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Vila-Farinas A, Pérez-Ríos M, Montes-Martínez A, Ahluwalia JS, Mourino N, Rey-Brandariz J, Triñanes-Pego Y, Candal-Pedreira C, Ruano-Ravina A, Gómez-Salgado P, Miguez-Varela C, Tajes-Alonso M, Loureiro-Fuentes I, Riesgo-Martín J, Valverde-Trillo A, Fernández-Lema I, Rey-Arijón M, Freiría-Somoza I, Rodríguez-Pampín M, Varela-Lema L. Perception of pregnant individuals, health providers and decision makers on interventions to cease substance consumption during pregnancy: a qualitative study. BMC Public Health 2024; 24:990. [PMID: 38594646 PMCID: PMC11003004 DOI: 10.1186/s12889-024-18397-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 03/20/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Despite multiple recommendations and strategies implemented at a national and international level, cigarette smoking, alcohol consumption, and cannabis use during pregnancy remains high in most countries. The objective of this study was to examine key stakeholders' perception of the treatment interventions adopted in Spain, to identify political, organizational and personal factors associated with successful implementation, and to propose strategies for improvement. METHODS A qualitative study with a phenomenological approach was conducted in 2022. The target groups were: (1) clinical decision makers in the field of addiction science, (2) health professionals who carry out treatment interventions, and (3) pregnant individuals who use tobacco, alcohol or cannabis. Two focus groups and eight in-depth interviews were conducted, recorded, and transcribed. Exploratory analysis and inductive open coding was performed, codes were merged into categories, and subcategories were identified. RESULTS The analysis resulted in 10 subcategories which were further merged into three main categories: (1) Degree of adoption and utility of treatment interventions implemented; (2) Needs and demands with respect to the organization of treatment interventions; and, (3) Personal barriers to and facilitators for treatment. Respondents reported that despite multiple national and regional cessation initiatives, treatment interventions were rarely adopted in clinical practice. Health care administrators demanded reliable records to quantify substance use for better planning of activities. Health care professionals advocated for additional time and training and both echoed the importance of integrating cessation interventions into routine prenatal care and creating in-house specialized units. The difficulty in quitting, lack of awareness of risk for foetus and child and the controversial advice were identified as barriers by pregnant individuals. CONCLUSIONS Consistent with previous work, this study found that cessation strategies implemented by the health authorities are not effective if they are not accompanied by organizational and behavioral changes. The current study identifies a set of factors that could be pivotal in ensuring the success of treatment interventions targeting tobacco, alcohol and cannabis use among pregnant individuals.
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Affiliation(s)
- Andrea Vila-Farinas
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
| | - Mónica Pérez-Ríos
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain.
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain.
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain.
| | - Agustín Montes-Martínez
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
| | - Jasjit S- Ahluwalia
- Departament of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI, USA
| | - Nerea Mourino
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
| | - Julia Rey-Brandariz
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
| | - Yolanda Triñanes-Pego
- Scientific-technical Assessment Unit [Avalia-t]. Galician Health Knowledge Management Agency, Agencia Gallega de Conocimiento en Salud/ACIS, A Coruna, Spain
| | - Cristina Candal-Pedreira
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
| | - Alberto Ruano-Ravina
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
| | - Patricia Gómez-Salgado
- Scientific-technical Assessment Unit [Avalia-t]. Galician Health Knowledge Management Agency, Agencia Gallega de Conocimiento en Salud/ACIS, A Coruna, Spain
| | - Carmen Miguez-Varela
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, A Coruna, Spain
| | - María Tajes-Alonso
- Mental Health Department, Regional Health Authority, Galician Regional Authority [Xunta de Galicia], A Coruna, Spain
| | - Isabel Loureiro-Fuentes
- Ordes Health Center, Galician Health Service [Servicio Galego de Saúde/SERGAS], A Coruna, Spain
| | - Juan Riesgo-Martín
- Catalonian Health Institute, Institut Català de la Salut/ICS, Barcelona, Spain
| | - Araceli Valverde-Trillo
- Department of Health, Catalonian Public Health Agency, Catalonian Regional Authority [Generalitat de Cataluña], A Coruna, Spain
| | | | - Mercedes Rey-Arijón
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - Isabel Freiría-Somoza
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - María Rodríguez-Pampín
- Santiago de Compostela University Clinical Teaching Hospital, Galician Health Service, A Coruna, Spain
| | - Leonor Varela-Lema
- Department of Preventive Medicine and Public Health, University of Santiago de Compostela, A Coruna, Spain
- Consortium for Biomedical Research in Epidemiology and Public Health, [CIBER en Epidemiología y Salud Pública/CIBERESP], A Coruna, Spain
- Health Research Institute of Santiago de Compostela [Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS], A Coruna, Spain
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Dahl B, Johannessen A, Bondas T. Opening Pandora's box: A meta-ethnography about alcohol use in pregnancy from midwives' and other healthcare providers' perspectives. Eur J Midwifery 2023; 7:14. [PMID: 37405231 PMCID: PMC10316433 DOI: 10.18332/ejm/166189] [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: 03/20/2023] [Revised: 04/28/2023] [Accepted: 05/25/2023] [Indexed: 07/06/2023] Open
Abstract
INTRODUCTION Alcohol consumption has increased in recent years, including among women of childbearing age. A woman's alcohol intake during pregnancy is linked to complications and injuries in the newborn, and the risk of the child being harmed by the mother's alcohol use increases in proportion to the amount of alcohol she consumes. This meta-ethnography aims to explore midwives' and other healthcare providers' experiences of screening pregnant women for alcohol use in pregnancy and counselling them on the subject. METHODS A systematic literature search in CINAHL, Maternity & Infant Care, MEDLINE, and Scopus was conducted in August 2021 and updated in January 2023. The CASP checklist was used to assess the included articles and meta-ethnography was used to synthesize the data. RESULTS Fourteen qualitative studies were included. In the synthesis, we use the metaphor of Pandora's box to deepen our understanding of the topic. We found that some healthcare providers tiptoe around the box, not wanting to face the consequences and responsibilities of asking women about their alcohol use. Others refuse or are reluctant to open the box because they lack knowledge about screening and counselling. Some eventually open the box, understanding the importance of establishing a trusting relationship to address alcohol use and seeing the need for knowledge and screening tools. CONCLUSIONS Healthcare education has the important task of ensuring that healthcare personnel have sufficient evidence-based knowledge about alcohol use in pregnancy. In the future, a health-promoting, tailored approach offering women in pre-pregnancy and early pregnancy sufficient evidence-based information should be implemented.
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Affiliation(s)
- Bente Dahl
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Centre for Women’s, Family and Child Health, Faculty of Health and Social Sciences, University of South-Eastern Norway, Borre, Norway
| | - Aud Johannessen
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Terese Bondas
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
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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]
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Okulicz-Kozaryn K. Is Public Health Response to the Phenomenon of Alcohol Use during Pregnancy Adequate to the Polish Women’s Needs? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084552. [PMID: 35457420 PMCID: PMC9025347 DOI: 10.3390/ijerph19084552] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 04/01/2022] [Accepted: 04/06/2022] [Indexed: 11/16/2022]
Abstract
Due to the risks it poses to a child’s health, drinking alcohol during pregnancy is a serious problem that the public health sector is struggling to deal with. The reasons why women who do not have alcohol problems do not give up drinking alcohol completely during pregnancy are still poorly understood. And the knowledge available about them does not translate into communication strategies in Poland. The analysis of standards and examples of good practice allows to formulate proposals for improving the quality and effectiveness of social campaigns addressed to the general population and women of childbearing age in order to reduce the risk associated with the prenatal exposure to alcohol.
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Affiliation(s)
- Katarzyna Okulicz-Kozaryn
- Institute of Mother and Child, 01-211 Warsaw, Poland;
- National Centre for Prevention of Addictions, 02-776 Warsaw, Poland
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5
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Rockliffe L, Peters S, Heazell AEP, Smith DM. Understanding pregnancy as a teachable moment for behaviour change: a comparison of the COM-B and teachable moments models. Health Psychol Behav Med 2022; 10:41-59. [PMID: 34993005 PMCID: PMC8725882 DOI: 10.1080/21642850.2021.2014851] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives Theoretical models have informed the understanding of pregnancy as a ‘teachable moment’ for health behaviour change. However, these models have not been developed specifically for, nor widely tested, in this population. Currently, no pregnancy-specific model of behaviour change exists, which is important given it is a unique yet common health event. This study aimed to assess the extent to which factors influencing antenatal behaviour change are accounted for by the COM-B model and Teachable Moments (TM) model and to identify which model is best used to understand behaviour change during pregnancy. Design Theoretical mapping exercise. Methods A deductive approach was adopted; nine sub-themes identified in a previous thematic synthesis of 92 studies were mapped to the constructs of the TM and COM-B models. The sub-themes reflected factors influencing antenatal health behaviour. Findings All sub-themes mapped to the COM-B model constructs, whereas the TM model failed to incorporate three sub-themes. Missed factors were non-psychological, including practical and environmental factors, social influences, and physical pregnancy symptoms. In contrast to the COM-B model, the TM model provided an enhanced conceptual understanding of pregnancy as a teachable moment for behaviour change, however, neither model accounted for the changeable salience of influencing factors throughout the pregnancy experience. Conclusions The TM and COM-B models are both limited when applied within the context of pregnancy. Nevertheless, both models offer valuable insight that should be drawn upon when developing a pregnancy-specific model of behaviour change.
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Affiliation(s)
- Lauren Rockliffe
- Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Sarah Peters
- Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
| | - Alexander E P Heazell
- Faculty of Biology, Medicine and Health, Maternal and Fetal Health Research Centre, School of Medical Sciences, University of Manchester, Manchester, UK.,St. Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Debbie M Smith
- Faculty of Biology, Medicine and Health, Manchester Centre for Health Psychology, School of Health Sciences, University of Manchester, Manchester, UK
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Lager S, Gidén K, Axfors C, Sigvardsson F, Kollia N, Nylander I, Fransson E, Skalkidou A. Alcohol consumption habits and associations with anxiety or depressive symptoms postpartum in women with high socioeconomic status in Sweden. Arch Womens Ment Health 2022; 25:1087-1095. [PMID: 36161365 PMCID: PMC9734201 DOI: 10.1007/s00737-022-01268-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 09/14/2022] [Indexed: 12/14/2022]
Abstract
Postpar tum depression and anxiety are common among new mothers. It is well-established that in the general population alcohol use is associated with depression and anxiety. Linking alcohol consumption to symptoms of postpartum depression (PPDS) or postpartum anxiety (PPAS) is presently less established. This study aims to determine if alcohol consumption pre-pregnancy, 6 weeks postpartum, 6 months postpartum, or changes in alcohol consumption are associated with PPDS or PPAS. Longitudinal data on 3849 women from a Swedish perinatal cohort were analyzed using logistic regression analyses for associations between alcohol consumption and symptoms of anxiety or depression, as assessed with the Edinburgh Postnatal Depression Scale. There was no association between pre-pregnancy drinking habits and PPDS (p = 0.588, n = 2479) or PPAS (p = 0.942; n = 2449) at 6 weeks postpartum. Similarly, no associations were observed between concurrent drinking habits at 6 weeks postpartum and PPAS (p = 0.070, n = 3626), 6 months postpartum and PPDS (0.647, n = 3461) or PPAS (p = 0.700, n = 3431). However, there was an association between drinking habits at 6 weeks postpartum and concurrent PPDS (p = 0.047, n = 3659). In conclusion, robust associations were not found between postpartum alcohol consumption and mood symptoms. This lack of association between poor mental health and risk behaviors in new mothers could be interpreted as a result of long-term policy work and high participation in Swedish maternity care. Future studies need to address these research questions in more diverse socio-cultural contexts.
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Affiliation(s)
- Susanne Lager
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Karin Gidén
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Cathrine Axfors
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Meta-Research Innovation Center at Stanford (METRICS), Stanford, CA, USA
| | - Frida Sigvardsson
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Natasa Kollia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Ingrid Nylander
- Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
| | - Emma Fransson
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden.
- Department of Microbiology, Tumor and Cell Biology, Centre for Translational Microbiome Research, Karolinska Institutet, Stockholm, Sweden.
| | - Alkistis Skalkidou
- Department for Women's and Children's Health, Uppsala University, Uppsala, Sweden
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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.
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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
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Lyall V, Wolfson L, Reid N, Poole N, Moritz KM, Egert S, Browne AJ, Askew DA. "The Problem Is that We Hear a Bit of Everything…": A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3445. [PMID: 33810338 PMCID: PMC8037183 DOI: 10.3390/ijerph18073445] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 01/09/2023]
Abstract
Understanding the factors that contribute to women's alcohol use in pregnancy is critical to supporting women's health and wellness and preventing Fetal Alcohol Spectrum Disorder. A systematic review of qualitative studies involving pregnant and recently postpartum women was undertaken to understand the barriers and facilitators that influence alcohol use in pregnancy (PROSPERO: CRD42018098831). Twenty-seven (n = 27) articles were identified through EMBASE, CINAHL, PsycINFO, PubMed and Web of Science. The included articles were thematically analyzed using NVivo12. The analysis was informed by Canada's Action Framework for Building an Inclusive Health System to articulate the ways in which stigma and related barriers are enacted at the individual, interpersonal, institutional and population levels. Five themes impacting women's alcohol use, abstention and reduction were identified: (1) social relationships and norms; (2) stigma; (3) trauma and other stressors; (4) alcohol information and messaging; and (5) access to trusted equitable care and essential resources. The impact of structural and systemic factors on prenatal alcohol use was largely absent in the included studies, instead focusing on individual choice. This silence risks perpetuating stigma and highlights the criticality of addressing intersecting structural and systemic factors in supporting maternal and fetal health.
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Affiliation(s)
- Vivian Lyall
- Primary Care Clinical Unit, University of Queensland, Brisbane, QLD 4006, Australia; (V.L.); (D.A.A.)
| | - Lindsay Wolfson
- Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada;
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC V5R OA4, Canada
| | - Natasha Reid
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia; (N.R.); (K.M.M.)
| | - Nancy Poole
- Centre of Excellence for Women’s Health, Vancouver, BC V6H 3N1, Canada;
- Canada Fetal Alcohol Spectrum Disorder Research Network, Vancouver, BC V5R OA4, Canada
| | - Karen M. Moritz
- Child Health Research Centre, University of Queensland, Brisbane, QLD 4101, Australia; (N.R.); (K.M.M.)
- School of Biomedical Sciences, The University of Queensland, St. Lucia, QLD 4072, Australia
| | - Sonya Egert
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD 4077, Australia;
| | - Annette J. Browne
- School of Nursing, University of British Columbia, Vancouver, BC V6T 1Z4, Canada;
| | - Deborah A. Askew
- Primary Care Clinical Unit, University of Queensland, Brisbane, QLD 4006, Australia; (V.L.); (D.A.A.)
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care, Inala, QLD 4077, Australia;
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9
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Binder A, Hanke S, Petersen KU, Huber C, Banabak M, Preiser C, Batra A. [Opinions on Alcohol Consumption During Pregnancy and The Role of The Medical Staff as an Expert in This Regard - A Grounded Theory Analysis of Online Forum Discussions]. Z Geburtshilfe Neonatol 2020; 225:216-225. [PMID: 33242896 DOI: 10.1055/a-1299-2342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND Alcohol consumption during pregnancy carries many risks for the unborn child. Despite preventive measures, some pregnant women consume alcohol. The aim of this study is to identify possible reasons for consumption during pregnancy and also to shed light on the attribution of an expert role to medical professionals by those affected. METHODS In this study, 9 discussion threads from online forums on the topic of alcohol consumption during pregnancy with a total of 115 discussion participants were analyzed using grounded theory. The discursive validation of the results took place in the research team. RESULTS It turned out that the individual definition of the mother role has an influence on consumer behavior. Women who are very concerned about the child's well-being occasionally used alcohol in stressful situations or on social occasions, but often reported a guilty conscience after the consumption. Women who gave more weight to their own needs were more likely to consume for pleasure or because they felt they were being patronized by prohibitions. An equitable doctor-patient relationship and detailed, non-directive information were identified as beneficial factors for ascribing the expert role to the gynecologist. On the other hand, a paternalistic attitude and the issuing of bans proved to be a hindrance. DISCUSSION All women showed a high need for information about alcohol consumption during pregnancy. The doctor-patient relationship seems to play an important role in conveying information. In addition, it became clear that the desire for support in women striving for abstinence is not being sufficiently fulfilled. CONCLUSION Alcohol consumption during pregnancy should be addressed regularly in the care of all pregnant women. In addition to information on consumption risks, information on support offers is relevant.
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Affiliation(s)
- Annette Binder
- Sektion Suchtmedizin und Suchtforschung, Universitätsklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen
| | - Sara Hanke
- Sektion Suchtmedizin und Suchtforschung, Universitätsklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen
| | - Kay Uwe Petersen
- Sektion Suchtmedizin und Suchtforschung, Universitätsklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen
| | - Clara Huber
- Sektion Suchtmedizin und Suchtforschung, Universitätsklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen
| | - Meryem Banabak
- Sektion Suchtmedizin und Suchtforschung, Universitätsklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen
| | - Christine Preiser
- Zentrum für öffentliches Gesundheitswesen und Versorgungsforschung, Universitätsklinikum Tübingen, Tübingen.,Institut für Arbeitsmedizin, Sozialmedizin und Versorgungsforschung, Universitätsklinikum Tübingen, Tübingen
| | - Anil Batra
- Sektion Suchtmedizin und Suchtforschung, Universitätsklinik für Psychiatrie und Psychotherapie, Universitätsklinikum Tübingen, Tübingen
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McQuire C, Daniel R, Hurt L, Kemp A, Paranjothy S. The causal web of foetal alcohol spectrum disorders: a review and causal diagram. Eur Child Adolesc Psychiatry 2020; 29:575-594. [PMID: 30648224 PMCID: PMC7250957 DOI: 10.1007/s00787-018-1264-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 12/05/2018] [Indexed: 12/21/2022]
Abstract
Foetal alcohol spectrum disorders (FASDs) are a leading cause of developmental disability. Prenatal alcohol use is the sole necessary cause of FASD, but it is not always sufficient. Multiple factors influence a child's susceptibility to FASD following prenatal alcohol exposure. Much of the FASD risk factor literature has been limited to discussions of association, rather than causation. While knowledge of predictor variables is important for identifying who is most at risk of FASD and for targeting interventions, causal knowledge is important for identifying effective mechanisms for prevention and intervention programmes. We conducted a systematic search and narrative synthesis of the evidence and used this to create a causal diagram (directed acyclic graph; DAG) to describe the causal pathways to FASD. Our results show that the aetiology of FASD is multifaceted and complex. FASD risk is determined by a range of lifestyle, sociodemographic, maternal, social, gestational, and genetic factors. The causal diagram that we present in this review provides a comprehensive summary of causal risk factors for FASD and can be used as a tool to inform data collection and statistical modelling strategies to minimise bias in future studies of FASD.
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Affiliation(s)
- Cheryl McQuire
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.
| | - R. Daniel
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - L. Hurt
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - A. Kemp
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
| | - S. Paranjothy
- Division of Population Medicine, Cardiff University, 3rd Floor, Neuadd Meirionnydd, Heath Park, Cardiff, CF14 4YS UK
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11
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My partner and my neighbourhood: The built environment and social networks’ impact on alcohol consumption during early pregnancy. Health Place 2020; 61:102239. [DOI: 10.1016/j.healthplace.2019.102239] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 10/18/2019] [Accepted: 11/01/2019] [Indexed: 11/17/2022]
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Schölin L, Hughes K, Bellis MA, Eriksson C, Porcellato L. “I think we should all be singing from the same hymn sheet” – English and Swedish midwives’ views of advising pregnant women about alcohol. DRUGS: EDUCATION, PREVENTION AND POLICY 2019. [DOI: 10.1080/09687637.2018.1478949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Lisa Schölin
- Liverpool John Moores Unviersity, Public Health Institute, Henry Cotton Campus, Liverpool, UK
| | - Karen Hughes
- Public Health Wales Directorate of Policy Research and International Development Public Health Wales, Wrexham, UK
- Bangor University College of Health and Behavioural Sciences, Bangor, UK
| | - Mark A. Bellis
- Public Health Wales Directorate of Policy Research and International Development Public Health Wales, Wrexham, UK
- Bangor University College of Health and Behavioural Sciences, Bangor, UK
| | - Charli Eriksson
- School of Health and Medical Sciences, Örebro Universitet, Örebro, Sweden
| | - Lorna Porcellato
- Liverpool John Moores Unviersity, Public Health Institute, Henry Cotton Campus, Liverpool, UK
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