence of prenatal alcohol use and associated maternal and neonatal outcomes. METHODS Linked maternal and neonatal data (2015-2018) for alcohol-exposed pregnancies were obtained from the Better Outcomes Registry and Network (BORN) Ontario. Descriptive statistics were generated for maternal demographics, prenatal substance use, mental health/substance use history, and neonatal outcomes. Logistic regression models were performed to assess the odds of prenatal heavy (binge or weekly) alcohol and other substance use based on mental health/substance use history and other maternal demographics, and the impacts of heavy alcohol use and other prenatal substance exposures on neonatal outcomes. RESULTS A total of 10,172 (2.4%) women reported alcohol use during pregnancy. One-third had pre-existing or current mental health and/or substance use problems, which was associated with significantly higher odds of heavy alcohol use during pregnancy. Prenatal exposure to heavy alcohol use was associated with increased odds of neonatal abstinence syndrome (2.5 times); respiratory distress syndrome (2.3 times); neonatal intensive care unit (NICU) admission (58%); and hyperbilirubinemia (57%). Prenatal exposure to one or more substances in addition to alcohol was associated with significantly higher odds of fetal/maternal/placental pregnancy complications; preterm birth; NICU admission; low APGAR scores; one or more confirmed congenital anomalies at birth; respiratory distress syndrome; and intrauterine growth restriction. CONCLUSIONS It is crucial to routinely screen childbearing-age and pregnant women for alcohol and other substance use as well as mental health problems in order to prevent adverse maternal and neonatal outcomes.
Collapse
Affiliation(s)
- Svetlana Popova
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada;
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON M5S 1V4, Canada
| | - Danijela Dozet
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1, Canada;
- Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Valerie Temple
- Surrey Place, 2 Surrey Place, Toronto, ON M5S 2C2, Canada;
| | - Catherine Riddell
- Better Outcomes Registry and Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada; (C.R.); (C.Y.)
| | - Cathy Yang
- Better Outcomes Registry and Network (BORN) Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada; (C.R.); (C.Y.)
| |
Collapse
|
2
|
Sennsfelder L, Guilly S, Henkous S, Lebon C, Leruste S, Beuvain P, Ferroul F, Benard S, Payet F, Nekaa M, Bagard M, Lauret M, Hoareau V, Caillier A, Robin S, Lanneaux J, Etchebarren L, Spodenkiewicz M, Alessandri JL, Morel G, Roy-Doray B. First Description of a Large Clinical Series of Fetal Alcohol Spectrum Disorders Children and Adolescents in Reunion Island, France. CHILDREN (BASEL, SWITZERLAND) 2024; 11:955. [PMID: 39201890 PMCID: PMC11352436 DOI: 10.3390/children11080955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2024] [Revised: 08/02/2024] [Accepted: 08/06/2024] [Indexed: 09/03/2024]
Abstract
BACKGROUND Despite several diagnostic guidelines, Fetal Alcohol Spectrum Disorders (FASDs) remain underdiagnosed or misdiagnosed, delaying the care of these patients and support for families. OBJECTIVE This study aims to help professionals caring for these children and their families to suspect this diagnosis earlier and to provide the most appropriate follow-up. METHODS A retrospective chart review with monocentric recruitment was performed at the Genetics Unit of the University Hospital of Reunion Island. A total of 147 children and adolescents with FASDs were included. RESULTS Prenatal alcohol exposure was associated with paternal alcohol consumption in 42.9%, and a high rate of prematurity (33.3%) was observed. Sixty percent of children or adolescents were placed in foster families. Learning difficulties without cognitive deficits were found in 65.8% of cases (50/76). Postural control and fine motor skills disabilities were described, respectively, in 54.7% (35/64) and 72.5% (50/69) of cases. A systematic genetic assessment was carried out, identifying in these FASD patients an associated Copy Number Variation (CNVs) in 22.6% of cases. CONCLUSION Children with FASDs combine significant vulnerabilities, associating exposure to alcohol during the preconception and/or the prenatal period, prematurity, complex familial and sociocultural living conditions, and a genetic anomaly in almost a quarter of cases.
Collapse
Affiliation(s)
- Laëtitia Sennsfelder
- Laboratoire EPI (Etudes Pharmaco-Immunologiques), UFR Santé, Université de La Réunion, CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France;
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
| | - Susie Guilly
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
| | - Sonia Henkous
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, 97546 Saint-Pierre, France
| | - Christophe Lebon
- CIC 1410 (Centre d’Investigation Clinique), CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France; (C.L.); (S.L.); (M.S.)
| | - Sébastien Leruste
- CIC 1410 (Centre d’Investigation Clinique), CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France; (C.L.); (S.L.); (M.S.)
- UFR Santé, Université de La Réunion, 97410 Saint-Pierre, France
| | - Pauline Beuvain
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
| | - Fanny Ferroul
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
| | - Stéphanie Benard
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
| | - Frédérique Payet
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
| | - Meissa Nekaa
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, 97546 Saint-Pierre, France
| | - Maité Bagard
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, 97546 Saint-Pierre, France
| | - Magaly Lauret
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, 97546 Saint-Pierre, France
| | - Virginie Hoareau
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, 97546 Saint-Pierre, France
| | - Aurélie Caillier
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, 97546 Saint-Pierre, France
| | - Stéphanie Robin
- Centre Diagnostic TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France
| | - Justine Lanneaux
- Centre Diagnostic TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France
| | - Léa Etchebarren
- Centre Diagnostic TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France
| | - Michel Spodenkiewicz
- CIC 1410 (Centre d’Investigation Clinique), CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France; (C.L.); (S.L.); (M.S.)
- Pôle de Santé Mentale, CHU (Centre Hospitalier Universitaire) de La Réunion, 97448 Saint-Pierre, France
| | - Jean-Luc Alessandri
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest Occitanie Réunion, Site Constitutif de La Réunion, 97400 Saint-Denis, France
| | - Godelieve Morel
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest Occitanie Réunion, Site Constitutif de La Réunion, 97400 Saint-Denis, France
| | - Bérénice Roy-Doray
- Laboratoire EPI (Etudes Pharmaco-Immunologiques), UFR Santé, Université de La Réunion, CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France;
- Service de Génétique, CHU (Centre Hospitalier Universitaire) de La Réunion, La Réunion, 97400 Saint-Denis, France
- Centre Ressources TSAF (Troubles du Spectre de l’Alcoolisation Fœtale), Fondation Père Favron, CHU (Centre Hospitalier Universitaire) de La Réunion, 97546 Saint-Pierre, France
- CIC 1410 (Centre d’Investigation Clinique), CHU (Centre Hospitalier Universitaire) de La Réunion, 97400 Saint-Denis, France; (C.L.); (S.L.); (M.S.)
- UFR Santé, Université de La Réunion, 97410 Saint-Pierre, France
- Centre de Référence Anomalies du Développement et Syndromes Malformatifs Sud-Ouest Occitanie Réunion, Site Constitutif de La Réunion, 97400 Saint-Denis, France
| |
Collapse
|
3
|
Washio Y, Erasmus-Claassen LA, Taylor SN, Zhang Z, Browne FA, Myers B, Wechsberg WM, Parry CDH, Petersen Williams P. An incentive-based text-messaging intervention to reduce maternal alcohol use during pregnancy and lactation in South Africa (MaRISA study): Findings from a single-arm pilot study. ALCOHOL, CLINICAL & EXPERIMENTAL RESEARCH 2024; 48:1600-1609. [PMID: 38884353 DOI: 10.1111/acer.15392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 05/24/2024] [Accepted: 05/30/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND South Africa has the highest rate of fetal alcohol spectrum disorders (FASD) globally. As with alcohol use during pregnancy, alcohol consumption while breastfeeding adversely impacts infant development. We pilot tested an incentive-based text-messaging intervention to reduce alcohol use during pregnancy and lactation in South Africa. METHODS A single-arm pilot trial was conducted over 3 months in healthcare facilities in Cape Town, South Africa. Pregnant and breastfeeding participants tested positive for recent alcohol use by urinalysis. The three-month intervention had two components, contingency management of alcohol abstinence confirmed by urinalysis twice weekly and weekly health-related text messaging from an evidence-based brief intervention. We collected twice weekly urine samples for measurement of ethyl glucuronide (EtG), an alcohol biomarker, and measures of self-reported alcohol and drug use, violence exposure, and mental health at six weeks and three months post-enrollment. RESULTS Sixty participants were enrolled, of whom 31 were pregnant and 29 lactating. The number of days with four or more drinks in the past month decreased from 9 days at baseline, on average, to 1-3 days (p-value range: 0.144-0.010) at follow-up timepoints. There were statistically significant increases in the proportions of participants with alcohol-negative urine tests (p < 0.001). The percentages of participants breastfeeding while using alcohol decreased from baseline to the end of 3 months in the overall sample and among those enrolled postpartum, though these were not significant (p-value range: 0.255-0.147). Maternal depression scores also decreased among participants enrolled postpartum (p = 0.054). Emotional abuse by the main partner, but neither physical nor sexual abuse, significantly decreased at both follow-ups in the overall sample (p = 0.032) and among participants enrolled while pregnant (p = 0.015). CONCLUSIONS This study is among the first to pilot test an incentive-based text-messaging intervention for maternal alcohol use and other outcomes such as depression and violence exposure. Further testing is warranted in a well-powered, randomized controlled trial.
Collapse
Affiliation(s)
- Yukiko Washio
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, North Carolina, USA
- Department of Obstetrics, Gynecology and Reproductive Sciences, Temple University Lewis Katz School of Medicine, Philadelphia, Pennsylvania, USA
| | - Lesley-Ann Erasmus-Claassen
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa
| | - Shantae N Taylor
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, North Carolina, USA
| | - Zugui Zhang
- Christiana Care Health System, Institute for Research on Equity and Community Health, Newark, Delaware, USA
| | - Felicia A Browne
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, North Carolina, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Bronwyn Myers
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Curtin enAble Institute, Curtin University, Bentley, Western Australia, Australia
| | - Wendee M Wechsberg
- Substance Use, Gender and Applied Research, RTI International, Research Triangle Park, North Carolina, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, USA
| | - Charles D H Parry
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | - Petal Petersen Williams
- Mental Health, Alcohol, Substance Use and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Cape Town, South Africa
| |
Collapse
|
4
|
Fernandes RC, Höfelmann DA. Simultaneity of health-related behaviors and food insecurity among pregnant women. Health Care Women Int 2024:1-16. [PMID: 38394291 DOI: 10.1080/07399332.2024.2317334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
The researchers aimed through this cross-sectional study to explore the co-occurrence of health-related behaviors and their association with food insecurity in pregnant women. The investigated behaviors include smoking, alcohol consumption, non-regular consumption of fruit, and physical inactivity among 605 participants. Our findings reveal that women experiencing food insecurity exhibit a higher prevalence of simultaneous engagement in specific health behaviors. Specifically, the co-occurrence of alcohol consumption and non-regular fruit consumption is elevated, as is the co-occurrence of smoking, alcohol consumption, and physical inactivity, and alcohol consumption, regular fruit consumption, and physical inactivity. The implications of these findings underscore the need for targeted interventions addressing both food insecurity and clustered health behaviors during pregnancy.
Collapse
Affiliation(s)
- Renata Cordeiro Fernandes
- Post-Graduate Program in Food and Nutrition, Department of Nutrition, Federal University of Paraná, Curitiba, Brazil
| | - Doroteia Aparecida Höfelmann
- Post-Graduate Program in Food and Nutrition, Department of Nutrition, Federal University of Paraná, Curitiba, Brazil
- Post-Graduate Program in Public Health, Department of Collective Health, Federal University of Paraná, Curitiba, Brazil
| |
Collapse
|
5
|
Stevens MWR, Cooper M, Cusack L, Ali RL, Briley AL. Improving the quality of antenatal screening and early intervention for alcohol and other drug use: protocol for a multi-stage approach to systems reform. Addict Sci Clin Pract 2024; 19:2. [PMID: 38183129 PMCID: PMC10768159 DOI: 10.1186/s13722-023-00434-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/18/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Alcohol, tobacco and illicit drug use during pregnancy can cause significant harm to women and their developing fetuses. Despite recommendations for abstinence during pregnancy, some women continue to use, making screening for substance use during antenatal clinic attendances an important strategy for reducing risk. This study aims to improve the rates of screening and intervention for substance use among pregnant women, including appropriate referral for those who may be substance-dependent. The protocol outlined here focuses on a multi-stage implementation study. METHODS This study will occur in four phases. Phase 1 will identify a baseline rate of screening and subsequent care at the antenatal clinics of two, South Australian hospital-based maternity services, through a retrospective case note audit. Rates of self-reported substance use identified in the case notes will also be compared against representative data from Adelaide Primary Health Network to establish rates of over or underreporting. Phase 2 will involve an online Training Needs Analysis of midwifery staff working at those services, to assess their knowledge, attitudes, beliefs, and commitment to the care of women who use substances during pregnancy. Phase 3 will involve a training package for all midwifery staff at those services, focused on routine screening for substance use, and how to provide appropriate care. Outcome measures from phase 2 will be reassessed during phase 3 and any changes since training will be evaluated. Phase 4 will then repeat phase 1 to compare the changes in rates of both screening and any associated intervention before and after training. DISCUSSION From a public health perspective, this project has the potential to make a significant impact on reducing risk of harm from substance use disorders among pregnant women, and contribute to better health outcomes for their children. TRIAL REGISTRATION This trial has been pre-registered under the Open Science Framework. REGISTRATION https://doi.org/10.17605/OSF.IO/73FDZ .
Collapse
Affiliation(s)
- Matthew W R Stevens
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia.
| | - Megan Cooper
- Caring Futures Institute Flinders University, Bedford Park, South Australia, Australia
| | - Lynette Cusack
- Adelaide Nursing School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert L Ali
- School of Biomedicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Annette L Briley
- Caring Futures Institute Flinders University, Bedford Park, South Australia, Australia
- Northern Adelaide Local Health Network, Lyell McEwin Hospital, Elizabeth, South Australia, Australia
| |
Collapse
|
6
|
Corrales-Gutierrez I, Gomez-Baya D, Leon-Larios F, Medero-Canela R, Marchei E, Mendoza-Berjano R, García-Algar Ó. Alcohol Consumption Assessed by a Biomarker and Self-Reported Drinking in a Sample of Pregnant Women in the South of Europe: A Comparative Study. TOXICS 2023; 11:930. [PMID: 37999582 PMCID: PMC10675307 DOI: 10.3390/toxics11110930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 11/05/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023]
Abstract
(1) Background: Alcohol consumption during pregnancy is a major concern, particularly in Europe and North America. Its prevalence has so far been under-researched. In most studies, the determination of this consumption may be underestimated, as it is based on the information obtained from questionnaires rather than from biomarkers, which will provide a much more reliable approach. The main objective of this study was to compare the prevalence of consumption during pregnancy as assessed by a questionnaire and a hair biomarker. (2) Method: A cross-sectional study with a random sample of 425 pregnant women treated in public hospital consultations in Seville (Spain) and in the 20th week of their pregnancy, orally interviewed using an elaborated ad hoc questionnaire that evaluated variables of sociodemographic, obstetric, and alcohol consumption. Furthermore, the ethyl glucuronide metabolite (EtG) was tested on a hair sample in 252 pregnant women who agreed to facilitate it. Once the data obtained through the questionnaire and hair test were analyzed, the level of metabolites and self-reported alcohol consumption were compared. (3) Results: The prevalence of self-reported alcohol consumption (questionnaire) was 20.7%, and the real consumption (metabolite analysis) was 20.2%. In 16.8% of pregnant women who declared not consuming alcohol during their pregnancy, noticeable consumption was detected according to the metabolite test. No relevant level of variability in estimated alcohol consumption was detected in the biomarker with respect to the sociodemographic and obstetric variables studied. (4) Conclusions: The prevalence of alcohol consumption during pregnancy obtained through both questionnaires and metabolite analyses was similar and high. There is no association between consumption and sociodemographic factors in this sample. The determination of consumption through biomarkers allows for a more accurate approximation of the prevalence of consumption than estimated through questionnaires. Larger sample-sized studies are needed to determine consumption patterns and thus guide the adoption of more precise policies fostering abstinence from alcohol consumption since the preconception period.
Collapse
Affiliation(s)
- Isabel Corrales-Gutierrez
- Foetal Medicine Unit, University Hospital Virgen Macarena, 41009 Seville, Spain;
- Department of Surgery, Faculty of Medicine, University of Seville, 41009 Seville, Spain
| | - Diego Gomez-Baya
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain;
- Research Group on Health Promotion and Development of Lifestyle across the Lifespan, University of Huelva, 21007 Huelva, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
| | - Rocío Medero-Canela
- Multiprofessional Teaching Unit for Family and Community Care in Huelva, Huelva Costa Condado Campiña Health District, 21001 Huelva, Spain;
| | | | - Ramon Mendoza-Berjano
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain;
- Research Group on Health Promotion and Development of Lifestyle across the Lifespan, University of Huelva, 21007 Huelva, Spain
| | - Óscar García-Algar
- Neonatology Unit, Hospital Clinic, Universitat de Barcelona, 08028 Barcelona, Spain;
| |
Collapse
|
7
|
Preis H, Djurić PM, Ajirak M, Mane V, Garry DJ, Garretto D, Herrera K, Heiselman C, Lobel M. Missingness patterns in a comprehensive instrument identifying psychosocial and substance use risk in antenatal care. J Reprod Infant Psychol 2023; 41:376-390. [PMID: 34787528 PMCID: PMC9110558 DOI: 10.1080/02646838.2021.2004302] [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: 05/08/2021] [Accepted: 11/02/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Psychosocial vulnerabilities (e.g. inadequate social support, financial insecurity, stress) and substance use elevate risks for adverse perinatal outcomes and maternal mental health morbidities. However, various barriers, including paucity of validated, simple and usable comprehensive instruments, impede execution of the recommendations to screen for such vulnerabilities in the first antenatal care visit. The current study presents findings from a newly implemented self-report tool created to overcome screening barriers in outpatient antenatal clinics. METHODS This was a retrospective chart-review of 904 women who completed the Profile for Maternal & Obstetric Treatment Effectiveness (PROMOTE) during their first antenatal visit between June and December 2019. The PROMOTE includes the 4-item NIDA Quick Screen and 15 additional items that each assess a different psychosocial vulnerability. Statistical analysis included evaluation of missing data, and exploration of missing data patterns using univariate correlations and hierarchical clustering. RESULTS Three quarters of women (70.0%) had no missing items. In the entire sample, all but four PROMOTE items (opioid use, planned pregnancy, educational level, and financial state) had < 5% missing values, suggesting good acceptability and feasibility. Several respondent-related characteristics such as lower education, less family support, and greater stress were associated with greater likelihood of missing items. Instrument-related characteristics associated with missing values were completing the PROMOTE in Spanish or question positioning at the end of the instrument. CONCLUSIONS AND IMPLICATIONS Conducting a comprehensive screening of theoretically and clinically meaningful vulnerabilities in an outpatient setting is feasible. Study findings will inform modifications of the PROMOTE and subsequent digitisation.
Collapse
Affiliation(s)
- Heidi Preis
- Department of Psychology, Stony Brook University, Stony Brook, New York 11794 USA
| | - Petar M. Djurić
- Department of Electrical and Computer Engineering, Stony Brook University, Stony Brook, New York 11794 USA
| | - Marzieh Ajirak
- Department of Electrical and Computer Engineering, Stony Brook University, Stony Brook, New York 11794 USA
| | - Vibha Mane
- Department of Electrical and Computer Engineering, Stony Brook University, Stony Brook, New York 11794 USA
| | - David J. Garry
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York 11794 USA
| | - Diana Garretto
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York 11794 USA
| | - Kimberly Herrera
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York 11794 USA
| | - Cassandra Heiselman
- Department of Obstetrics, Gynecology and Reproductive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, New York 11794 USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, New York 11794 USA
| |
Collapse
|
8
|
Lopes CDS. Alcohol consumption during pregnancy: the result of a risky consumption trajectory? CAD SAUDE PUBLICA 2023; 39:e00129523. [PMID: 37556614 PMCID: PMC10494682 DOI: 10.1590/0102-311xpt129523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/11/2023] Open
Affiliation(s)
- Claudia de Souza Lopes
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| |
Collapse
|
9
|
Cabral VP, Moraes CLD, Bastos FI, Abreu AMM, Domingues RMSM. Prevalence of alcohol use during pregnancy, Brazil, 2011-2012. CAD SAUDE PUBLICA 2023; 39:e00232422. [PMID: 37556615 PMCID: PMC10494674 DOI: 10.1590/0102-311xpt232422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 03/20/2023] [Accepted: 04/10/2023] [Indexed: 08/11/2023] Open
Abstract
This is a national cross-sectional, hospital-based study, which interviewed 23,894 postpartum women in 2011-2012 aiming to estimate the prevalence of alcohol use during pregnancy and identifying more vulnerable groups. Alcohol use during pregnancy was identified using the TWEAK scale, and women with a score of ≥ 2 were classified as having a "presumable diagnosis of inadequate alcohol use". The national prevalence of alcohol use and the prevalence in subgroups were calculated according to maternal characteristics, with respective 95% confidence intervals (95%CI). Coexistence of smoking, inadequate prenatal consultations, and alcohol use during pregnancy were graphically identified. The prevalence of alcohol use was 14% (95%CI: 13.3-14.7), with 10% (95%CI: 9.3-10.6) of women presenting presumable diagnosis of inadequate alcohol us during pregnancy. Higher prevalence of alcohol use and presumable diagnosis of inadequate alcohol us was observed in black women, aged 12-19 years, with lower educational level, from a lower economic class, without a partner, without paid work, with more than three previous births, who did not want to get pregnant, with inadequate prenatal care, with previous delivery in public services, and who reported smoking during pregnancy. Among the interviewees, 1.2% presented all three risk factors for negative perinatal outcomes at the same time: smoking, alcohol use, and inadequate prenatal care. The results showed a high prevalence of alcohol use during pregnancy and presumable diagnosis of inadequate alcohol us, especially among women with worse social conditions. These data are relevant for the formulation of public policies to prevent alcohol use and provide support services to help this population stop alcohol use during pregnancy.
Collapse
Affiliation(s)
- Vanderlea Poeys Cabral
- Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | - Claudia Leite de Moraes
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil
| | - Francisco I Bastos
- Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil
| | | | | |
Collapse
|
10
|
Saxov KR, Pristed SG, Kesmodel US. Characteristic associated with alcohol drinking in early pregnancy: a cross sectional study. Sci Rep 2023; 13:10925. [PMID: 37407640 DOI: 10.1038/s41598-023-38055-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 07/02/2023] [Indexed: 07/07/2023] Open
Abstract
We aimed to identify characteristics associated with alcohol drinking before and during pregnancy to better target pregnancy guidance and public health campaigns. A cross sectional study including 1895 pregnant women interviewed at 16 weeks' gestation. Information on characteristics and drinking habits before and during pregnancy was collected by in-person interview. Associations between characteristics and alcohol consumption were estimated by ordinal logistic regression models. Average alcohol intake before pregnancy was categorised; 0; > 0-3; > 3-6; > 6 drinks/week; and intake during pregnancy 0; < 1; 1-3; > 3 drinks/week; binge drinking 0; 1; 2; 3; ≥ 4 episodes. Characteristics for average alcohol intake before pregnancy were older age, odds ratio (OR) 3.99 (95% CI 2.77-5.74) when being 35 years or older. Schooling > 10 years, being primiparous and partner's alcohol consumption were also significantly associated with average alcohol intake before pregnancy. Characteristics for average alcohol intake during pregnancy were age 25 to < 35 years, OR 0.78 (CI 95% 0.61-0.98) and being single OR 1.52 (CI 95% 1.01-2.29). Characteristics for binge drinking during pregnancy were smoking OR 1.34 (CI 95% 1.06-1.69) when binge drinking was defined as ≥ 3 drinks/occasion and OR 1.49 (CI 95% 1.18-1.91) when defined as ≥ 5 drinks/ occasion. Other characterises found with a significant association were schooling > 10 years, being single, being primiparous and partner's alcohol consumption. We identified characteristics that may be considered when counselling pregnant women or women planning to conceive. Public persuasive campaigns can be used to reach the general public, especially women of childbearing age, before they start planning to conceive, but also their partners, since women with partners consuming alcohol, did show to be more likely to consume alcohol during pregnancy.
Collapse
Affiliation(s)
- Kristina R Saxov
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Reberbansgade 15, 9000, Aalborg, Denmark.
| | - Sofie Gry Pristed
- Programme of Biomedical Laboratory Science, University College of Northern Denmark, Hjørring, Denmark
| | - Ulrik Schiøler Kesmodel
- Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Reberbansgade 15, 9000, Aalborg, Denmark
| |
Collapse
|
11
|
Thomson KC, Greenwood CJ, Letcher P, Spry EA, Macdonald JA, McAnally HM, Hines LA, Youssef GJ, McIntosh JE, Hutchinson D, Hancox RJ, Patton GC, Olsson CA. Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium. Psychol Med 2023; 53:2136-2145. [PMID: 37310325 DOI: 10.1017/s0033291721003925] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum. METHODS Data were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13-18 years), young adulthood (19-29 years) and at ages 29-35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum. RESULTS Frequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception. CONCLUSIONS Persistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.
Collapse
Affiliation(s)
- Kimberly C Thomson
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- University of British Columbia, Human Early Learning Partnership, School of Population and Public Health, Vancouver, British Columbia, Canada
- Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
| | - Christopher J Greenwood
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Primrose Letcher
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Elizabeth A Spry
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Jacqui A Macdonald
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Helena M McAnally
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Lindsey A Hines
- Centre for Academic Mental Health, Population Health Sciences Institute, University of Bristol, Bristol, UK
- Integrative Epidemiology Unit, Population Health Sciences Institute, University of Bristol, Bristol, UK
| | - George J Youssef
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Jennifer E McIntosh
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Psychology, La Trobe University, The Bouverie Centre, Melbourne, Victoria, Australia
| | - Delyse Hutchinson
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Faculty of Medicine, University of New South Wales, National Drug and Alcohol Research Centre, Sydney, New South Wales, Australia
| | - Robert J Hancox
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - George C Patton
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| | - Craig A Olsson
- Faculty of Health, Deakin University, Centre for Social and Early Emotional Development, School of Psychology, Geelong, Victoria, Australia
- Murdoch Children's Research Institute, Centre for Adolescent Health, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
- Department of Paediatrics, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, The Royal Children's Hospital Campus, Parkville, Victoria, Australia
| |
Collapse
|
12
|
Perinatal Psychoactive Substances Use: A Rising Perinatal Mental Health Concern. J Clin Med 2023; 12:jcm12062175. [PMID: 36983176 PMCID: PMC10056692 DOI: 10.3390/jcm12062175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/07/2023] [Accepted: 03/09/2023] [Indexed: 03/16/2023] Open
Abstract
Introduction: A significant increase in psychoactive drugs use was observed in women of childbearing age and during the perinatal period worldwide. Yet, the use of illicit drugs, alcohol and tobacco during pregnancy is a serious health risk for the mother, developing fetus and newborn. Methods: This review of current trends and consequences of psychoactive substance use in the general population and in pregnant women was conducted using the English and French literature published during the years 2000 to 2022, supplemented by guidelines, meta-analyses and reviews. Results: According to current rates of prenatal substances use, it was calculated that 380,000 offspring were exposed to illicit substances, more than 500,000 to alcohol and over one million to tobacco during uterine life. Alarmingly, drug-related pregnancy-associated mortality has shown a staggering 190% rise between 2010 and 2019 in the USA. Different drugs of abuse, when used during pregnancy, increase the risk of stillbirth, neonatal abstinence syndrome and sudden infant death. Adverse effects on pregnancy include premature rupture of membranes, placental abruption, preterm birth, low birth space? weight and small-for-gestational-age infants. There is also an increased risk of morbidity and mortality for the pregnant women. Long-term negative adverse effects of perinatal exposure to substances also include a number of neurocognitive, behavioral and emotional dysfunctions in infants. Each type of substance has its own specificities, which will be briefly summarized. Conclusion: All childbearing age women must be informed about the potential harm of the prenatal use of psychoactive substances and should be encouraged to stop their use when pregnancy is planned and, at least, when pregnancy is known. Questioning women about their alcohol consumption should be systematic at the first prenatal visit and then at every prenatal visit until delivery. Multidisciplinary prevention approaches as well as intervention measures targeted to each type of psychoactive substance can save mothers’ lives and mitigate serious adversities to the offspring.
Collapse
|
13
|
Brunton R, Dryer R. Alcohol consumption after pregnancy awareness and the additive effect of pregnancy-related anxiety and child abuse. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04387-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
AbstractThis study examined whether pregnant women alter their alcohol consumption upon pregnancy awareness and any additive effect of a maternal history of child abuse and pregnancy-related anxiety in predicting antenatal alcohol consumption. Pregnant women (N = 548, M = 31.44, SD = 4.58) completed an online survey consisting of the Pregnancy-related Anxiety Scale, Adverse Childhood Experience Questionnaire, questions on alcohol consumption and demographics. The Wilcoxon test examined difference scores between pre-pregnancy awareness and post-awareness drinking. More women reduced or ceased drinking after pregnancy awareness (M = 0.15, SD = 1.03) than before pregnancy recognition (M = 3.12, SD = 3.91). Only two women increased their alcohol consumption, with 140 reporting no change. In the hierarchical regression analysis, child abuse was not significant in the model, whereas pregnancy-related anxiety predicted alcohol consumption, with pre-pregnancy drinking the strongest predictor. There was no significant interaction effect between pregnancy-related anxiety and child abuse. While limited by a cross-sectional design and single questions to assess alcohol intake, our findings are consistent with extant literature. Findings related to child abuse were not significant, and likely due to low prevalence in the sample, Despite this, we further established that pregnancy-related anxiety remains a significant predictor of antenatal drinking regardless of how much alcohol a woman may consume pre-pregnancy. This relationship may be explained by drinking used to cope with pregnancy-related anxieties. While current guidelines recommend alcohol screening, many women may not accurately report their alcohol intake screening for pregnancy-related anxiety may provide an avenue to identify women more at risk of drinking during pregnancy.
Collapse
|
14
|
Schmidt RA, Wey TW, Harding KD, Fortier I, Atkinson S, Tough S, Letourneau N, Knight JA, Fraser WD, Bocking A. A harmonized analysis of five Canadian pregnancy cohort studies: exploring the characteristics and pregnancy outcomes associated with prenatal alcohol exposure. BMC Pregnancy Childbirth 2023; 23:128. [PMID: 36855094 PMCID: PMC9972615 DOI: 10.1186/s12884-023-05447-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/14/2023] [Indexed: 03/02/2023] Open
Abstract
BACKGROUND As a teratogen, alcohol exposure during pregnancy can impact fetal development and result in adverse birth outcomes. Despite the clinical and social importance of prenatal alcohol use, limited routinely collected information or epidemiological data exists in Canada. The aim of this study was to pool data from multiple Canadian cohort studies to identify sociodemographic characteristics before and during pregnancy that were associated with alcohol consumption during pregnancy and to assess the impact of different patterns of alcohol use on birth outcomes. METHODS We harmonized information collected (e.g., pregnant women's alcohol intake, infants' gestational age and birth weight) from five Canadian pregnancy cohort studies to consolidate a large sample (n = 11,448). Risk factors for any alcohol use during pregnancy, including any alcohol use prior to pregnancy recognition, and binge drinking, were estimated using binomial regressions including fixed effects of pregnancy cohort membership and multiple maternal risk factors. Impacts of alcohol use during pregnancy on birth outcomes (preterm birth and low birth weight for gestational) were also estimated using binomial regression models. RESULTS In analyses adjusting for multiple risk factors, women's alcohol use during pregnancy, both any use and any binge drinking, was associated with drinking prior to pregnancy, smoking during pregnancy, and white ethnicity. Higher income level was associated with any drinking during pregnancy. Neither drinking during pregnancy nor binge drinking during pregnancy was significantly associated with preterm delivery or low birth weight for gestational age in our sample. CONCLUSIONS Pooling data across pregnancy cohort studies allowed us to create a large sample of Canadian women and investigate the risk factors for alcohol consumption during pregnancy. We suggest that future pregnancy and birth cohorts should always include questions related to the frequency and amount of alcohol consumed before and during pregnancy that are prospectively harmonized to support data reusability and collaborative research.
Collapse
Affiliation(s)
- Rose A. Schmidt
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health (CAMH), Toronto, ON Canada
| | - Tina W. Wey
- grid.63984.300000 0000 9064 4811Research Institute of the McGill University Health Centre, Montreal, QC Canada
| | - Kelly D. Harding
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC Canada ,grid.258970.10000 0004 0469 5874Department of Psychology, Laurentian University, Sudbury, ON Canada
| | - Isabel Fortier
- grid.63984.300000 0000 9064 4811Research Institute of the McGill University Health Centre, Montreal, QC Canada
| | - Stephanie Atkinson
- grid.25073.330000 0004 1936 8227Department of Pediatrics, McMaster University, Hamilton, ON Canada
| | - Suzanne Tough
- grid.22072.350000 0004 1936 7697Owerko Centre at the Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB Canada ,grid.22072.350000 0004 1936 7697Cumming School of Medecine, University of Calgary, Calgary, AB Canada
| | - Nicole Letourneau
- grid.22072.350000 0004 1936 7697Owerko Centre at the Alberta Children’s Hospital Research Institute, University of Calgary, Calgary, AB Canada
| | - Julia A. Knight
- grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, Toronto, ON Canada ,grid.250674.20000 0004 0626 6184Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON Canada
| | - William D. Fraser
- grid.86715.3d0000 0000 9064 6198Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, QC Canada
| | - Alan Bocking
- grid.17063.330000 0001 2157 2938Department of Obstetrics and Gynecology, University of Toronto, Toronto, ON Canada
| |
Collapse
|
15
|
Popova S, Charness ME, Burd L, Crawford A, Hoyme HE, Mukherjee RAS, Riley EP, Elliott EJ. Fetal alcohol spectrum disorders. Nat Rev Dis Primers 2023; 9:11. [PMID: 36823161 DOI: 10.1038/s41572-023-00420-x] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/16/2023] [Indexed: 02/25/2023]
Abstract
Alcohol readily crosses the placenta and may disrupt fetal development. Harm from prenatal alcohol exposure (PAE) is determined by the dose, pattern, timing and duration of exposure, fetal and maternal genetics, maternal nutrition, concurrent substance use, and epigenetic responses. A safe dose of alcohol use during pregnancy has not been established. PAE can cause fetal alcohol spectrum disorders (FASD), which are characterized by neurodevelopmental impairment with or without facial dysmorphology, congenital anomalies and poor growth. FASD are a leading preventable cause of birth defects and developmental disability. The prevalence of FASD in 76 countries is >1% and is high in individuals living in out-of-home care or engaged in justice and mental health systems. The social and economic effects of FASD are profound, but the diagnosis is often missed or delayed and receives little public recognition. Future research should be informed by people living with FASD and be guided by cultural context, seek consensus on diagnostic criteria and evidence-based treatments, and describe the pathophysiology and lifelong effects of FASD. Imperatives include reducing stigma, equitable access to services, improved quality of life for people with FASD and FASD prevention in future generations.
Collapse
Affiliation(s)
- Svetlana Popova
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada.
| | - Michael E Charness
- VA Boston Healthcare System, West Roxbury, MA, USA.,Department of Neurology, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.,Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Larry Burd
- North Dakota Fetal Alcohol Syndrome Center, Department of Pediatrics, University of North Dakota School of Medicine and Health Sciences, Pediatric Therapy Services, Altru Health System, Grand Forks, ND, USA
| | - Andi Crawford
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - H Eugene Hoyme
- Sanford Children's Genomic Medicine Consortium, Sanford Health, and University of South Dakota Sanford School of Medicine, Sioux Falls, SD, USA
| | - Raja A S Mukherjee
- National UK FASD Clinic, Surrey and Borders Partnership NHS Foundation Trust, Redhill, Surrey, UK
| | - Edward P Riley
- Center for Behavioral Teratology, San Diego State University, San Diego, CA, USA
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,New South Wales FASD Assessment Service, CICADA Centre for Care and Intervention for Children and Adolescents affected by Drugs and Alcohol, Sydney Children's Hospitals Network, Westmead, Sydney, New South Wales, Australia
| |
Collapse
|
16
|
Romeo JS, Huckle T, Casswell S, Connor J, Rehm J, McGinn V. Foetal alcohol spectrum disorder in Aotearoa, New Zealand: Estimates of prevalence and indications of inequity. Drug Alcohol Rev 2023; 42:859-867. [PMID: 36809679 DOI: 10.1111/dar.13619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/21/2022] [Accepted: 01/08/2023] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Foetal alcohol spectrum disorder (FASD) is 100% caused by alcohol. The lifelong disability caused by prenatal alcohol exposure cannot be reversed. Lack of reliable national prevalence estimates of FASD is common internationally and true of Aotearoa, New Zealand. This study modelled the national prevalence of FASD and differences by ethnicity. METHODS FASD prevalence was estimated from self-reported data on any alcohol use during pregnancy for 2012/2013 and 2018/2019, combined with risk estimates for FASD from a meta-analysis of case-ascertainment or clinic-based studies in seven other countries. A sensitivity analysis using four more recent active case ascertainment studies was performed to account for the possibility of underestimation. RESULTS We estimated FASD prevalence in the general population to be 1.7% (95% confidence interval [CI] 1.0%; 2.7%) in the 2012/2013 year. For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. In the 2018/2019 year, FASD prevalence was 1.3% (95% CI 0.9%; 1.9%). For Māori, the prevalence was significantly higher than for Pasifika and Asian populations. The sensitivity analysis estimated the prevalence of FASD in the 2018/2019 year to range between 1.1% and 3.9% and for Māori, from 1.7% to 6.3%. DISCUSSION AND CONCLUSIONS This study used methodology from comparative risk assessments, using the best available national data. These findings are probably underestimates but indicate a disproportionate experience of FASD by Māori compared with some ethnicities. The findings support the need for policy and prevention initiatives to support alcohol-free pregnancies to reduce lifelong disability caused by prenatal alcohol exposure.
Collapse
Affiliation(s)
- Jose S Romeo
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Taisia Huckle
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Sally Casswell
- SHORE & Whariki Research Centre, College of Health, Massey University, Auckland, New Zealand
| | - Jennie Connor
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Jurgen Rehm
- Institute for Mental Health Policy Research and Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada.,Department of Psychiatry, University of Toronto, Toronto, Canada.,PAHO/WHO Collaborating Centre for Addiction and Mental Health, Technische Universität Dresden, Klinische Psychologie and Psychotherapie, Dresden, Germany.,Zentrum für Interdisziplinäre Suchtforschung der Universität Hamburg, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Valerie McGinn
- National Institute for Health Innovation, School of Population Health, The University of Auckland, Auckland, New Zealand.,FASD Centre, Aotearoa, Auckland, New Zealand
| |
Collapse
|
17
|
Popova S, Dozet D, Pandya E, Sanches M, Brower K, Segura L, Ondersma SJ. Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis. BMC Pregnancy Childbirth 2023; 23:61. [PMID: 36694121 PMCID: PMC9872314 DOI: 10.1186/s12884-023-05344-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 01/02/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) can result in a range of adverse neonatal outcomes, including Fetal Alcohol Spectrum Disorder (FASD). This systematic review and meta-analysis sought to investigate the effectiveness of brief interventions (BIs) in eliminating or reducing 1) alcohol consumption during pregnancy; and 2) PAE-related adverse neonatal outcomes; and 3) cost-effectiveness of BIs. METHOD We conducted a systematic literature search for original controlled studies (randomized control trials (RCTs); quasi-experimental) in any setting, published from 1987 to 2021. The comparison group was no/minimal intervention, where a measure of alcohol consumption was reported. Studies were critically appraised using the Centre for Evidence-based Medicine Oxford critical appraisal tool for RCTs (1). The certainty in the evidence for each outcome was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) (2). Meta-analysis of continuous and binary estimates of effect-size for similar outcome measures for BIs versus control groups were pooled and reported as mean difference (MD) Hedges' g and odds ratios (ORs), respectively. RESULTS In total, 26 studies, all from high income countries, met inclusion criteria. Alcohol abstinence outcome available in 12 studies (n = 2620) found modest effects in favor of BIs conditions by increasing the odds of abstinence by 56% (OR = 1.56, 95% confidence interval (CI) = 1.15-2.13, I2 = 46.75%; p = 0.04). BIs effects for reduction in mean drinks/week (Cohen's d = - 0.21, 95%CI = - 0.78 to 0.36; p = 0.08) and AUDIT scores (g = 0.10, 95%CI = - 0.06 to 0.26; p = 0.17) were not statistically significant. Among seven studies (n = 740) reporting neonatal outcomes, BI receipt was associated with a modest and significant reduction in preterm birth (OR = 0.67, 95% CI = 0.46-0.98, I2 = 0.00%; p = 0.58). No statistically significant differences were observed for mean birthweight or lower likelihood of low birth weight (LBW). Certainty in the evidence was rated as 'low'. No eligible studies were found on cost-effectiveness of BIs. CONCLUSION BIs are moderately effective in increasing abstinence during pregnancy and preventing preterm birth. More studies on the effectiveness of BIs are needed from low- and middle-income countries, as well as with younger mothers and with a broader range of ethnic groups.
Collapse
Affiliation(s)
- Svetlana Popova
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7 Canada ,grid.17063.330000 0001 2157 2938Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON M5S 1V4 Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON M5S 1A8 Canada
| | - Danijela Dozet
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada ,grid.17063.330000 0001 2157 2938Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, Toronto, ON M5S 1A8 Canada
| | - Ekta Pandya
- grid.155956.b0000 0000 8793 5925Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Marcos Sanches
- grid.155956.b0000 0000 8793 5925Biostatistics Core, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, Toronto, ON M5S 2S1 Canada
| | - Krista Brower
- Edmonton Oliver Primary Care Network, 130, 11910-111 Avenue NW, Edmonton, Alberta Canada ,grid.9835.70000 0000 8190 6402Department of Educational Research, Lancaster University, Lancaster, LA1 4YW UK
| | - Lidia Segura
- grid.500777.2Program on Substance Abuse, Public Health Agency of Catalonia, C.Roc Boronat 81 – 95, 08005 Barcelona, Catalonia Spain
| | - Steven J. Ondersma
- grid.17088.360000 0001 2150 1785Department of Obstetrics, Gynecology, & Reproductive Biology, Michigan State University, 965 Wilson Rd, East Lansing, MI 48824 USA
| |
Collapse
|
18
|
Broccia M, Hansen BM, Winckler JM, Larsen T, Strandberg-Larsen K, Torp-Pedersen C, Kesmodel US. Heavy prenatal alcohol exposure and obstetric and birth outcomes: a Danish nationwide cohort study from 1996 to 2018. Lancet Public Health 2023; 8:e28-e35. [PMID: 36603908 DOI: 10.1016/s2468-2667(22)00263-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/29/2022] [Accepted: 10/18/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Heavy alcohol use during pregnancy can harm the fetus, but the relation to most obstetric outcomes remains unclear. We therefore aimed to describe maternal characteristics and estimate the association between heavy prenatal alcohol exposure and 22 adverse obstetric and birth outcomes. METHODS We carried out a Danish nationwide register-based historical cohort study, including all singleton births from Jan 1, 1996, to Dec 31, 2018. Births of women who had emigrated to Denmark were excluded from the study due to missing data and women who migrated within 1 year before or during pregnancy were also excluded due to loss to follow-up. Data were extracted from the Danish Medical Birth Register, the Danish National Patient Registry, the Danish National Prescription Registry, the Danish Civil Registration System, and the Population Education Register. Logistic regression models were used to estimate crude and adjusted odds ratios (ORs) of obstetric and birth outcomes. Heavy alcohol use was defined by hospital contacts for alcohol-attributable diagnoses given to the mother, her infant, or both, or maternal redeemed prescriptions for drugs to treat alcohol dependence within 1 year before or during pregnancy. FINDINGS Of 1 191 295 included births, 4823 (0·40%) were defined as heavily alcohol-exposed and 1 186 472 were categorised as a reference group with no identified heavy prenatal alcohol exposure. Heavy-alcohol-exposed births more often had mothers with psychiatric diagnoses (49·8% vs 9·6%), substance use (22·0% vs 0·4%), tobacco use (64·3% vs 15·8%), and low educational level (64·1% vs 17·6%) than did the reference group. For heavy-alcohol-exposed births, significantly increased adjusted ORs were found for small for gestational age (OR 2·20 [95% CI 1·97-2·45]), preterm birth (OR 1·32 [1·19-1·46]), haemorrhage in late pregnancy (OR 1·25 [1·05-1·49]), and preterm prelabour rupture of membranes (OR 1·18 [1·00-1·39]). Decreased adjusted ORs were found for postpartum haemorrhage (500-999 mL; OR 0·80 [95% CI 0·69-0·93]), gestational diabetes (OR 0·81 [0·67-0·99]), planned caesarean section (OR 0·82 [0·72-0·94]), pre-eclampsia and eclampsia (OR 0·83 [0·71-0·96]), and abnormalities of forces of labour (OR 0·92 [0·86-0·99]). INTERPRETATION Heavy prenatal alcohol exposure is associated with adverse obstetric and birth outcomes and high proportions of maternal low educational level, psychiatric disease, and lifestyle risk behaviours. These findings highlight a need for holistic public health programmes and policy attention on improving pre-conceptional care and antenatal care. FUNDING The Obel Family Foundation, The Health Foundation, TrygFonden, Aase and Ejnar Danielsens Foundation, The North Denmark Region Health Science and Research Foundation, Holms Memorial Foundation, Dagmar Marshalls Foundation, the A.P. Møller Foundation, King Christian X Foundation, Torben and Alice Frimodts Foundation, the Axel and Eva Kastrup-Nielsens Foundation, the A.V. Lykfeldts Foundation.
Collapse
Affiliation(s)
- Marcella Broccia
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark; Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Denmark.
| | - Bo Mølholm Hansen
- Department of Paediatrics and Adolescent Medicine, Nordsjællands Hospital, Hillerød, Denmark
| | - Julie Marie Winckler
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark; Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | | | | | - Christian Torp-Pedersen
- Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Schiøler Kesmodel
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
19
|
Miller AP, Shoptaw S, Mvududu R, Mashele N, Coates TJ, Bekker LG, Essack Z, Groenewald C, Petersen Z, Gorbach PM, Myer L, Joseph Davey DL. Sexual Risk among Pregnant Women at Risk of HIV Infection in Cape Town, South Africa: What Does Alcohol Have to Do with It? AIDS Behav 2023; 27:37-50. [PMID: 35737280 PMCID: PMC9780404 DOI: 10.1007/s10461-022-03742-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2022] [Indexed: 01/24/2023]
Abstract
This study examines baseline associations between alcohol use and HIV sexual risk among a cohort of HIV-uninfected pregnant women (n = 1201) residing in a high HIV burdened community in Cape Town, South Africa. Alcohol use was measured using a modified version of the Alcohol Use Disorder Identification Test (AUDIT). HIV sexual risk was measured through a composite variable of four risk factors: diagnosis with a STI, self-report of > 1 recent sex partners, partner HIV serostatus (unknown or HIV+) and condomless sex at last sex. Any past year alcohol use prior to pregnancy was reported by half of participants (50%); 6.0% reported alcohol use during pregnancy. Alcohol use prior to pregnancy was associated with increased odds of being at high risk of HIV (aOR = 1.33, 95% CI 1.05-1.68, for 2 risks and aOR = 1.47, 95% CI 0.95-2.27 for 3 risks). In addition to reducing alcohol use, several other strategies to address HIV sexual risk were identified. Evidence-based interventions to address alcohol use and other HIV sexual risk behaviors during pregnancy in South Africa are desperately needed. Qualitative work exploring individual and community level drivers of alcohol use among pregnant and breastfeeding women in this setting could support development of a culturally tailored intervention to address these issues in this population.
Collapse
Affiliation(s)
- Amanda P Miller
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA.
- Department of Epidemiology, Fielding School of Public Health, 650 Charles E. Young Drive South, Room #41-295CHS, Los Angeles, CA, 90095-1772, USA.
| | - Steven Shoptaw
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Rufaro Mvududu
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Nyiko Mashele
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Thomas J Coates
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Linda-Gail Bekker
- The Desmond Tutu HIV Centre, Faculty of Health Science, Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Zaynab Essack
- Centre for Community-Based Research, Human Sciences Research Council, Pretoria, South Africa
| | - Candice Groenewald
- Centre for Community-Based Research, Human Sciences Research Council, Pretoria, South Africa
- Psychology Department, Rhodes University, Makhanda, South Africa
| | - Zaino Petersen
- Impact and Research Development, Human Sciences Research Council, Pretoria, South Africa
| | - Pamina M Gorbach
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - Landon Myer
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
| | - Dvora L Joseph Davey
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, USA
- Division of Epidemiology and Biostatistics, School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town, South Africa
- Division of Infectious Diseases, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- The Desmond Tutu HIV Centre, Faculty of Health Science, Institute for Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
20
|
Broccia M, Munch A, Hansen BM, Sørensen KK, Larsen T, Strandberg-Larsen K, Gerds TA, Torp-Pedersen C, Kesmodel US. Heavy prenatal alcohol exposure and overall morbidities: a Danish nationwide cohort study from 1996 to 2018. Lancet Public Health 2023; 8:e36-e46. [PMID: 36603909 DOI: 10.1016/s2468-2667(22)00289-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Heavy prenatal alcohol exposure is harmful and can lead to fetal alcohol spectrum disorders. A systematic review and meta-analysis identified 428 comorbidities in individuals with fetal alcohol spectrum disorders, and reported pooled prevalence estimates. We aimed to investigate overall risk of morbidities in heavy prenatal alcohol-exposed children by estimating risk of the identified comorbidities, and previously unidentified diseases and health-related problems. METHODS Our Danish nationwide register-based cohort study included all singleton births. Individuals were followed up to age 18 years, between 1996 and 2018. Stillbirths and children of immigrants were not included in the study, and births of women who migrated within 1 year before or during pregnancy were also excluded due to loss to follow-up. Data on health and education were extracted from the Danish Medical Birth Register, the Danish National Patient Registry, the Danish National Prescription Registry, the Danish Civil Registration System, and the Population Education Register. We estimated crude and standardised risk differences of hospital diagnoses. Heavy prenatal alcohol exposure was defined by hospital contacts with alcohol-attributable diagnoses given to the mother or her child, or by maternal redeemed prescriptions for drugs to treat alcohol dependence 1 year before or during pregnancy. FINDINGS Of 1 407 689 identified singleton births, 219 186 were excluded for reasons including they were born to immigrants, lost to follow-up, or were stillbirths. Of the remaining 1 188 503 children, 4799 (0·4%) had heavy prenatal alcohol exposure and 1 183 704 (99·6%) were classified as non-alcohol-exposed births. 578 179 (48·6%) babies were female and 610 324 (51·4%) were male. We found 234 of 428 previously identified comorbidities in individuals with fetal alcohol spectrum disorder, of which 29 conditions had a standardised risk difference of at least 0·5%, predominantly related to brain function, behavioural disorders, infections, and neonatal conditions. The four highest standardised risk differences were found for low birthweight (4·70% [95% CI 3·70-5·71]), small for gestational age (4·63% [3·72-5·55]), delayed milestone (3·81% [2·99-4·64]), and other preterm infants (2·69% [1·71-3·68]). Of previously unidentified diseases and health-related problems, 32 of 719 had a standardised risk difference of at least 1·0%, mainly related to brain function, some injuries, substance-related conditions, and childhood adversities. INTERPRETATION Heavy prenatal alcohol exposure is associated with an overall increased risk of child morbidities and previously unrecognised alcohol-related health problems. Prenatal alcohol exposure is a key public health issue with a potential negative impact on child and adolescent health. This study urges for renewed efforts and substantiates the profound degree to which pre-conceptional care is mandatory. FUNDING The Obel Family Foundation, The Health Foundation, TrygFonden, Aase and Ejnar Danielsens Foundation, The North Denmark Region Health Science and Research Foundation, Holms Memorial Foundation, Dagmar Marshalls Foundation, the A.P. Møller Foundation, King Christian X Foundation, Torben and Alice Frimodts Foundation, the Axel and Eva Kastrup-Nielsens Foundation, and the A.V. Lykfeldts Foundation.
Collapse
Affiliation(s)
- Marcella Broccia
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark; Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark; Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Anders Munch
- Section of Biostatistics, University of Copenhagen, Copenhagen, Denmark
| | - Bo Mølholm Hansen
- Department of Paediatrics and Adolescent Medicine, Nordsjaellands Hospital, Hillerød, Denmark
| | | | | | | | | | - Christian Torp-Pedersen
- Department of Cardiology, Nordsjaellands Hospital, Hillerød, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Schiøler Kesmodel
- Department of Obstetrics and Gynaecology, Aalborg University Hospital, Aalborg, Denmark; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
21
|
Fletcher T, Mullan B, Finlay-Jones A. Perceptions of two different alcohol use behaviours in pregnancy: an application of the prototype/willingness model. Health Psychol Behav Med 2022; 10:1071-1085. [PMID: 36388869 PMCID: PMC9645282 DOI: 10.1080/21642850.2022.2143362] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Objective: This study explored whether exposure to either an ‘ambiguous consumption’ prototype (no amount of alcohol specified) or a ‘small consumption’ prototype (‘small’ amount of alcohol specified) had an impact on prototype perceptions of, and willingness to use, small amounts of alcohol during pregnancy. Method: Participants were 140 women living in the UK, aged 20–45 years old, of whom 92% had previously been, or intended to become, pregnant. Participants completed measures to assess how favourably they viewed alcohol use in pregnancy, how similar they felt to those who would use alcohol in pregnancy and how responsible they perceived those who would use alcohol in pregnancy to be. Participant’s own willingness to use small amounts of alcohol during pregnancy was also assessed. Results: Having at least one child was positively correlated with being willing to accept an alcoholic drink while pregnant for those exposed to the ‘ambiguous consumption’ prototype only. Although perceptions of favourability, similarity and responsibility were consistently higher for those exposed to a ‘small consumption’ condition, there were no differences in willingness to drink according to exposure. Conclusion: This research suggests that women’s perceptions of those who drink alcohol while pregnant differ according to the amount of alcohol that they perceive as typical. This may have implications for how alcohol use in pregnancy is portrayed in public health messaging, particularly regarding the level of acceptance that may be associated with low to moderate alcohol use.
Collapse
Affiliation(s)
- Tess Fletcher
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Nedlands, Australia
- Enable Institute, Curtin University, Perth, Australia
- School of Population Health, Curtin University, Perth, Australia
| | | | - Amy Finlay-Jones
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Nedlands, Australia
| |
Collapse
|
22
|
Ujhelyi Gomez K, Goodwin L, Chisholm A, Rose AK. Alcohol use during pregnancy and motherhood: Attitudes and experiences of pregnant women, mothers, and healthcare professionals. PLoS One 2022; 17:e0275609. [PMID: 36454984 PMCID: PMC9714863 DOI: 10.1371/journal.pone.0275609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 09/13/2022] [Indexed: 12/03/2022] Open
Abstract
Alcohol is the most used substance by women of childbearing age. Alcohol exposed pregnancies can have serious consequences to the fetus, and the UK has one of the highest rates of drinking during pregnancy. Alcohol use during motherhood is also a public health concern, linked with potential harms to the woman and child. This qualitative study investigated the attitudes and experiences of pregnant/parenting women and healthcare professionals regarding maternal drinking. A semi-structured focus group and interviews were conducted in the North West of England with pregnant women, mothers, and healthcare professionals. Quantitative measures captured demographics, alcohol use, and screened for mental ill-health for pregnant women and mothers. Reflexive thematic analysis was used to analyse narratives. Findings revealed that most participants believed avoiding alcohol during pregnancy is the safest option. However, some pregnant women and mothers stated that there was insufficient evidence to demonstrate the harms of low-level drinking and that abstinence guidelines were patronising. All participants reported that low-level drinking during motherhood was acceptable. Heavy drinking was believed to pose serious harm during pregnancy and motherhood to the baby and mother, in addition to damaging relationships. Strong motives were revealed for choosing and avoiding to drink, such as coping with the difficulties of motherhood and parental responsibilities, respectively. Contradictions were found across quantitative and qualitative self-reports of consumption, reflecting potential underreporting of alcohol use. Additionally, drinking levels were discussed in extremes only (low/heavy) without considering 'grey area' drinking. Clear, consistent advice and guidelines are needed to support women in reducing their alcohol use during pregnancy and motherhood. These should include the unique potential risks regarding maternal drinking, and the harm attributable to non-clinically dependent alcohol use. The maternal participants in this study were middle-class, therefore, research is needed to capture the views and experiences of women of all socioeconomic backgrounds.
Collapse
Affiliation(s)
- Katalin Ujhelyi Gomez
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, United Kingdom
| | - Laura Goodwin
- Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - Anna Chisholm
- Department of Psychological Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Abigail K. Rose
- School of Psychology, Liverpool John Moor University, Liverpool, United Kingdom
- * E-mail:
| |
Collapse
|
23
|
Lee SY, Lee HK, Yoon CG, Jeon H, Saunders JB. Does Drinking Culture Induce Problematic Alcohol Use? Evidence From a Military Representative Survey in Korea. Psychiatry Investig 2022; 19:937-948. [PMID: 36444157 PMCID: PMC9708860 DOI: 10.30773/pi.2021.0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To examine the relationship between problematic alcohol use and contributing factors among Korean professional soldiers. METHODS Cross-sectional data of 2,646 participants collected by 2014 military-wide representative health survey was analyzed. Multivariate logistic models were used to identify contributing factors for problematic alcohol use. Problematic alcohol use was defined by the Alcohol Use Disorders Identification Test (AUDIT) questionnaire as hazardous (8≤ AUDIT <16) or harmful (AUDIT ≥16). Tolerant drinking culture was measured by the Drinking Culture Questionnaire. RESULTS Hazardous alcohol use was found in 56.9% of men and 46.8% of women and harmful use in a further 16.2% of men and 5.4% of women. In univariate analyses, perceived health status, subjective sleep quality, depression, and drinking culture were related to the outcome variable. In multivariate models controlling covariates, the likelihood of problematic alcohol use was significantly increased by man gender, being single, current/past smoking, and tolerant/permissive drinking culture. In those with harmful alcohol consumption, tolerant drinking culture was a particularly powerful influence. CONCLUSION A substantial proportion of Korean professional soldiers demonstrated problematic alcohol use. Tolerant drinking culture was shown to have a significant influence on problematic alcohol use in the military. Our findings underscore the need for public health policies that address this drinking culture to mitigate negative health consequences and preserve the forces' combat readiness.
Collapse
Affiliation(s)
- Seung-Yup Lee
- Department of Medical and Health Operation, Armed Forces Medical Command, Seongnam, Republic of Korea.,Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hae Kook Lee
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chang-Gyo Yoon
- Department of Medical and Health Operation, Armed Forces Medical Command, Seongnam, Republic of Korea.,Preventive Medicine Program, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hankaram Jeon
- Department of Psychiatry, Armed Forces Capital Hospital, Seongnam, Republic of Korea
| | - John B Saunders
- Centre for Youth Substance Abuse Research, University of Queensland, Brisbane, Australia
| |
Collapse
|
24
|
Aubert AM, Chen LW, Shivappa N, Cooper C, Crozier SR, Duijts L, Forhan A, Hanke W, Harvey NC, Jankowska A, Kelleher CC, de Lauzon-Guillain B, McAuliffe FM, Mensink-Bout SM, Polanska K, Relton CL, Suderman M, Hebert JR, Phillips CM, Bernard JY, Heude B. Predictors of maternal dietary quality and dietary inflammation during pregnancy: An individual participant data meta-analysis of seven European cohorts from the ALPHABET consortium. Clin Nutr 2022; 41:1991-2002. [PMID: 35964423 DOI: 10.1016/j.clnu.2022.06.042] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 06/10/2022] [Accepted: 06/30/2022] [Indexed: 11/23/2022]
Abstract
BACKGROUND & AIMS Maternal diet during pregnancy is a modifiable behaviour which plays an important role in maternal, neonatal and child health outcomes. Thus, knowledge of predictors of dietary quality and dietary inflammatory potential in European countries may contribute to developing maternal diet-related public health policies that target specific at-risk populations in Europe. METHODS We used harmonised data from >26,000 pregnant women enrolled in the ALSPAC, EDEN, Generation R, Lifeways, REPRO_PL, ROLO and SWS cohorts, as part of the ALPHABET consortium. Maternal dietary quality and inflammatory potential were assessed using the Dietary Approaches to Stop Hypertension (DASH) and the energy-adjusted Dietary Inflammatory Index (E-DII). We conducted an individual participant data meta-analysis to investigate the maternal sociodemographic, health and behavioural predictors of maternal diet before and during pregnancy. RESULTS DASH and E-DII scores were moderately correlated: from -0.63 (95% CI: -0.66, -0.59) to -0.48 (95% CI: -0.49, -0.47) across cohorts. Higher maternal age, education, household income, and physical activity during pregnancy were associated with a better dietary quality and a more anti-inflammatory diet. Conversely, multiparity and smoking during pregnancy were associated with a poorer dietary quality and a more proinflammatory diet. Women with obesity had a poorer pregnancy dietary quality than women with a normal body mass index range. CONCLUSIONS The results will help identify population subgroups who may benefit from targeted public health strategies and interventions aimed at improving women's dietary quality during pregnancy.
Collapse
Affiliation(s)
- Adrien M Aubert
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Ling-Wei Chen
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), 117609, Singapore.
| | - Nitin Shivappa
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK; NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford OX1 2JD, UK.
| | - Sarah R Crozier
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Applied Research Collaboration Wessex, Southampton Science Park, Innovation Centre, Southampton SO16 7NP, UK.
| | - Liesbeth Duijts
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands; Department of Pediatrics, Division of Neonatology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands.
| | - Anne Forhan
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital Southampton, Southampton SO16 6YD, UK; NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, UK.
| | - Agnieszka Jankowska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Cecily C Kelleher
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Blandine de Lauzon-Guillain
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin 2, Ireland.
| | - Sara M Mensink-Bout
- The Generation R Study Group, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands; Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center Rotterdam, 3000 CB Rotterdam, the Netherlands.
| | - Kinga Polanska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Caroline L Relton
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - Matthew Suderman
- MRC Integrative Epidemiology Unit, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol BS8 2BN, UK.
| | - James R Hebert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.
| | - Catherine M Phillips
- School of Public Health, Physiotherapy, and Sports Science, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Jonathan Y Bernard
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France; Singapore Institute for Clinical Sciences (SICS), Agency for Science, Technology and Research (A∗STAR), 117609, Singapore.
| | - Barbara Heude
- Université Paris Cité, Inserm, INRAE, Centre for Research in Epidemiology and StatisticS (CRESS), F-75004 Paris, France.
| |
Collapse
|
25
|
Alcohol use during pregnancy: findings from a gender-based violence survey in Mongolia. Arch Womens Ment Health 2022; 25:789-795. [PMID: 35687163 DOI: 10.1007/s00737-022-01242-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 05/31/2022] [Indexed: 11/02/2022]
Abstract
This study aimed to explore the risk factors for alcohol use during pregnancy in Mongolia, wherein high-risk alcohol use is prevalent. We analyzed nationwide data from the Gender-Based Violence (GBV) Survey of Mongolia conducted in 2017. We conducted an analysis restricted to 2714 women who had given birth within 5 years of the survey and who had responded to questions about their health-related behaviors during pregnancy. We assessed the association between alcohol use during pregnancy and pregnancy-related factors, including maternal age, educational attainment, history of abortion, smoking during pregnancy, unintended pregnancy, prior experience of sexual and physical violence, physical violence during pregnancy, and current binge drinking while also considering their residential region. Alcohol use during pregnancy was reported in 5.4% of the participating women. Unintended pregnancy for women (OR = 1.95, 95% confidence interval [CI]: 1.60, 2.38), abortion history (1.89, 95% CI: 1.60, 2.24), smoking during pregnancy (8.30, 95% CI: 6.60, 10.43), physical violence during pregnancy (2.22, 95% CI: 1.75, 2.81), and being a binge drinker (6.05, 95% CI: 3.63, 10.10) were associated with higher odds of alcohol use during pregnancy. Associations with maternal age, marital status, higher education, or multiparity were not evident. Our finding provides knowledge of risk factors for alcohol drinking among pregnant women and evidence for another harm of gender-based violence. This would contribute to the development of effective strategies for preventing antenatal exposure to alcohol in Mongolia.
Collapse
|
26
|
Polanek E, Karai A, Molnár R, Németh G, Orvos H, Balogh P, Paulik E. Association between sociodemographic, obstetric, and lifestyle factors among Hungarian pregnant women—A cross‐sectional study. J Obstet Gynaecol Res 2022; 48:2541-2551. [DOI: 10.1111/jog.15364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 03/29/2022] [Accepted: 06/29/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Evelin Polanek
- Department of Public Health University of Szeged Szeged Hungary
| | - Adrienn Karai
- Department of Pediatrics University of Szeged Szeged Hungary
| | - Regina Molnár
- Department of Public Health University of Szeged Szeged Hungary
| | - Gábor Németh
- Department of Obstetrics and Gynecology University of Szeged Szeged Hungary
| | - Hajnalka Orvos
- Department of Obstetrics and Gynecology University of Szeged Szeged Hungary
| | - Péter Balogh
- Department of Sociology University of Szeged Szeged Hungary
| | - Edit Paulik
- Department of Public Health University of Szeged Szeged Hungary
| |
Collapse
|
27
|
Tsang TW, Kingsland M, Doherty E, Anderson AE, Tully B, Ward S, Wiggers J, Elliott EJ. Written information and health professionals are the information sources about alcohol use in pregnancy most often used by pregnant women. Drug Alcohol Rev 2022; 41:1599-1609. [PMID: 35836339 DOI: 10.1111/dar.13512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 06/22/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Alcohol use in pregnancy remains common in Australia, despite national guidelines recommending that pregnant women abstain. The aims of this study were to investigate where pregnant women obtain information about alcohol use in pregnancy and the relationship between the information source used and women's demographic characteristics and alcohol use. METHODS In this cross-sectional survey of pregnant women attending public maternity services in the Hunter New England region (New South Wales), women were asked, 'Where did you get information to help you make decisions about alcohol use during pregnancy?'. The number and types of information sources were analysed using descriptive statistics. Associations between women's information sources, and their demographic characteristics and alcohol use in pregnancy were assessed using chi-square tests and logistic regression. RESULTS Of 4511 pregnant women surveyed, 80.1% used at least one type of information source (range 0-5). Written/electronic information (45.4%), health providers (37.6%) and family/friends (19.5%) were the sources most reported. Higher use of written/electronic information, antenatal health providers and family/friends was associated with first pregnancy, younger age and higher education. The type of information source used was associated with alcohol use in pregnancy. Women who reported alcohol use were more likely to receive information from written/electronic sources. Almost 20% of women (older, multiparous [>1 pregnancy] and more highly educated) obtained no information regarding alcohol use in pregnancy. DISCUSSION AND CONCLUSIONS Antenatal providers should routinely provide information on alcohol use in pregnancy, including for women least likely to access available information.
Collapse
Affiliation(s)
- Tracey W Tsang
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Sydney, Australia.,Sydney Children's Hospitals Network, Kids Research, Sydney, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Amy E Anderson
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Sarah Ward
- Foundation for Alcohol Research and Education, Canberra, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Elizabeth J Elliott
- Faculty of Medicine and Health, Specialty of Child and Adolescent Health, The University of Sydney, Sydney, Australia.,Sydney Children's Hospitals Network, Kids Research, Sydney, Australia
| |
Collapse
|
28
|
Maralit AM. Beyond the bump: ethical and legal considerations for psychologists providing services to pregnant individuals who use substances. ETHICS & BEHAVIOR 2022. [DOI: 10.1080/10508422.2022.2093202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Anna M. Maralit
- Department of Psychological Sciences, University of Missouri, Columbia, MO
| |
Collapse
|
29
|
Grafe EL, Wade MMM, Hodson CE, Thomas JD, Christie BR. Postnatal Choline Supplementation Rescues Deficits in Synaptic Plasticity Following Prenatal Ethanol Exposure. Nutrients 2022; 14:2004. [PMID: 35631142 PMCID: PMC9146219 DOI: 10.3390/nu14102004] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 02/06/2023] Open
Abstract
Prenatal ethanol exposure (PNEE) is a leading cause of neurodevelopmental impairments, yet treatments for individuals with PNEE are limited. Importantly, postnatal supplementation with the essential nutrient choline can attenuate some adverse effects of PNEE on cognitive development; however, the mechanisms of action for choline supplementation remain unclear. This study used an animal model to determine if choline supplementation could restore hippocampal synaptic plasticity that is normally impaired by prenatal alcohol. Throughout gestation, pregnant Sprague Dawley rats were fed an ethanol liquid diet (35.5% ethanol-derived calories). Offspring were injected with choline chloride (100 mg/kg/day) from postnatal days (PD) 10-30, and then used for in vitro electrophysiology experiments as juveniles (PD 31-35). High-frequency conditioning stimuli were used to induce long-term potentiation (LTP) in the medial perforant path input to the dentate gyrus of the hippocampus. PNEE altered synaptic transmission in female offspring by increasing excitability, an effect that was mitigated with choline supplementation. In contrast, PNEE juvenile males had decreased LTP compared to controls, and this was rescued by choline supplementation. These data demonstrate sex-specific changes in plasticity following PNEE, and provide evidence that choline-related improvements in cognitive functioning may be due to its positive impact on hippocampal synaptic physiology.
Collapse
Affiliation(s)
- Erin L. Grafe
- Division of Medical Sciences, University of Victoria, Victoria, BC V8W 2Y2, Canada; (E.L.G.); (M.M.M.W.); (C.E.H.); (B.R.C.)
| | - Mira M. M. Wade
- Division of Medical Sciences, University of Victoria, Victoria, BC V8W 2Y2, Canada; (E.L.G.); (M.M.M.W.); (C.E.H.); (B.R.C.)
| | - Claire E. Hodson
- Division of Medical Sciences, University of Victoria, Victoria, BC V8W 2Y2, Canada; (E.L.G.); (M.M.M.W.); (C.E.H.); (B.R.C.)
| | - Jennifer D. Thomas
- Department of Psychology, San Diego State University, San Diego, CA 92120, USA
| | - Brian R. Christie
- Division of Medical Sciences, University of Victoria, Victoria, BC V8W 2Y2, Canada; (E.L.G.); (M.M.M.W.); (C.E.H.); (B.R.C.)
| |
Collapse
|
30
|
Women's views and experiences of occasional alcohol consumption during pregnancy: A systematic review of qualitative studies and their recommendations. Midwifery 2022; 111:103357. [DOI: 10.1016/j.midw.2022.103357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 11/23/2021] [Accepted: 04/29/2022] [Indexed: 11/19/2022]
|
31
|
Voutilainen T, Rysä J, Keski-Nisula L, Kärkkäinen O. Self-reported alcohol consumption of pregnant women and their partners correlates both before and during pregnancy: A cohort study with 21,472 singleton pregnancies. Alcohol Clin Exp Res 2022; 46:797-808. [PMID: 35569108 PMCID: PMC9321706 DOI: 10.1111/acer.14806] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/30/2022]
Abstract
Background The partners’ role in determining the alcohol consumption behavior of pregnant women is not well studied. We measured alcohol use before and during pregnancy in pregnant women and their partners to evaluate the correlation in their levels of consumption. Methods We evaluated the self‐reported alcohol use of 14,822 women and their partners during 21,472 singleton pregnancies delivered in Kuopio University Hospital, Finland during the period 2009‒2018. The information was gathered during pregnancy and at the time of childbirth and recorded in two databases that were merged to yield a single cohort. Missing data were accounted for by multiple imputation using the predictive mean matching method. Results In 86% of the pregnancies, women reported alcohol use before pregnancy, whereas in 4.5% of the pregnancies women reported alcohol use during pregnancy. In contrast, no decrease was detected in their partners’ alcohol use before or during pregnancy. In 26% of the pregnancies, the woman reported stopping alcohol use only after recognizing that she was pregnant. Before pregnancy, there were strong correlations between the pregnant women and their partners in the total Alcohol Use Disorders Identification Test score (rs = 0.69, p < 0.0001) and the self‐reported average weekly amount of alcohol consumed (rs = 0.56, p < 0.0001). During pregnancy, there were weak correlations between the pregnant women and their partners in the frequency of drinking (rs = 0.20, p < 0.0001) and the average weekly amount of alcohol consumed (rs = 0.18, p < 0.0001). Conclusions The self‐reported alcohol consumption of pregnant women and their partners was positively correlated both before and during pregnancy, though the correlation declined substantially during pregnancy. Evaluating the alcohol consumption of both parents before pregnancy could assist in identifying women at risk of prenatal alcohol exposure. Supporting a reduction in partners' alcohol use could help to reduce pregnant women's alcohol consumption and prevent its associated harms.
Collapse
Affiliation(s)
- Taija Voutilainen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Jaana Rysä
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Leea Keski-Nisula
- Department of Obstetrics and Gynecology, Kuopio University Hospital, Kuopio, Finland.,Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Olli Kärkkäinen
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| |
Collapse
|
32
|
Kim HW, Kang SY, Kim J. Factors influencing adolescents' healthy pregnancy preparation behavior: a cross-sectional gender comparison applying the health belief model. Reprod Health 2022; 19:90. [PMID: 35382837 PMCID: PMC8985308 DOI: 10.1186/s12978-022-01392-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Interventions to prepare for a healthy pregnancy from an early age can ensure the health of both mother and child. This study aims to compare the factors associated with healthy pregnancy preparation behavior (HPPB) among male and female adolescents. METHODS A total of 690 Korean adolescents participated in this cross-sectional study from July 11 to August 24, 2018. Determinants of the likelihood of engaging in HPPB were described using hierarchical regression about the importance of and confidence in HPPB, the gender equality related to pregnancy and birth, and the health belief model (HBM) constructs about HPPB. RESULTS Smoking experience (β = - 0.18, p < 0.001 for boys, β = - 0.25, p < 0.001 for girls), and HBM constructs were identified as factors correlated with HPPB in both genders. The significant factors in boys were perceived susceptibility (β = - 0.13, p = 0.005), perceived severity (β = 0.12, p = 0.015), perceived benefits (β = 0.23, p < 0.001), and perceived barriers (β = - 0.18, p < 0.001), whereas the corresponding factors in girls were perceived severity (β = 0.20, p = 0.001), and perceived barriers (β = - 0.23, p < 0.001). The importance of HPPB was identified as a factor only among girls (β = 0.19, p = 0.005), while confidence in HPPB (β = 0.12, p = 0.401), gender equality related to pregnancy and childbirth (β = - 0.20, p = 0.001 for women's responsibility variable, β = 0.14, p = 0.018 for men's responsibility variable), and alcohol (β = - 0.10, p = 0.022) were factors identified only among boys. CONCLUSIONS The gender differences in opinions on HPPB identified in this study can help nurses and community health care professionals recognize issues for which they can develop and implement preventive interventions. For healthy pregnancy preparation, interventions based on HBM constructs and smoking should be presented for both male and female adolescents. Imparting education to females on the importance of HPPB and to males on confidence in HPPB, gender equality related to pregnancy and childbirth, and alcohol consumption, should be emphasized. In addition, as perceived susceptibility may be low in a disease prevention model using the health belief model, it is necessary to prioritize increasing the perceived susceptibility of school-age children as an intervention.
Collapse
Affiliation(s)
- Hae Won Kim
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) Four Project, College of Nursing, Research Institute of Nursing Science, Seoul National University, Seoul, 03080, Republic of Korea
| | - Saem Yi Kang
- College of Nursing, Gyeongsang National University, Jinju, 52727, Republic of Korea
| | - Jieun Kim
- Red Cross College of Nursing, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
| |
Collapse
|
33
|
Popova S, Dozet D, Akhand Laboni S, Brower K, Temple V. Why do women consume alcohol during pregnancy or while breastfeeding? Drug Alcohol Rev 2021; 41:759-777. [PMID: 34963039 PMCID: PMC9305227 DOI: 10.1111/dar.13425] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 02/06/2023]
Abstract
Issue Alcohol consumption during pregnancy and breastfeeding cause adverse health outcomes to the mother and child, including Fetal Alcohol Spectrum Disorder (FASD). Approach Systematic literature review and thematic synthesis. Original studies that contained reasons for alcohol consumption in pregnancy and while breastfeeding were included. The Mixed Methods Appraisal Tool (MMAT) and the Confidence in the Evidence of Reviews of Qualitative Research (CerQUAL) approach were utilised. The review protocol is available on PROSPERO (registration number: CRD42018116998). Key Findings Forty‐two eligible studies comprising women from 16 countries were included. Most commonly reported reasons of alcohol use in pregnancy were societal pressure and the belief that only “strong” alcohol and alcohol in large quantities is harmful. Other reasons were: a lack of awareness of adverse effects on the fetus; coping with adverse life experiences; consumption based on intuitive decision‐making and influenced by personal/peer experiences; belief in the beneficial properties of alcohol; advice from medical practitioners; unwanted or unplanned pregnancy; alcohol dependence; and consumption as a cultural/traditional custom. Reasons for alcohol use during breastfeeding included the belief that alcohol stimulates breast milk production, unclear advice from medical practitioners, unawareness of the risks of infant exposure and to improve mood and celebrate events. Implications Understanding the context of reasons for alcohol use in pregnancy is crucial for implementing prenatal health education, and preventing FASD and other adverse maternal and child health outcomes. Conclusion Individual beliefs, knowledge/advice, culture and personal circumstances influence alcohol use in pregnancy. Data are limited for reasons surrounding alcohol use while breastfeeding.
Collapse
Affiliation(s)
- Svetlana Popova
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.,Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Danijela Dozet
- Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, Canada.,Institute of Medical Science, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Shahela Akhand Laboni
- Center for Clinical and Translational Science, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Krista Brower
- Edmonton Oliver Primary Care Network, Edmonton, Alberta, Canada.,Department of Educational Research, Lancaster University, Lancaster, UK
| | | |
Collapse
|
34
|
Fletcher TMD, Mullan B, Novoradovskaya E, Finlay-Jones A. Is 'a little' too much?: An exploration of women's beliefs about alcohol use during pregnancy. Psychol Health 2021:1-19. [PMID: 34658281 DOI: 10.1080/08870446.2021.1991342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Interventions to address alcohol use during pregnancy need to target underlying determinants of the behaviour. Using the theory of planned behaviour as a theoretical framework, the aim of this study was to identify behavioural, normative and control beliefs regarding alcohol use during pregnancy among a sample of women. Design: 435 women completed a 15-minute online questionnaire designed to identify beliefs about alcohol use during pregnancy. Data were categorised according to type of belief and then summarised and described. Results: The majority of respondents saw few advantages of consuming alcohol during pregnancy and believed that most people would disapprove of alcohol use during pregnancy. Although most women endorsed alcohol abstinence during pregnancy, views on the perceived risk of different levels of alcohol use and perceptions of the 'typical' person who drinks while pregnant varied between participants. Conclusion: This work contributes to the understanding of women's beliefs about alcohol use during pregnancy. Future research should explore how women's beliefs inform their decision making about different levels of alcohol use in pregnancy. Additionally, further research or messaging about alcohol use in pregnancy must also consider the potential for contributing to stigmatising beliefs.
Collapse
Affiliation(s)
- Tess M D Fletcher
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Perth, Australia.,Faculty of Health Sciences, Health Psychology & Behavioural Medicine Research Group, Curtin University, Perth, Australia
| | - Barbara Mullan
- Faculty of Health Sciences, Health Psychology & Behavioural Medicine Research Group, Curtin University, Perth, Australia
| | - Elizaveta Novoradovskaya
- Faculty of Health Sciences, Health Psychology & Behavioural Medicine Research Group, Curtin University, Perth, Australia
| | - Amy Finlay-Jones
- FASD Research Australia Centre for Research Excellence, Telethon Kids Institute, Perth, Australia
| |
Collapse
|
35
|
Marlow M, Christie H, Skeen S, Rabie S, Louw JG, Swartz L, Mofokeng S, Makhetha M, Tomlinson M. Alcohol use during pregnancy in rural Lesotho: "There is nothing else except alcohol". Soc Sci Med 2021; 291:114482. [PMID: 34700117 DOI: 10.1016/j.socscimed.2021.114482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 09/19/2021] [Accepted: 10/09/2021] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Reducing alcohol use during pregnancy is a pressing public health priority in Sub-Saharan Africa, but insight into the factors that influence prenatal drinking practices is lacking. This study investigated perceptions of, and motivations for, alcohol consumption during pregnancy and associated practices in a rural district of Lesotho. METHODS A combination of purposive and snowball sampling methods were used to identify pregnant women and mothers with young children from the general community, as well as from alcohol-serving venues. Between September 2016 and March 2017, a trained data collector conducted in-depth interviews with 40 women on reasons why pregnant women drink, what they know about the risk of drinking alcohol during pregnancy, and perceptions of women who drink during pregnancy. RESULTS Sixty-five percent of women (n = 26) reported that they consumed alcohol during pregnancy. Findings were clustered into four themes: 1) alcohol use in daily and cultural life; 2) alcohol as relief from stress and hunger; 3) alcohol's effect on the baby; and 4) access to information about alcohol consumption. Our data suggest that alcohol use was a prominent feature of daily life and a key part of traditional events and ceremonies. Other than potentially harming the baby through falling on their stomachs while inebriated, women did not mention other risks associated with prenatal alcohol use. Rather, there were prominent beliefs that drinking alcohol - home-brewed alcohol in particular - had cleansing or protective benefits for the baby. Experiences of food insecurity were prominent, and women reported that alcohol helped curb their hunger and allowed them to save food to give to their children. CONCLUSIONS Within this context of chronic poverty and food insecurity, alcohol use during pregnancy will continue to represent a valid, though tragic choice if the structural conditions and current social arrangements that facilitate prenatal alcohol use remain unchanged.
Collapse
Affiliation(s)
- Marguerite Marlow
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Office 4009, 4th Floor, Education Building, Francie van Zijl Drive, Tygerberg, 7505, South Africa.
| | - Hope Christie
- Department of Clinical Psychology, University of Edinburgh, Medical School, Teviot Place, Edinburgh, EH8 9AG, United Kingdom.
| | - Sarah Skeen
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Office 4009, 4th Floor, Education Building, Francie van Zijl Drive, Tygerberg, 7505, South Africa.
| | - Stephan Rabie
- HIV Mental Health Research Unit, Neuroscience Institute, Department of Psychiatry and Mental Health, University of Cape Town, J-Block, Groote Schuur Hospital, Observatory, Cape Town, South Africa.
| | - Jacobus G Louw
- Foundation for Alcohol Related Research, 42 Bloemhof Rd, Bloemhof, Cape Town, 7530, South Africa; Department of Psychology, Stellenbosch University, Stellenbosch, RW Wilcocks Building, 2nd Floor, Ryneveld Street, Stellenbosch, 7600, South Africa.
| | - Leslie Swartz
- Department of Psychology, Stellenbosch University, Stellenbosch, RW Wilcocks Building, 2nd Floor, Ryneveld Street, Stellenbosch, 7600, South Africa.
| | - Shoeshoe Mofokeng
- Department of Social Work, Sociology and Anthropology, National University of Lesotho, P.O Roma 180, Maseru, Lesotho, Lesotho.
| | - Moroesi Makhetha
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Office 4009, 4th Floor, Education Building, Francie van Zijl Drive, Tygerberg, 7505, South Africa.
| | - Mark Tomlinson
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Office 4009, 4th Floor, Education Building, Francie van Zijl Drive, Tygerberg, 7505, South Africa; School of Nursing and Midwifery, Queens University, Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast, Northern Ireland, BT9 7BL, United Kingdom.
| |
Collapse
|
36
|
Screening for Alcohol Use in Pregnancy: a Review of Current Practices and Perspectives. Int J Ment Health Addict 2021; 21:1220-1239. [PMID: 34580577 PMCID: PMC8457028 DOI: 10.1007/s11469-021-00655-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 10/27/2022] Open
Abstract
Global trends of increasing alcohol consumption among women of childbearing age, social acceptability of women's alcohol use, as well as recent changes in alcohol use patterns due to the COVID-19 pandemic may put many pregnancies at higher risk for prenatal alcohol exposure (PAE), which can cause fetal alcohol spectrum disorder (FASD). Therefore, screening of pregnant women for alcohol use has become more important than ever and should be a public health priority. This narrative review presents the state of the science on various existing prenatal alcohol use screening strategies, including the clinical utility of validated alcohol use screening instruments. It also discusses barriers for alcohol use screening in pregnancy, such as practitioner constraints, unplanned pregnancies, delayed access to prenatal care, and stigma associated with substance use in pregnancy, providing recommendations to address these barriers. By implementing consistent alcohol use screening, prenatal care providers have the opportunity to facilitate access to counseling and brief interventions and thus, to prevent new cases of FASD and improve maternal and child health.
Collapse
|
37
|
Wechsberg WM, Browne FA, Bonner CP, Washio Y, Howard BN, van der Drift I. Current Interventions for People Living with HIV Who Use Alcohol: Why Gender Matters. Curr HIV/AIDS Rep 2021; 18:351-364. [PMID: 34110591 PMCID: PMC8190977 DOI: 10.1007/s11904-021-00558-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW Alcohol is the most misused substance in the world. For people living with HIV (PLWH), alcohol misuse may impact ART adherence and viral suppression. This review of the most recently published alcohol intervention studies with PLWH examines how these studies considered gender in the samples, design, and analyses. RECENT FINDINGS Three searches were conducted initially, and 13 intervention studies fit our criteria with alcohol outcomes. In general, most studies did not consider gender and had used small samples, and few demonstrated significant efficacy/effectiveness outcomes. Five studies considered gender in their samples or analyses and/or were woman-focused with larger samples and demonstrated significant outcomes. It is essential for women who misuse alcohol to not only be well represented in alcohol and HIV research but also for studies to consider the barriers to reaching them and their contextual demands and/or co-occurring issues that may affect participation and outcomes in intervention research.
Collapse
Affiliation(s)
- Wendee M Wechsberg
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA.
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA.
- Department of Psychology, North Carolina State University, Raleigh, NC, USA.
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA.
| | - Felicia A Browne
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Courtney Peasant Bonner
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
- Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Yukiko Washio
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Brittni N Howard
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| | - Isa van der Drift
- Substance Use, Gender, and Applied Research Program, RTI International, Research Triangle Park, NC, USA
| |
Collapse
|
38
|
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.
Collapse
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.
| |
Collapse
|
39
|
Associations of education and work status with alcohol use and cessation among pregnant women in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. BMC Public Health 2021; 21:1400. [PMID: 34266393 PMCID: PMC8281686 DOI: 10.1186/s12889-021-11461-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/07/2021] [Indexed: 11/29/2022] Open
Abstract
Background There is inconsistent evidence on the associations of education and work status with alcohol use during pregnancy. Our aim was to examine the associations of education and work status with alcohol use and alcohol cessation during pregnancy in Japan. Methods Data were analyzed from 11,839 pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017 in Japan. Women were dichotomized as current drinkers or non-drinkers in both early and middle pregnancy. Alcohol cessation was defined as alcohol use in early pregnancy, but not in middle pregnancy. Multivariable log-binomial regression analyses were conducted to examine associations of education and work status with alcohol use in early and middle pregnancy and alcohol cessation, adjusted for age and income. The prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated by work status and education. Results The prevalence of alcohol use in early and middle pregnancy was 20.9 and 6.4%, respectively. Higher education was associated with alcohol use in early pregnancy both among working and non-working women; the PRs of university education or higher compared with high school education or lower were 1.62 (95% CI, 1.34–1.96) and 1.29 (95% CI, 1.16–1.45), respectively. Higher education was associated with alcohol cessation during pregnancy among working women; the corresponding PR was 1.09 (95% CI, 1.01–1.17). Working was associated with alcohol use in early and middle pregnancy. Working was associated with a decreased probability of alcohol cessation among women with lower education but with an increased probability of alcohol cessation among women with higher education; the PRs of working compared with not working were 0.91 (95% CI, 0.82–1.00) and 1.10 (95% CI, 1.00–1.20), respectively. Conclusions Women with higher education were more likely to consume alcohol in early pregnancy and to cease alcohol use between early and middle pregnancy, especially working women. Working women were more likely to consume alcohol throughout pregnancy. Working women with lower education were less likely to cease alcohol use, whereas working women with higher education were more likely to cease alcohol use between early and middle pregnancy. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11461-w.
Collapse
|
40
|
The Importance of Creating Habilitation Programs for Children with Fetal Alcohol Syndrome and Fetal Alcohol Spectrum Disorders. ACTA BIOMEDICA SCIENTIFICA 2021. [DOI: 10.29413/abs.2021-6.2.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim of the study: to analyze the data of studies aimed at studying and substantiating the urgent need to create in Russia comprehensive habilitation programs for people with fetal alcohol syndrome, fetal alcohol spectrum disorders and other mental disorders.Methods. The results of Russian and foreign studies have been analyzed concerning the following problems: observation and diagnosis of people with fetal alcohol syndrome and fetal alcohol spectrum disorders; studying the experience of foreign countries in addressing issues of prevention and overcoming of fetal alcohol syndrome and fetal alcohol spectrum disorders; studying the experience of Russian specialists (obstetricians-gynecologists, neurologists, psychiatrists, psychologists, correctional teachers, etc.) working with the diagnosis of “Alcohol syndrome in the fetus”; assessing the socio-economic impact of organizing programs for the prevention of fetal alcohol syndrome and fetal alcohol spectrum disorders by comparison with similar indicators in other countries.Results. The presented analysis of the data indicates that there is an urgent need for timely diagnosis of the disease, the search/creation of new drugs, for the treatment of the consequences of alcohol syndrome and the organization of training of specialists in this area. The article shows the importance of providing lifelong medical and social assistance to people with fetal alcohol spectrum disorders, as well as to their families. The effectiveness of the creation of a system of measures for the prevention of fetal alcohol syndrome and fetal alcohol spectrum disorders throughout the country has been confirmed.Conclusion. The development at the state level and implementation of prevention programs will significantly reduce the birth rate of children diagnosed with “Alcohol syndrome in the fetus” and, thus, reduce the costs of the state and society on overcoming the consequences of FAS/FASD. At the same time, timely and well-organized habilitation of people with FAS/FASD will significantly improve the social situation in society as a whole, as well as reduce the psychological burden on every family faced with this problem.
Collapse
|
41
|
Individual and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia: a multilevel logistic regression analysis. BMC Pregnancy Childbirth 2021; 21:419. [PMID: 34090373 PMCID: PMC8180107 DOI: 10.1186/s12884-021-03885-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Prenatal alcohol consumption is a serious public health concern that is considered as one of the preventable risk factors for neonatal and childhood morbidity and several adverse pregnancy outcomes. This study aimed to determine the individual- and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia. METHODS A community-based cross-sectional study was conducted among pregnant women in Gondar town from 13 June to 24 August 2019. A cluster random sampling technique was used to select 1237 pregnant women. Data collection was carried out using the AUDIT-C pretested standard questionnaire. Bivariable and multivariable multilevel logistic regression analyses were computed to identify predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05. RESULTS The prevalence of alcohol consumption during pregnancy was found to be 30.26% (95% CI: 27.74%, 32.91%). The study revealed that pregnant women who have a low knowledge level on harmful effect of alcohol consumption (AOR = 3.2; 95% CI: 1.9, 5.4), positive attitude towards alcohol consumption (AOR = 7.5; 95% 5, 11), history of pre-pregnancy alcohol consumption (AOR = 4.8; 95% CI: 3.4, 6.9), whose partner consume alcohol (AOR = 3.9; 95% CI: 2.5, 6), a perception that alcohol consumption is culturally or socially acceptable (AOR = 3.6; 95% CI: 2.4, 5.3), who were encouraged by their partners to consume alcohol (AOR = 4; 95% CI: 1.9, 8) were significantly associated with pregnancy alcohol consumption. Concerning the community-level characteristics, who had not ever heard/media exposure about the risk of alcohol drinking during pregnancy (AOR = 3; 95% CI: 1.7, 5.5), and who were from low community women's education attainment (AOR = 4; 95% CI: 2.2, 7.7) were statistically significant predictors of alcohol consumption during pregnancy. CONCLUSIONS The study revealed that alcohol consumption during pregnancy is prevalent in Gondar town. Both individual- and community-level predictors were found to be associated with alcohol consumption during pregnancy. Policymakers may take into account these predictors for individual and community-based interventions to which our results appear to point.
Collapse
|
42
|
Tsang TW, Kingsland M, Doherty E, Anderson AE, Tully B, Crooks K, Symonds I, Tremain D, Dunlop AJ, Wiggers J, Elliott EJ. Predictors of alcohol use during pregnancy in Australian women. Drug Alcohol Rev 2021; 41:171-181. [PMID: 34062031 DOI: 10.1111/dar.13330] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION This paper aimed to document alcohol use during pregnancy and determine predictors of ongoing use, including knowledge and agreement with national alcohol guideline recommendations. METHODS Pregnant women (n = 1179) attending public antenatal services in a Local Health District in NSW, Australia, were surveyed about their alcohol use before pregnancy and after pregnancy recognition, and awareness of, and agreement with, national alcohol guidelines and health-related statements. Respondent characteristics, drinking behaviour and predictors of ongoing drinking during pregnancy were assessed. RESULTS Most women consumed alcohol before pregnancy (79.3%) but the majority (82.0%) stopped following pregnancy recognition. Half the ongoing drinkers only drank on special occasions. Most (63.6%) women were aware of the national guidelines: 78.1% knew the recommendation that consuming no alcohol in pregnancy is safest, 4.6% thought some alcohol was safe and 17.3% were unsure. Predictors [OR (95%CI)] of ongoing drinking were older age [1.11 (1.07, 1.15)]; medium [2.42 (1.46, 4.00)] or high-risk drinking pre-pregnancy [3.93 (2.35, 6.56)]; and agreement that: avoiding alcohol in pregnancy is safest [0.05 (0.006, 0.47)]; avoiding alcohol is important for baby's health [0.14 (0.06, 0.31)] and pregnancy is a good time to change alcohol use for mother's health [0.29 (0.13, 0.63)]. DISCUSSION AND CONCLUSIONS Results emphasise the importance of asking about special occasion drinking, the link between pre-pregnancy drinking and ongoing drinking during pregnancy, and the need to understand why women disagree with the national guideline. To ensure guidelines have their intended benefit, interventions to promote behaviour change relating to alcohol consumption during pregnancy are warranted.
Collapse
Affiliation(s)
- Tracey W Tsang
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia.,Sydney Children's Hospital Network, Kids Research, Sydney, Australia
| | - Melanie Kingsland
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Emma Doherty
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Amy E Anderson
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Belinda Tully
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia
| | - Kristy Crooks
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Ian Symonds
- Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Danika Tremain
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Adrian J Dunlop
- School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia.,Drug and Alcohol Clinical Services, Hunter New England Local Health District, Newcastle, Australia
| | - John Wiggers
- Hunter New England Population Health, Hunter New England Local Health District, Newcastle, Australia.,School of Medicine and Public Health, The University of Newcastle, Newcastle, Australia.,Hunter Medical Research Institute, Newcastle, Australia
| | - Elizabeth J Elliott
- Discipline of Child and Adolescent Health, Faculty of Medicine and Health, The University of Sydney Children's Hospital Westmead Clinical School, Sydney, Australia.,Sydney Children's Hospital Network, Kids Research, Sydney, Australia
| |
Collapse
|
43
|
The Effectiveness of Smoking Cessation, Alcohol Reduction, Diet and Physical Activity Interventions in Improving Maternal and Infant Health Outcomes: A Systematic Review of Meta-Analyses. Nutrients 2021; 13:nu13031036. [PMID: 33806997 PMCID: PMC8005204 DOI: 10.3390/nu13031036] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 12/30/2022] Open
Abstract
Diet, physical activity, smoking and alcohol behaviour-change interventions delivered in pregnancy aim to prevent adverse pregnancy outcomes. This review reports a synthesis of evidence from meta-analyses on the effectiveness of interventions at reducing risk of adverse health outcomes. Sixty-five systematic reviews (63 diet and physical activity; 2 smoking) reporting 602 meta-analyses, published since 2011, were identified; no data were identified for alcohol interventions. A wide range of outcomes were reported, including gestational weight gain, hypertensive disorders, gestational diabetes (GDM) and fetal growth. There was consistent evidence from diet and physical activity interventions for a significantly reduced mean gestational weight gain (ranging from -0.21 kg (95% confidence interval -0.34, -0.08) to -5.77 kg (95% CI -9.34, -2.21). There was evidence from larger diet and physical activity meta-analyses for a significant reduction in postnatal weight retention, caesarean delivery, preeclampsia, hypertension, GDM and preterm delivery, and for smoking interventions to significantly increase birth weight. There was no statistically significant evidence of interventions having an effect on low or high birthweight, neonatal intensive care unit admission, Apgar score or mortality outcomes. Priority areas for future research to capitalise on pregnancy as an opportunity to improve the lifelong wellbeing of women and their children are highlighted.
Collapse
|
44
|
Isumi A, Takahashi K, Fujiwara T. Prenatal Sociodemographic Factors Predicting Maltreatment of Children up to 3 Years Old: A Prospective Cohort Study Using Administrative Data in Japan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052505. [PMID: 33802518 PMCID: PMC7967638 DOI: 10.3390/ijerph18052505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 02/24/2021] [Accepted: 02/25/2021] [Indexed: 11/16/2022]
Abstract
Identifying risk factors from pregnancy is essential for preventing child maltreatment. However, few studies have explored prenatal risk factors assessed at pregnancy registration. This study aimed to identify prenatal risk factors for child maltreatment during the first three years of life using population-level survey data from pregnancy notification forms. This prospective cohort study targeted all mothers and their infants enrolled for a 3- to 4-month-old health check between October 2013 and February 2014 in five municipalities in Aichi Prefecture, Japan, and followed them until the child turned 3 years old. Administrative records of registration with Regional Councils for Children Requiring Care (RCCRC), which is suggestive of child maltreatment cases, were linked with survey data from pregnancy notification forms registered at municipalities (n = 893). Exact logistic regression was used for analysis. A total of 11 children (1.2%) were registered with RCCRC by 3 years of age. Unmarried marital status, history of artificial abortion, and smoking during pregnancy were significantly associated with child maltreatment. Prenatal risk scores calculated as the sum of these prenatal risk factors, ranging from 0 to 7, showed high predictive power (area under receiver operating characteristic curve 0.805; 95% confidence interval (CI), 0.660–0.950) at a cut-off score of 2 (sensitivity = 72.7%, specificity = 83.2%). These findings suggest that variables from pregnancy notification forms may be predictors of the risk for child maltreatment by the age of three.
Collapse
Affiliation(s)
- Aya Isumi
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo 113-8519, Japan;
- Japan Society for the Promotion of Science, Tokyo 102-0083, Japan
- Correspondence: ; Tel.: +81-3-5803-5188
| | - Kunihiko Takahashi
- Medical and Dental Data Science Center, Tokyo Medical and Dental University (TMDU), Tokyo 113-8519, Japan;
| | - Takeo Fujiwara
- Department of Global Health Promotion, Tokyo Medical and Dental University (TMDU), Tokyo 113-8519, Japan;
| |
Collapse
|
45
|
Modjadji P, Pitso M. Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis. CHILDREN-BASEL 2021; 8:children8020133. [PMID: 33670265 PMCID: PMC7918556 DOI: 10.3390/children8020133] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 11/16/2022]
Abstract
Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.
Collapse
|
46
|
Ruggieri S, Maltese S, Drago G, Cibella F, Panunzi S. The Neonatal Environment and Health Outcomes (NEHO) Birth Cohort Study: Behavioral and Socioeconomic Characteristics and Drop-Out Rate from a Longitudinal Birth Cohort in Three Industrially Contaminated Sites in Southern Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031252. [PMID: 33573257 PMCID: PMC7908468 DOI: 10.3390/ijerph18031252] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/22/2021] [Accepted: 01/27/2021] [Indexed: 12/23/2022]
Abstract
Pregnant women living in industrially contaminated sites (ICSs) are exposed to environmental contaminants through different pathways, and thus children’s health may be affected by pollutants. We created the Neonatal Environment and Health Outcomes (NEHO) longitudinal birth cohort in three ICSs in the Mediterranean area of southern Italy, collecting comprehensive information on personal data and lifestyles by questionnaire. Through multiple correspondence analysis, we identified possible clusters of enrolled women, and a neural network classifier analysis (NNCA) was performed to identify variables capable of predicting the attrition rate of the study. NEHO recruited 845 mother–child pairs over two years. The mothers’ mean age was 31.1 ± 5.2 SD years. We found significant differences in socioeconomic status (SES) among the three evaluated ICS, and an overall 11.1% prevalence of mothers who actively smoked during pregnancy. Active smoking during pregnancy was strongly associated with the lowest socioeconomic level (p < 0.0001). By means of the NNCA, we found that smoking during pregnancy and the lowest education level characterized the cluster with the highest attrition rate (p < 0.001). Our results demonstrate that reason for public health concern still exists regarding smoking during pregnancy and that SES influences both lifestyles, producing negative pregnancy outcomes and a higher survey attrition rate.
Collapse
Affiliation(s)
- Silvia Ruggieri
- Institute for Biomedical Research and Innovation, National Research Council of Italy, 90146 Palermo, Italy; (S.R.); (S.M.); (G.D.)
| | - Sabina Maltese
- Institute for Biomedical Research and Innovation, National Research Council of Italy, 90146 Palermo, Italy; (S.R.); (S.M.); (G.D.)
| | - Gaspare Drago
- Institute for Biomedical Research and Innovation, National Research Council of Italy, 90146 Palermo, Italy; (S.R.); (S.M.); (G.D.)
| | - Fabio Cibella
- Institute for Biomedical Research and Innovation, National Research Council of Italy, 90146 Palermo, Italy; (S.R.); (S.M.); (G.D.)
- Correspondence:
| | - Simona Panunzi
- Institute for System Analysis and Computer Science—BioMatLab, National Research Council of Italy, 00168 Rome, Italy;
| |
Collapse
|
47
|
Römer P, Mathes B, Reinelt T, Stoyanova P, Petermann F, Zierul C. Systematic review showed that low and moderate prenatal alcohol and nicotine exposure affected early child development. Acta Paediatr 2020; 109:2491-2501. [PMID: 32603488 DOI: 10.1111/apa.15453] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/22/2020] [Accepted: 06/24/2020] [Indexed: 12/17/2022]
Abstract
AIM We systematically reviewed the literature on the influence of low and moderate amounts of prenatal alcohol and nicotine exposure on early child development. This paper also suggests possible directions for future research in order to tackle the controversial findings identified. METHODS The PubMed and Web of Science electronic databases were searched together with the reference lists of the selected papers. Empirical studies were included if they focused on the effects of low or moderate exposure, reported outcomes on child development within the first 2 years of life and were published in English between January 2009 and December 2019. The eligibility of the included studies was based on three authors reading the full text. RESULTS The final sample comprised 17 papers. Of these, 13 focused on the effects of prenatal alcohol exposure and they reported decreased sensory sensibility, smaller body sizes and increased cognitive capacities. The other four looked at prenatal nicotine exposure, and they primarily found impairments in children's orienting, communication and motor skills. CONCLUSION Any amount of prenatal alcohol and nicotine exposure appeared to risk healthy child development. There were many reasons for consumption and numerous effects on the child, but representative data from interdisciplinary research were missing.
Collapse
Affiliation(s)
- Pia Römer
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Birgit Mathes
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Tilman Reinelt
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Polina Stoyanova
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Franz Petermann
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| | - Claudia Zierul
- Centre for Clinical Psychology and Rehabilitation University of Bremen Bremen Germany
| |
Collapse
|
48
|
McCormack C, Monk C. Considering Prenatal Alcohol Exposure in a Developmental Origins of Health and Disease Framework. Am J Psychiatry 2020; 177:1025-1028. [PMID: 33135469 DOI: 10.1176/appi.ajp.2020.20091376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Clare McCormack
- Center for Science and Society (McCormack), and Departments of Obstetrics and Gynecology and of Psychiatry (Monk), Columbia University, New York; New York State Psychiatric Institute, New York (Monk)
| | - Catherine Monk
- Center for Science and Society (McCormack), and Departments of Obstetrics and Gynecology and of Psychiatry (Monk), Columbia University, New York; New York State Psychiatric Institute, New York (Monk)
| |
Collapse
|
49
|
Raghunathan R, Liu CH, Kouka A, Singh M, Miranda RC, Larin KV. Dose-response analysis of microvasculature changes in the murine fetal brain and the maternal extremities due to prenatal ethanol exposure. JOURNAL OF BIOMEDICAL OPTICS 2020; 25:JBO-200176RR. [PMID: 33244919 PMCID: PMC7689263 DOI: 10.1117/1.jbo.25.12.126001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 11/06/2020] [Indexed: 05/29/2023]
Abstract
SIGNIFICANCE Prenatal exposure to ethanol causes several morphological and neurobehavioral deficits. While there are some studies on the effects of ethanol exposure on blood flow, research focusing on acute changes in the microvasculature is limited. AIM The first aim of this study was to assess the dose-dependent changes in murine fetal brain microvasculature of developing fetuses in response to maternal alcohol consumption. The second aim was to quantify changes in vasculature occurring concurrently in the mother's hindlimb and the fetus's brain after maternal exposure to alcohol. APPROACH Correlation mapping optical coherence angiography was used to evaluate the effects of prenatal exposure to different doses of ethanol (3, 1.5, and 0.75 g / kg) on murine fetal brain vasculature in utero. Additionally, simultaneous imaging of maternal peripheral vessels and the fetal brain vasculature was performed to assess changes of the vasculature occurring concurrently in response to ethanol consumption. RESULTS The fetal brain vessel diameters (VDs) decreased by ∼47 % , 30%, and 14% in response to ethanol doses of 3, 1.5, and 0.75 g / kg, respectively. However, the mother's hindlimb VD increased by 63% in response to ethanol at a dose of 3 g / kg. CONCLUSIONS Results showed a dose-dependent reduction in vascular blood flow in fetal brain vessels when the mother was exposed to ethanol, whereas vessels in the maternal hindlimb exhibited concurrent vasodilation.
Collapse
Affiliation(s)
- Raksha Raghunathan
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Chih-Hao Liu
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Amur Kouka
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Manmohan Singh
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| | - Rajesh C. Miranda
- Texas A&M University Health Science Center College of Medicine, Department of Neuroscience and Experimental Therapeutics, Bryan, Texas, United States
| | - Kirill V. Larin
- University of Houston, Department of Biomedical Engineering, Houston, Texas, United States
| |
Collapse
|
50
|
Ishitsuka K, Hanada-Yamamoto K, Mezawa H, Saito-Abe M, Konishi M, Ohya Y. Determinants of Alcohol Consumption in Women Before and After Awareness of Conception. Matern Child Health J 2020; 24:165-176. [PMID: 31853680 DOI: 10.1007/s10995-019-02840-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES We examined the socio-demographic and behavioral factors associated with alcohol consumption before and after pregnancy awareness in pregnant women. METHODS This cross-sectional study included 91,828 pregnant women in a nationwide Japanese birth cohort study from 2011 to 2014. Alcohol consumption before and after pregnancy awareness, and sociodemographic behavioral characteristics were assessed through self-reported questionnaires. Determinants of alcohol consumption were investigated using logistic regression. RESULTS Prevalence of alcohol consumption before and after pregnancy awareness was 50.0% and 2.8%, respectively. Most women consumed low to moderate levels of alcohol. Before pregnancy awareness, high educational level (odds ratios [OR] 1.11, 95% confidence interval [CI] 1.07 to 1.15), high household income (OR 1.16, 95% CI 1.09 to 1.24), and smoking (OR 1.77, 95% CI 1.65 to 1.90) were significantly associated with increased odds of alcohol consumption. After pregnancy awareness, older age (OR 1.73, 95% CI 1.54 to 1.94) and smoking (OR 5.57, 95% CI 4.88 to 6.37) were significantly associated with increased odds of alcohol consumption, and high education level (OR 0.72, 95% CI 0.64 to 0.81) and high household income (OR 0.75, 95% CI 0.63 to 0.89) were significantly associated with decreased odds of alcohol consumption. CONCLUSION A half of women consumed alcohol before pregnancy awareness. Guidelines recommend abstinence from alcohol consumption in pregnant women for precaution, although influence of low to moderate levels of prenatal alcohol exposure on the fetus is inconclusive. Social-demographic characteristics differed between women who consumed alcohol before pregnancy awareness and women who continued alcohol after pregnancy awareness.
Collapse
Affiliation(s)
- Kazue Ishitsuka
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 1578535, Japan.
| | - Kiwako Hanada-Yamamoto
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 1578535, Japan
| | - Hidetoshi Mezawa
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 1578535, Japan
| | - Mayako Saito-Abe
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 1578535, Japan
| | - Mizuho Konishi
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 1578535, Japan
| | - Yukihiro Ohya
- Medical Research Center for Japan Environment and Children's Study, National Research Institute for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 1578535, Japan
| | | |
Collapse
|