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Giglia RC, Symons M, Shaw T. The provision of alcohol and breastfeeding information by maternal health practitioners in the Australian setting. Aust N Z J Obstet Gynaecol 2018; 59:258-264. [PMID: 29926916 DOI: 10.1111/ajo.12837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/17/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the 2009 National Health and Medical Research Council (NHMRC) Australian Guidelines to Reduce Health Risks from Drinking, a guideline specific to lactating women was included. For the first time the effect of alcohol at this important developmental stage was nationally and internationally acknowledged. AIMS To determine the degree to which maternal health practitioners adopted an Australian national policy guideline (Guideline 4B) on alcohol and breastfeeding into their everyday health practice and the factors associated with adoption. MATERIALS AND METHODS A convenience sample of participants completed an online survey based on the Nursing Practice Questionnaire (NPQ) to elicit measures of knowledge, awareness and practice implementation. RESULTS In total, 240 maternal health practitioners completed the online survey. All statistical analyses clearly indicated a higher adoption of Guideline 4B by the child health nurses, midwives and general practitioners (GPs) than was the case for paediatricians and obstetricians. A mean adoption score (range 0-4) indicative of 'some' practice implementation of 3.13, 3.04 and 2.73 was obtained by child health nurses, midwives and GPs, respectively. Obstetricians and paediatricians scored a mean of 2.0, indicating they remain to be 'persuaded about the practice' of incorporating discussions around alcohol and breastfeeding into their practice. CONCLUSION Despite the existence of a national alcohol guideline for breastfeeding women, maternal health practitioners are not incorporating this advice into their everyday practice with lactating women. Opportunities exist for all maternal practitioners along the reproductive continuum to protect long-term breastfeeding duration using an evidence-based harm minimisation approach to alcohol consumption.
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Affiliation(s)
- Roslyn Carmel Giglia
- FASD Research Australia Centre of Research Excellence, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Martyn Symons
- FASD Research Australia Centre of Research Excellence, Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
| | - Thérèse Shaw
- Telethon Kids Institute, University of Western Australia, Perth, Western Australia, Australia
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da Silva FBR, Cunha PA, Ribera PC, Barros MA, Cartágenes SC, Fernandes LMP, Teixeira FB, Fontes-Júnior EA, Prediger RD, Lima RR, Maia CSF. Heavy Chronic Ethanol Exposure From Adolescence to Adulthood Induces Cerebellar Neuronal Loss and Motor Function Damage in Female Rats. Front Behav Neurosci 2018; 12:88. [PMID: 29867389 PMCID: PMC5968384 DOI: 10.3389/fnbeh.2018.00088] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 04/20/2018] [Indexed: 01/23/2023] Open
Abstract
Over the last years, heavy ethanol consumption by teenagers/younger adults has increased considerably among females. However, few studies have addressed the long-term impact on brain structures’ morphology and function of chronic exposure to high ethanol doses from adolescence to adulthood in females. In line with this idea, in the current study we investigated whether heavy chronic ethanol exposure during adolescence to adulthood may induce motor impairments and morphological and cellular alterations in the cerebellum of female rats. Adolescent female Wistar rats (35 days old) were treated with distilled water or ethanol (6.5 g/kg/day, 22.5% w/v) during 55 days by gavage. At 90 days of age, motor function of animals was assessed using open field (OF), pole, beam walking and rotarod tests. Following completion of behavioral tests, morphological and immunohistochemical analyses of the cerebellum were performed. Chronic ethanol exposure impaired significantly motor performance of female rats, inducing spontaneous locomotor activity deficits, bradykinesia, incoordination and motor learning disruption. Moreover, histological analysis revealed that ethanol exposure induced atrophy and neuronal loss in the cerebellum. These findings indicate that heavy ethanol exposure during adolescence is associated with long-lasting cerebellar degeneration and motor impairments in female rats.
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Affiliation(s)
- Fernando B R da Silva
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Polyane A Cunha
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Paula C Ribera
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Mayara A Barros
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Sabrina C Cartágenes
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Luanna M P Fernandes
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Francisco B Teixeira
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Enéas A Fontes-Júnior
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Rui D Prediger
- Laboratório Experimental de Doenças Neurodegenerativas (LEXDON), Department of Pharmacology, Center of Biological Sciences, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Rafael R Lima
- Laboratory of Functional and Structural Biology, Institute of Biological Sciences, Universidade Federal do Pará, Belém, Brazil
| | - Cristiane S F Maia
- Laboratory of Pharmacology of Inflammation and Behavior (LAFICO), Institute of Health Sciences, Universidade Federal do Pará, Belém, Brazil
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Fan J, Jacobson SW, Taylor PA, Molteno CD, Dodge NC, Stanton ME, Jacobson JL, Meintjes EM. White matter deficits mediate effects of prenatal alcohol exposure on cognitive development in childhood. Hum Brain Mapp 2016; 37:2943-58. [PMID: 27219850 DOI: 10.1002/hbm.23218] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Revised: 04/01/2016] [Accepted: 04/05/2016] [Indexed: 11/09/2022] Open
Abstract
Fetal alcohol spectrum disorders comprise the spectrum of cognitive, behavioral, and neurological impairments caused by prenatal alcohol exposure (PAE). Diffusion tensor imaging (DTI) was performed on 54 children (age 10.1 ± 1.0 years) from the Cape Town Longitudinal Cohort, for whom detailed drinking histories obtained during pregnancy are available: 26 with full fetal alcohol syndrome (FAS) or partial FAS (PFAS), 15 nonsyndromal heavily exposed (HE), and 13 controls. Using voxelwise analyses, children with FAS/PFAS showed significantly lower fractional anisotropy (FA) in four white matter (WM) regions and higher mean diffusivity (MD) in seven; three regions of FA and MD differences (left inferior longitudinal fasciculus (ILF), splenium, and isthmus) overlapped, and the fourth FA cluster was located in the same WM bundle (right ILF) as an MD cluster. HE children showed lower FA and higher MD in a subset of these regions. Significant correlations were observed between three continuous alcohol measures and DTI values at cluster peaks, indicating that WM damage in several regions is dose dependent. Lower FA in the regions of interest was attributable primarily to increased radial diffusivity rather than decreased axonal diffusivity, suggesting poorer axon packing density and/or myelination. Multiple regression models indicated that this cortical WM impairment partially mediated adverse effects of PAE on information processing speed and eyeblink conditioning. Hum Brain Mapp 37:2943-2958, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Jia Fan
- MRC/UCT Medical Imaging Research Unit, University of Cape Town, Cape Town, South Africa.,Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Sandra W Jacobson
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.,Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Paul A Taylor
- MRC/UCT Medical Imaging Research Unit, University of Cape Town, Cape Town, South Africa.,Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.,African Institute for Mathematical Sciences, Muizenberg, Western Cape, South Africa
| | - Christopher D Molteno
- Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Neil C Dodge
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Mark E Stanton
- Department of Psychology, University of Delaware, Newark, Delaware
| | - Joseph L Jacobson
- Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.,Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, Michigan
| | - Ernesta M Meintjes
- MRC/UCT Medical Imaging Research Unit, University of Cape Town, Cape Town, South Africa.,Department of Human Biology, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
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Payne JM, Watkins RE, Jones HM, Reibel T, Mutch R, Wilkins A, Whitlock J, Bower C. Midwives' knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder. BMC Pregnancy Childbirth 2014; 14:377. [PMID: 25366388 PMCID: PMC4228156 DOI: 10.1186/s12884-014-0377-z] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 10/17/2014] [Indexed: 01/26/2023] Open
Abstract
Background Midwives are an influential profession and a key group in informing women about alcohol consumption in pregnancy and its consequences. There are no current quantitative Australian data on midwives’ knowledge, attitudes and practice in relation to alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorder. We aimed to reduce this knowledge gap by understanding midwives’ perceptions of their practice in addressing alcohol consumption during pregnancy. Methods This cross-sectional study was conducted at 19 maternity sites across the seven health regions of country Western Australia. A questionnaire was designed following review of the literature and other relevant surveys. Midwifery managers of the maternity sites distributed questionnaires to all midwives working in their line of management. A total of 334 midwives were invited to participate in the research and (n = 245, 73.4%) of these were eligible. Results The response fraction was (n = 166, 67.8%). Nearly all (n = 151, 93.2%) midwives asked pregnant women about their alcohol consumption during pregnancy and (n = 164, 99.4%) offered advice about alcohol consumption in accordance with the Australian Alcohol Guideline, which states “For women who are pregnant or planning a pregnancy, not drinking is the safest option”. Nearly two thirds (n = 104, 64.2%) of the midwives informed pregnant women about the effects of alcohol consumption in pregnancy, they did not always use the recommended AUDIT screening tool (n = 66, 47.5%) to assess alcohol consumption during pregnancy, nor conduct brief intervention when indicated (n = 107, 70.4%). Most midwives endorsed professional development about screening tools (n = 145, 93.5%), brief intervention (n = 144, 92.9%), and alcohol consumption during pregnancy and FASD (n = 144, 92.9%). Conclusion Nearly all midwives in this study asked and advised about alcohol consumption in pregnancy and around two thirds provided information about the effects of alcohol in pregnancy. Our findings support the need for further professional development for midwives on screening and brief intervention. Policy should support midwives’ practice to screen for alcohol consumption in pregnancy and offer brief intervention when indicated.
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Li Q, Hankin J, Wilsnack SC, Abel EL, Kirby RS, Keith LG, Obican SG. Detection of alcohol use in the second trimester among low-income pregnant women in the prenatal care settings in Jefferson County, Alabama. Alcohol Clin Exp Res 2012; 36:1449-55. [PMID: 22375628 DOI: 10.1111/j.1530-0277.2012.01745.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 12/06/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Prenatal alcohol use, a leading preventable cause of birth defects and developmental disabilities, remains a prevalent public health concern in the United States. This study aims to detect the proportion and correlates of prenatal alcohol use in the prenatal care settings in Alabama. Prenatal care settings were chosen because of their potential as stable locations to screen for and to reduce prenatal alcohol use within a community. METHODS We conducted a cross-sectional study of 3,046 women in the 22 and 23 weeks of gestation who sought prenatal care in 8 community-based public clinics and participated in the Perinatal Emphasis Research Center project in Jefferson County, Alabama, from 1997 to 2001. Frequency and quantity of alcohol use in the past 3 months were assessed by research nurses during face-to-face interviews. We conducted logistic regression analyses to calculate adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of correlates of prenatal alcohol use. RESULTS Participants were predominantly young, African American, and unmarried, 86.5% on Medicaid. The proportion of alcohol use in the second trimester of pregnancy was 5.1%; 0.3% of women reported 4 or more drinks on a drinking day to research nurses. Older maternal age (OR = 1.11; 95% CI = 1.08 to 1.15), use of welfare (OR = 1.43; 95% CI = 1.02 to 2.02), and male partner-perpetrated violence (OR = 2.96; 95% CI = 1.92 to 4.56) were positively associated with elevated risk of prenatal alcohol use. Protective factors included higher levels of self-esteem (OR = 0.94; 95% CI = 0.89 to 0.98) and more years of education (OR = 0.88; 95% CI = 0.78 to 0.98). CONCLUSIONS Prenatal alcohol use remains a public health issue among low-income pregnant women in Jefferson County, Alabama. Research nurses detected it in the second trimester. Future studies need to encourage screening for prenatal alcohol use in the prenatal care settings by obstetrician-gynecologists, family physicians, nurses, and midwives. Combined interventions to educate and empower women and strengthen families are needed.
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Affiliation(s)
- Qing Li
- Center for Social Medicine and Sexually Transmitted Diseases, Department of Sociology, University of Alabama at Birmingham, USA.
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Partridge B, Lucke J, Hall W. In the face of uncertainty about the risks of low-level drinking, abstinence is prudent, not misogynistic, advice. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2011; 11:66-67. [PMID: 22146040 DOI: 10.1080/15265161.2011.615887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Brad Partridge
- The University of Queensland, UQ Centre for Clinical Research, Herston, Queensland, Australia.
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