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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.
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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;
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Bete T, Asfaw H, Nigussie K, Alemu A, Eyeberu Gebrie A, Dechasa DB, Gemechu K, Arkew M, Daniel B, Gelaye H, Wolde A, Kassa MA, Anbesaw T. Alcohol consumption and associated factors among pregnant women attending antenatal care at governmental hospitals in Harari regional state, Eastern, Ethiopia. Subst Abuse Treat Prev Policy 2023; 18:61. [PMID: 37904208 PMCID: PMC10617170 DOI: 10.1186/s13011-023-00567-6] [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: 05/09/2023] [Accepted: 10/10/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Alcohol consumption during the pregnancy period is high despite the well-established evidence of its harmful effects on pregnancy and infant development. Early identification and behavioral modification are of great significance. This study aimed to assess the prevalence and associated factors of alcohol consumption among pregnant women attending antenatal care at governmental hospitals in the Harari regional state, Eastern Ethiopia. METHOD From April 1/2022-May 1/2022, an institutional-based cross-sectional survey was conducted among 589 pregnant women attending antenatal care governmental hospitals in Harari regional state. A systematic random sampling technique was used to select study participants during the study period. Data were collected through face-to-face interview methods using AUDIT-C. The collected data were coded, entered into Epi-data data version 3.1, and analyzed by SPSS Version 26. Binary logistic regression was carried out to identify independent predictors of alcohol consumption at a 95% confidence level. RESULTS From a total of 617 eligible participants, 589 participated in the study with a response rate of 95.46%. The overall prevalence of alcohol consumption among pregnant women in Harari regional state governmental hospitals was 21.2% (95% CI:17.8, 24.4). In multivariate analysis, single marital status (AOR = 5.18;95% CI (2.66,10.11), previous history of abortion(AOR = 4.07;95% CI(2.06,8.04), family history of mental illness (AOR = 4.79;95% CI (1.94,11.83), depression (AOR 2.79; 95%CI(1.35,5.76), and anxiety(AOR = 2.51; 95% CI (1.23, 5.12) were variables found to have a statistically significant association with alcohol consumption during pregnancy in Harari regional state governmental hospitals. CONCLUSION In comparison to the majority of other research, the prevalence of alcohol usage during pregnancy was high in this study. This study observed that single marital status, previous history of abortion, family history of mental illness, depression, and anxiety were highly associated with alcohol consumption during pregnancy. Hence, responsible bodies working on mother and child health should try to mitigate or remove the above-mentioned risks when developing interventions.
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Affiliation(s)
- Tilahun Bete
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medicine Science, Haramaya University, Harar, Ethiopia
| | - Henock Asfaw
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medicine Science, Haramaya University, Harar, Ethiopia
| | - Kabtamu Nigussie
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medicine Science, Haramaya University, Harar, Ethiopia
| | - Addisu Alemu
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Addis Eyeberu Gebrie
- Department of Midwifery, School of Nursing and Midwifery, College of Health and Medicine Science, Haramaya University, Harar, Ethiopia
| | - Deribe Bekele Dechasa
- Department of Nursing, School of Nursing and Midwifery, College of Health and Medicine Science, Haramaya University, Harar, Ethiopia
| | - Kabtamu Gemechu
- Department of Hematology, School of Medical Laboratory Science, College of Health and Medicine Science, Haramaya University, Harar, Ethiopia
| | - Mesay Arkew
- Department of Hematology, School of Medical Laboratory Science, College of Health and Medicine Science, Haramaya University, Harar, Ethiopia
| | - Beniam Daniel
- Department of Psychiatry, College of Health and Medicine Science, Arba Minch University, Arba-Minch, Ethiopia
| | - Habtam Gelaye
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, P.O. Box 1145, Dessie, Ethiopia
| | - Asrat Wolde
- Department of Psychiatry, School of Medicine, College of Medicine and Health Sciences, Mizan-Tepi University, Tepi, Ethiopia
| | - Mulat Awoke Kassa
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Science, Wollo University, P.O. Box 1145, Dessie, Ethiopia.
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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
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4
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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.
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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:
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5
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Marshall AT, Bodison SC, Uban KA, Adise S, Jonker D, Charles W, Donald KA, Kan E, Ipser JC, Butler-Kruger L, Steigelmann B, Narr KL, Joshi SH, Brink LT, Odendaal HJ, Scheffler F, Stein DJ, Sowell ER. The impact of prenatal alcohol and/or tobacco exposure on brain structure in a large sample of children from a South African birth cohort. Alcohol Clin Exp Res 2022; 46:1980-1992. [PMID: 36117382 DOI: 10.1111/acer.14945] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 08/30/2022] [Accepted: 09/13/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Neuroimaging studies have emphasized the impact of prenatal alcohol exposure (PAE) on brain development, traditionally in heavily exposed participants. However, less is known about how naturally occurring community patterns of PAE (including light to moderate exposure) affect brain development, particularly in consideration of commonly occurring concurrent impacts of prenatal tobacco exposure (PTE). METHODS Three hundred thirty-two children (ages 8 to 12) living in South Africa's Cape Flats townships underwent structural magnetic resonance imaging. During pregnancy, their mothers reported alcohol and tobacco use, which was used to evaluate PAE and PTE effects on their children's brain structure. Analyses involved the main effects of PAE and PTE (and their interaction) and the effects of PAE and PTE quantity on cortical thickness, surface area, and volume. RESULTS After false-discovery rate (FDR) correction, PAE was associated with thinner left parahippocampal cortices, while PTE was associated with smaller cortical surface area in the bilateral pericalcarine, left lateral orbitofrontal, right posterior cingulate, right rostral anterior cingulate, left caudal middle frontal, and right caudal anterior cingulate gyri. There were no PAE × PTE interactions nor any associations of PAE and PTE exposure on volumetrics that survived FDR correction. CONCLUSION PAE was associated with reduction in the structure of the medial temporal lobe, a brain region critical for learning and memory. PTE had stronger and broader associations, including with regions associated with executive function, reward processing, and emotional regulation, potentially reflecting continued postnatal exposure to tobacco (i.e., second-hand smoke exposure). These differential effects are discussed with respect to reduced PAE quantity in our exposed group versus prior studies within this geographical location, the deep poverty in which participants live, and the consequences of apartheid and racially and economically driven payment practices that contributed to heavy drinking in the region. Longer-term follow-up is needed to determine potential environmental and other moderators of the brain findings here and assess the extent to which they endure over time.
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Affiliation(s)
- Andrew T Marshall
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Stefanie C Bodison
- Department of Occupational Therapy, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Kristina A Uban
- Department of Public Health, University of California, Irvine, California, USA
| | - Shana Adise
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Deborah Jonker
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Weslin Charles
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Kirsten A Donald
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Eric Kan
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
| | - Jonathan C Ipser
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Letitia Butler-Kruger
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Katherine L Narr
- Department of Neurology, UCLA Brain Mapping Center, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Shantanu H Joshi
- Department of Neurology, UCLA Brain Mapping Center, Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, California, USA
| | - Lucy T Brink
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
| | - Hein J Odendaal
- Department of Obstetrics and Gynaecology, Stellenbosch University, Cape Town, South Africa
| | - Freda Scheffler
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - Dan J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Unit on Risk and Resilience in Mental Disorders, South African Medical Research Council (SAMRC), Cape Town, South Africa
| | - Elizabeth R Sowell
- Department of Pediatrics, Keck School of Medicine, Children's Hospital Los Angeles, University of Southern California, Los Angeles, California, USA
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6
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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.
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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
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Skogsdal Y, Karlsson J, Tydén T, Patil S, Backman H. The association of smoking, use of snuff, and preconception alcohol consumption with spontaneous abortion: A population-based cohort study. Acta Obstet Gynecol Scand 2022; 102:15-24. [PMID: 36222196 PMCID: PMC9780718 DOI: 10.1111/aogs.14470] [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: 04/20/2022] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION It is unclear whether tobacco in early pregnancy and alcohol use preceding pregnancy are associated with spontaneous abortion. The purpose was to investigate if use of tobacco and/or alcohol is associated with spontaneous abortion among women attending antenatal care, and if age and body mass index (BMI) attenuate the risk. MATERIAL AND METHODS A population-based cohort study based on data from the Swedish Pregnancy Register. All pregnant women having had the first antenatal visit from January 2014 to July 2018 were included (n = 525 604). The register had information about smoking and use of snuff before and in early pregnancy, as well as data on alcohol habits before pregnancy, measured by the Alcohol Use Disorders Identification Test (AUDIT), a validated questionnaire. Logistic regression analysis was used to estimate the association between lifestyle factors and spontaneous abortion, and multiple imputation was used to impute missing data. RESULTS In total, 34 867 (6.6%) pregnancies ended in a spontaneous abortion after the first visit to maternal health care. At the first maternal healthcare visit, daily smoking was reported by 24 214 (5.1%), and 6403 (1.2%) used snuff. For 19 837 (4.2%) women, a high alcohol score was reported for the year preceding pregnancy. After adjusting for potential confounders and multiple imputation, use of tobacco was associated with spontaneous abortion; smoking 1-9 cigarettes/day (adjusted odds ratio [aOR] 1.11, 95% confidence interval [CI] 1.04-1.18), smoking 10 or more cigarettes/day (aOR 1.12, 95% CI 1.-1.26), and use of snuff (aOR 1.20, 95% CI 1.06-1.37). Higher AUDIT scores were not significantly associated with spontaneous abortion (AUDIT 6-9: aOR 1.03, 95% CI 0.97-1.10 and AUDIT 10 or more: aOR 1.07, 95% CI 0.94-1.22). Increasing maternal age showed the highest risk of spontaneous abortion from the age of 35, and BMI of 30 kg/m2 or more increased the risk. There were interactions between different lifestyle factors associated with spontaneous abortion that could either increase or decrease the risk of spontaneous abortion. CONCLUSIONS Smoking and use of snuff were associated with an increased risk of spontaneous abortion. The AUDIT scores preceding pregnancy were not associated with an increased risk of spontaneous abortion, which contradicts the results from previous studies.
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Affiliation(s)
- Yvonne Skogsdal
- Maternal Health Care Unit, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Jan Karlsson
- University Health Care Research CenterFaculty of Medicine and Health, Örebro UniversityÖrebroSweden
| | - Tanja Tydén
- Department of Women's and Children's HealthAkademiska SjukhusetUppsalaSweden
| | - Snehal Patil
- Clinical Epidemiology and Biostatistics, School of Medical SciencesÖrebro UniversityÖrebroSweden
| | - Helena Backman
- Department of Obstetrics and Gynecology, Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
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Abetew MM, Alemu AA, Zeleke H, Ayenew AA, Aynalem FG, Kassa GM, Khajehei M. Alcohol consumption and its determinants among pregnant women in Gozamin district, Amhara, Ethiopia, 2020. SAGE Open Med 2022; 10:20503121221130903. [PMID: 36246534 PMCID: PMC9558849 DOI: 10.1177/20503121221130903] [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: 02/19/2022] [Accepted: 09/19/2022] [Indexed: 11/17/2022] Open
Abstract
Objective Alcohol consumption during pregnancy can cause many major severe illnesses to both mothers and their offspring. Despite this, many pregnant women consume both homemade and manufactured alcoholic beverages. We conducted this study to assess the prevalence and determinants of alcohol consumption among pregnant women in Gozamin district, Amhara, Ethiopia, in 2020. Methods Community-based cross-sectional study was employed from 1 to 30 November, 2020. The participants were recruited using a stratified multi-stage sampling technique. A structured and pretested interviewer-administered questionnaire was utilized for data collection. The collected data were entered into Epi-data Version 3.1 and exported to SPSS Version 25 for further analysis. The model fitness was checked by Hosmer and Lemeshow's goodness of fit test. Then, logistic regression models were considered to determine the associations of independent variables with the outcome variable. Variables with p < 0.25 in bivariable logistic regression were considered for multivariable logistic regression. Finally, variables with p < 0.05 in multivariable logistic regression were considered as determinants of alcohol consumption. Result A total of 555 pregnant women participated in this study, making the response rate of 97.4%. The prevalence of alcohol consumption among the participants was 45.6% (95% confidence interval = 41.4-49.2). The determinants of alcohol consumption among the participants were highest wealth index (adjusted odds ratio = 3.21; 95% CI = 1.68-6.14), pre-pregnancy alcohol consumption (adjusted odds ratio = 3.67; 95% confidence interval = 2.36-5.71), poor social support (adjusted odds ratio = 3.08; 95% confidence interval = 1.60-5.94), and unplanned pregnancy (adjusted odds ratio = 1.66; 95% confidence interval = 1.04-2.66). Conclusion In this study, the prevalence of alcohol consumption was high among the pregnant women. Our findings suggest introduction of policies and interventions that can help reduce alcohol consumption during pregnancy. The health education priority should be creation of awareness about the negative health impacts of alcohol on the health of pregnant mothers and their offspring.
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Affiliation(s)
| | - Addisu Alehegn Alemu
- College of Health Sciences, Debre
Markos University, Debre Markos, Ethiopia,University of New South Wales, Sydney,
NSW, Australia,Addisu Alehegn Alemu, College of Health
Sciences, Debre Markos University, Debre Markos, Ethiopia.
| | - Haymanot Zeleke
- College of Health Sciences, Debre
Markos University, Debre Markos, Ethiopia
| | | | | | | | - Marjan Khajehei
- University of New South Wales, Sydney,
NSW, Australia,Department of Women’s and Newborn
Health, Westmead Hospital, NSW, Australia,The University of Sydney, Sydney, New
South Wales, NSW, Australia
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9
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Asp J, Bergman L, Lager S, Axelsson O, Wikström A, Hesselman S. Alcohol exposure prior to pregnancy-does hazardous consumption affect placenta- and inflammatory-mediated pregnancy outcomes? A Swedish population-based cohort study. Acta Obstet Gynecol Scand 2022; 101:1386-1394. [PMID: 36073360 PMCID: PMC9812091 DOI: 10.1111/aogs.14451] [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: 01/25/2022] [Revised: 07/14/2022] [Accepted: 08/24/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Alcohol consumption during pregnancy is related to severe birth complications such as low birthweight, preterm birth and birth defects. During the last decade, the Alcohol Use Disorders Identification Test (AUDIT) has been used as a screening tool in Swedish maternal healthcare units to identify hazardous, pre-pregnancy alcohol use. However, evaluation of the screening with AUDIT, as well as adverse maternal or neonatal outcomes, has not been assessed at a national level. MATERIAL AND METHODS This was a population-based cohort study of 530 458 births from 2013 to 2018 using demographic, reproductive and maternal health data from the Swedish Pregnancy Register. Self-reported alcohol consumption in the year before pregnancy, measured as AUDIT scores, was categorized into moderate (6-13 points) and high-risk (14-40 points) consumption, with low-risk (0-5 points) consumption as the reference group. Associations with pregnancy- and birth outcomes were explored with logistic regressions using generalized estimating equation models, adjusting for maternal and socioeconomic characteristics. Estimates are presented as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). RESULTS High-risk and moderate pre-pregnancy alcohol consumption was associated with preeclampsia, preterm birth and birth of an infant small for gestational age (SGA), but these associations were nonsignificant after adjustments. Prior moderate-risk (aOR 1.29, 95% CI 1.17-1.42) and high-risk consumption (aOR 1.62, 95% CI 1.17-2.25) increased the likelihood of intrapartum and neonatal infections. CONCLUSIONS Apart from identifying hazardous alcohol consumption prior to pregnancy and the offer of counseling, screening with the AUDIT in early pregnancy indicates a high risk of inflammatory-/placenta-mediated pregnancy and birth outcomes. For most outcomes, AUDIT was not an independent contributor when adjusting for confounding factors. Hazardous alcohol use prior to pregnancy was independently linked to intrapartum and neonatal infections; conditions associated with morbidity and long-term sequalae. These associations may be explained by alcohol-induced changes in the maternal or fetal immune system in early pregnancy or persistent alcohol intake during pregnancy, or may depend on unidentified confounding factors.
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Affiliation(s)
- Joline Asp
- Center for Clinical Research SörmlandUppsala UniversityEskilstunaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Lina Bergman
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden,Department of Obstetrics and GynecologyInstitute of Clinical Science, Sahlgrenska Academy, University of GothenburgGothenburgSweden,Department of Obstetrics and GynecologyStellenbosch UniversityStellenboschSouth Africa
| | - Susanne Lager
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | - Ove Axelsson
- Center for Clinical Research SörmlandUppsala UniversityEskilstunaSweden,Department of Women's and Children's HealthUppsala UniversityUppsalaSweden
| | | | - Susanne Hesselman
- Department of Women's and Children's HealthUppsala UniversityUppsalaSweden,Center for Clinical Research DalarnaFalunSweden
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10
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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.
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Mulat B, Alemnew W, Shitu K. Alcohol use during pregnancy and associated factors among pregnant women in Sub-Saharan Africa: further analysis of the recent demographic and health survey data. BMC Pregnancy Childbirth 2022; 22:361. [PMID: 35473590 PMCID: PMC9044761 DOI: 10.1186/s12884-022-04694-z] [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: 09/05/2021] [Accepted: 04/19/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Alcohol drinking during pregnancy is towering despite the well-established proof of its unfavorable pregnancy results and destitute child improvement. Despite such enormous consequences, there are limited data that explore the extent of alcohol drinking and its associated factors among mothers during pregnancy in sub-Saharan Africa. OBJECTIVE This study aimed to assess the prevalence and associated factors of alcohol consumption during pregnancy among pregnant mothers in sub-Saharan Africa. METHOD A community-based crossectional demographic and health survey was conducted from 2013 to 2017 among four Sub-Sahara African countries: Burundi, Ethiopia, Liberia, and Zimbabwe. A two-stage stratified sampling technique was employed to select the participants. Multivariable Logistic regression analysis was used to identify factors associated with alcohol consumption during pregnancy. A p-value less than 0.05 and a 95% confidence interval were used to declare statistical significance. RESULT A total of 3953 weighted sample of pregnant mothers were included in the study. The mean age of the participants was 27.3 (± 6.8) years with an age range of 15-49 years. The overall prevalence of alcohol use during pregnancy was 22.8% with (95% CI (21.5, 24)) and it was significantly associated with increased age (AOR = 1.02, 95% CI (1.01, 1.04)), Muslim religion follower ( AOR = 0.07, 95% CI (0.05,0.11), husband/partner's educational status( primary (AOR = 0.7,95% CI (0.55,0.84), secondary (AOR = 0.53, 95% CI ( 0.41,0.7)) and higher (AOR = 0.49, 95% CI (0.31,0.8), being currently working (AOR = 1.5,95% CI ( 1.09,1.55), having ANC visit ( AOR = 0.82, 95% C I(0.68,0.98) and increased gravidity ( AOR = 0.93,95% CI( 0.86,0.99). CONCLUSION Alcohol drinking during pregnancy was high among pregnant women in sub-Saharan African countries. Maternal age, religion, husband educational status, current working status of the mother, presence of ANC visit, and gravidity of the mother were factors that have a significant association with alcohol drinking during pregnancy. This calls for a tailored behavior change intervention to reduce alcohol use during pregnancy. More emphasis should also be given to pregnant women with no ANC visit, lower gravidity, and an illiterate husband, currently working and Christianity followers.
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Affiliation(s)
- Bezawit Mulat
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Wallelign Alemnew
- Department of Health Education and Behavioral Sciences, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Kegnie Shitu
- Department of Health Education and Behavioral Sciences, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Corrales-Gutierrez I, Baena-Antequera F, Gomez-Baya D, Leon-Larios F, Mendoza R. Relationship between Eating Habits, Physical Activity and Tobacco and Alcohol Use in Pregnant Women: Sociodemographic Inequalities. Nutrients 2022; 14:nu14030557. [PMID: 35276912 PMCID: PMC8839613 DOI: 10.3390/nu14030557] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/17/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Pregnant women must maintain or acquire healthy habits during pregnancy to protect both their own health and their child's. Such habits include an adequate eating pattern along with good adherence to the intake of certain supplements, practice of moderate physical activity and avoiding the consumption of toxic products such as tobacco and alcohol. The objective of this study is to assess the interrelation between such habits and their association with sociodemographic variables. To such end, a cross-sectional study was conducted with a representative sample of pregnant women who attended the scheduled morphology echography consultation at the 20th gestational week in their reference public hospital in the city of Seville (Spain). Results: Younger pregnant women and with lower educational levels are the ones that present the worst eating habits and the highest smoking rate. Pregnant women with lower educational levels are the least active. Non-smoking pregnant women present better eating habits than those who smoke. Pregnant women with lower educational levels are those who accumulate more unhealthy habits during pregnancy. This should be taken into account when planning the health care provided to pregnant women and in public health intersectoral policies.
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Affiliation(s)
- Isabel Corrales-Gutierrez
- Foetal Medicine Unit, University Hospital Virgen Macarena, 41009 Seville, Spain;
- Department of Surgery, University of Seville, 41009 Seville, Spain
| | - Francisca Baena-Antequera
- Obstetric Unit, University Hospital Virgen de Valme, 41014 Seville, Spain
- Nursing Department, Osuna’s University School, 41640 Osuna, Spain
- Correspondence: ; Tel.: +34-615-51-95-65
| | - Diego Gomez-Baya
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
| | - Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Ramon Mendoza
- Research Group on Health Promotion and Development of Lifestyle across the Life Span, University of Huelva, 21007 Huelva, Spain; (D.G.-B.); (R.M.)
- Department of Social, Developmental and Educational Psychology, University of Huelva, 21007 Huelva, Spain
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Högberg H, Pålsson P, Spak F, Larsson M, Wells MB. Two screening instruments for collecting alcohol-related information from expectant mothers and fathers: Testing the reliability of the Parent Alcohol Screening Questionnaire and the Social Support for an Alcohol-Free Pregnancy Questionnaire. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1896-1914. [PMID: 33600617 DOI: 10.1111/hsc.13303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 09/17/2020] [Accepted: 01/07/2021] [Indexed: 06/12/2023]
Abstract
The aim is to test the reliability of two alcohol screening instruments: (1) The Parent Alcohol Screening Questionnaire (PASQ5), and (2) the Social Support for an Alcohol-free Pregnancy (SSAFP) questionnaire. This is a cohort study from the south of Sweden using repeated surveys during pregnancy. To examine if responses differed according to different data collection methods, two cohorts consisting of 289 expectant mothers and 141 fathers completed the PASQ5 both verbally (weeks 6-7) and in writing (week 12) within regular antenatal visits. One of the cohorts (n = 137/64) also completed the SSAFP in week 12 and later in week 33. The third cohort, consisting of 179 and 133 expectant mothers and fathers, respectively, completed the PASQ5 and the SSAFP twice in late pregnancy (week 31 + 33). Eight of 10 items in the PASQ5 were stable for both expectant mothers and expectant fathers when comparing verbal versus written-delivered formats. Eight of 10 questions in the PASQ5 were stable when assessing the items in a test-retest analysis in late pregnancy for expectant mothers and nine of 10 questions were stable for fathers. The SSAFP items showed high internal consistency (0.86) for expectant mothers and excellent internal consistency (0.94) for expectant fathers. Most SSAFP items (17 of 21 for expectant mothers and 18 of 22 for expectant fathers) were also stable in a test-retest scenario in late pregnancy. Both the PASQ5 and SSAFP are reliable tools and may be helpful for clinicians who aim to have a deeper dialogue about alcohol consumption during pregnancy. These tools may also be helpful for researchers aiming to better understand a person's changes in alcohol intake and/or their social support network.
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Affiliation(s)
- Hjördis Högberg
- Department of Women's and Children's Health, Uppsala University, Stockholm, Sweden
| | - Petra Pålsson
- Child and Family Health, Lund University, Lund, Sweden
| | | | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala University, Stockholm, Sweden
| | - Michael B Wells
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
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Legas G, Asnakew S, Belete A, Beyene GM, Wubet GM, Bayih WA, Chanie ES, Tigabu A, Dessie T. Magnitude and correlates of alcohol use disorder in south Gondar zone, northwest Ethiopia: A community based cross-sectional study. PLoS One 2021; 16:e0257804. [PMID: 34591890 PMCID: PMC8483395 DOI: 10.1371/journal.pone.0257804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/10/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Alcohol use disorder is the major public health problem in low- and middle-income countries that account for up to 70% of alcohol related premature mortality in the region. Therefore, the aim of this study was to assess the magnitude of alcohol use disorder and its associated factors among adult residents in south Gondar zone, Northwest Ethiopia. METHODS A community-based cross-sectional study was conducted among 848 adult residents of the south Gondar zone from January 13 to February 13, 2020. A multistage sampling technique was used to recruit study participants. We assessed alcohol use disorder (AUD) using the alcohol use disorder identification test (AUDIT). A binary logistic regression model was employed to identify factors associated with AUD. RESULTS The prevalence of alcohol use disorder over the last 12-months was found to be 23.7% (95% CI: 20.9, 26.7). Being male (AOR = 4.34, 95 CI; 2.800, 6.743), poor social support (AOR = 1.95, 95 CI: 1.098, 3.495), social phobia (AOR = 1.69, 95 CI; 1.117, 2.582), perceived high level of stress (AOR = 2.85, 95 CI; 1.829, 34.469), current cigarette smoking (AOR = 3.06, 95 CI; 1.764, 5.307) and comorbid depression (AOR = 1.81, 95 CI; 1.184, 2.778) were significantly associated with alcohol use disorder. CONCLUSION The prevalence of alcohol use disorder is high among adult residents of the south Gondar zone and associated with many factors. So, it needs public health attention to decrease the magnitude of alcohol use disorder in Ethiopia.
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Affiliation(s)
- Getasew Legas
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amsalu Belete
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getnet Mihretie Beyene
- Department of Psychiatry, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Gashaw Mehiret Wubet
- Department of Medicine, School of Medicine, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Wubet Alebachew Bayih
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Ermias Sisay Chanie
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Agimasie Tigabu
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Dessie
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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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.
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Fetene MT, Teji K, Assefa N, Bayih WA, Tsehaye G, Hailemeskel HS. Magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of eastern Ethiopia. BMC Psychiatry 2021; 21:96. [PMID: 33588806 PMCID: PMC7885430 DOI: 10.1186/s12888-021-03078-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 01/31/2021] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Use of substances like alcohol, tobacco and khat during pregnancy can bring miscarriage, prematurity, neurodevelopmental problems, sudden infant death syndrome and others. There are limited studies on the magnitude and associated factors of substance use among pregnant women in Eastern Ethiopia. Therefore, the aim of this study was to assess the magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of Easttern Ethiopia, 2019. METHOD Hospital based cross-sectional study was employed on 510 pregnant women attending ANC at public hospitals of Eastern Ethiopia (Jigjiga, Dire Dawa and Harar towns). Data were collected from the study participants that were selected using systematic sampling method from each public hospital. The data were collected through interviewer administered structured questionnaire. Binary logistic regressions with 95% confidence interval were used to determine the degree of association between covariates and outcome variable. Multicollinearity between independent variables by using the standard error was checked. The goodness of fit was tested by Hosmer-Lemeshow statistic and Omnibus tests. RESULTS Out of 526 participants, a total of 510 study participants were involved in this study thereby making a response rate of 96.9%. In this study, the magnitude of substance use among pregnant women attending ANC was 26.5% (95% CI: 22.7, 30.6%). Among the overall pregnant mothers, 100 (19.6%) chewed khat, 48 (9.4%) drank alcohol, 12 (2.4%) used tobacco products and 28(20.7%) were dual substance users. Pre pregnancy substance use (AOR = 27.25, CI: 14.107-52.66), partner substance use (AOR = 3.704 CI: 1.839-7.464), family substance use (AOR = 3.447 CI: 1.69-7.031) and the amount of monthly household income (AOR = 3.397, 95% CI: 1.316-8.766) were found to be statistically significant and positively associated with substance use during pregnancy. CONCLUSION The magnitude of antenatal substance use in the study area was 26.5%. Pre- pregnancy substance use, partner substance use, monthly house hold income and family substance use were found to be positively associated with substance use during pregnancy. Therefore, health education which is inclusive of child bearing age women with their partner and family may be helpful to decrease antenatal substance use during pregnancy.
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Affiliation(s)
| | - Kedir Teji
- School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
| | - Nega Assefa
- School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia
| | | | - Genet Tsehaye
- College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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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: 8] [Impact Index Per Article: 2.0] [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.
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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
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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.
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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
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Tebeka S, De Premorel Higgons A, Dubertret C, Le Strat Y. Changes in alcohol use and heavy episodic drinking in U.S. Women of childbearing-age and peripartum between 2001-2002 and 2012-2013. Addict Behav 2020; 107:106389. [PMID: 32244086 DOI: 10.1016/j.addbeh.2020.106389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/07/2020] [Accepted: 03/07/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Heavy episodic drinking (HED) is a frequent pattern of alcohol use in women of childbearing age with severe consequences for both women and child, making it a major public health issue. Some states in the US have reported laws that target the use of alcohol during pregnancy. Our aim was to examine the evolution of 12-month alcohol use and 12-month HED prevalence in childbearing age, pregnant and postpartum women between 2001 and 2002 and 2012-2013. METHODS Our data were drawn from the National Epidemiologic Study of Alcohol and Related Conditions (NESARC) conducted in 2001-2002 and NESARC-III conducted in 2012-2013, two independent, representative samples of U.S. POPULATION Past-year alcohol use and HED was evaluated according face-to-face interview for all participants. RESULTS Our sample consisted of 24,536 women of childbearing age, including 2846 pregnant and postpartum women. Prevalence of 12-month alcohol use increased from 2001 to 2002 to 2012-2013, in both childbearing-aged women (66.14% to 75.48%; aOR = 1.62, 95%CI = 1.46-1.80) and pregnant and postpartum women (57.81% to 66.19%; aOR = 1.56, 95%CI = 1.25-1.94). Prevalence of 12-month HED increased from 2001 to 2002 to 2012-2013, in both childbearing-aged women (22.57% to 36.34%; aOR = 1.97, 95%CI = 1.79-2.16) and pregnant and postpartum women (17.85% to 28.21%; aOR = 1.84, 95%CI = 1.47-2.30). CONCLUSIONS Alcohol use and HED increased in last 10 years in both childbearing age and pregnant and postpartum US women. That questions the impact of implemented laws, policies and alcohol guidelines in this population within the last 10 years.
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Affiliation(s)
- Sarah Tebeka
- APHP, Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; Université de Paris, France; Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris F-75014, France.
| | - Alix De Premorel Higgons
- APHP, Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; Université de Paris, France; Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris F-75014, France.
| | - Caroline Dubertret
- APHP, Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; Université de Paris, France; Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris F-75014, France.
| | - Yann Le Strat
- APHP, Department of Psychiatry, Universitary Hospital Louis Mourier, 92700 Colombes, France; Université de Paris, France; Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1266, Paris F-75014, France.
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Tesfaye G, Demlew D, G/tsadik M, Habte F, Molla G, Kifle Y, Gebreegziabher G. The prevalence and associated factors of alcohol use among pregnant women attending antenatal care at public hospitals Addis Ababa, Ethiopia, 2019. BMC Psychiatry 2020; 20:337. [PMID: 32600291 PMCID: PMC7325233 DOI: 10.1186/s12888-020-02747-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 06/19/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Alcohol use during pregnancy is a significant public health problem, ultimately affecting the neonatal offspring. Recent studies explore that no safe amount and safe time to drink alcohol during pregnancy. Even though drinking in pregnancy has a wide range of problems, a small number of scientific publications document on the magnitude of drinking alcohol during pregnancy in Sub-Saharan African countries including Ethiopia. The aim of this study was to assess prevalence and associated factors of alcohol use among pregnant women attending prenatal care at public hospitals, Addis Ababa, Ethiopia. METHODS Hospital based cross sectional study was employed from May 7 to June 6, 2019 at public hospitals, Addis Ababa. A total of 585 pregnant women participated in the study selected through systematic random sampling technique. Frequency of consumption was measured by using AUDIT. Frequency tables and graphs were used to describe the study variable. The association between variables analyzed with bi-variable and multivariable binary logistic regression. A statistical significance was declared at p value < 0.05 with 95% confidence interval. RESULT A total of 585 participants were included in the study with the response rate of 98.6%. The study showed that the prevalence of alcohol use among pregnant women were 37.1% with (95% CI, 33.2-41). Factors like no formal education [AOR = 3.22, 95%CI, 1.72, 6.02], pre-pregnancy alcohol use [AOR = 3.16, 95%CI, 2.03, 4.91], partner alcohol use [AOR = 3.43, 95%CI, 2.21, 5.32], and poor social support [AOR = 3.16, 95%CI, 1.88, 5.31] were statistically associated with alcohol use during pregnancy. CONCLUSION In this study the prevalence of alcohol use during pregnancy was high as compared to majority of other studies. This study observed that no formal education, pre-pregnancy alcohol use, partner alcohol use, and poor social support, were highly associated with alcohol use during pregnancy. Based on the findings of this study early management of alcohol use and problematic alcohol use is needed for pregnant women.
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Affiliation(s)
- Getaneh Tesfaye
- Department of Psychiatry, College of Health Sciences, Aksum University, Aksum, Ethiopia.
| | - Demeke Demlew
- grid.59547.3a0000 0000 8539 4635College of Medicine and Health, Department of Psychiatry, University of Gondar, Gondar, Ethiopia
| | | | | | - Gebeyaw Molla
- Department of Psychiatry, College of Health Sciences, Axum University, Aksum, Ethiopia
| | - Yohannes Kifle
- Department of Psychiatry, College of Health Sciences, Axum University, Aksum, Ethiopia
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21
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Kang SY, Kim HW. [Comparison of Awareness about Alcohol Use during Pregnancy among Female College Students by Drinking Levels: Using the Theory of Planned Behavior]. J Korean Acad Nurs 2020; 49:690-700. [PMID: 31932564 DOI: 10.4040/jkan.2019.49.6.690] [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: 05/08/2019] [Revised: 08/19/2019] [Accepted: 09/18/2019] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to examine the awareness of alcohol use during pregnancy and factors influencing the intention to abstain from alcohol during pregnancy by drinking levels. METHODS Utilizing a comparative descriptive design, a total of 359 female college students were recruited. Measurements were Theory of Planned Behavior (TPB) variables related awareness of alcohol use during pregnancy, Korean Version of the Alcohol Use Disorders Identification Test, knowledge about alcohol use during pregnancy, and socio-demographic factors. Main variables were compared by drinking levels. The factors influencing the intention to abstain from alcohol during pregnancy were identified using hierarchical regression analysis. RESULTS Non-problematic alcohol behavior group (n=185) had higher the intention to abstain from alcohol during pregnancy than problematic alcohol behavior group (n=174) (t=3.13, p=.002). The significant TPB variables influencing the intention to abstain from alcohol during pregnancy were that attitudes (β =-.44, p<.001), subjective norms (β =.14, p=.026), and perceived behavior control (β =.19, p=.002) in non-problematic alcohol behavior group, whereas the corresponding variables in the problematic alcohol behavior group were attitudes (β =-.51, p<.001) and subjective norms (β =.21, p=.006). CONCLUSION It is necessary to increase the intention to abstain from alcohol during pregnancy for the female college students having problematic alcohol behavior. The following strategies are recommended for them; decreasing acceptable attitudes toward alcohol use during pregnancy and reinforcing the influence of social pressure toward to abstain from alcohol during pregnancy.
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Affiliation(s)
- Saem Yi Kang
- College of Nursing, Seoul National University, Seoul, Korea
| | - Hae Won Kim
- College of Nursing · The Research Institute of Nursing Science, Seoul National University, Seoul, Korea.
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22
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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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23
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Romero-Rodríguez E, Cuevas L, Simón L, Bermejo-Sánchez E, Galán I. Changes in Alcohol Intake During Pregnancy in Spain, 1980 to 2014. Alcohol Clin Exp Res 2019; 43:2367-2373. [PMID: 31509616 DOI: 10.1111/acer.14193] [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: 04/13/2019] [Accepted: 08/20/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Even small amounts of alcohol consumed during pregnancy can have adverse effects on the embryo and the fetus. We estimated how alcohol intake among pregnant women in Spain changed between 1980 and 2014, and identified factors associated with alcohol use. METHODS Data came from the Spanish Collaborative Study of Congenital Malformations (ECEMC). The sample includes ECEMC's control mothers, 40,268 pregnant women from all regions of Spain. We classified alcohol consumption during pregnancy into 3 categories: no consumption; sporadic consumption of small amounts of alcohol; and regular consumption, or sporadic but in large quantities including drunkenness. Independent variables included sociodemographic factors, planned/unplanned pregnancy, maternal chronic diseases, gestational diabetes, and tobacco and illegal drug use during pregnancy. Trend analyses were performed using data from 1980 to 2014. The multinomial logistic regression models designed to identify associated factors differentiated between 2 periods: 1994 to 2004 and 2005 to 2014. RESULTS Prevalence of alcohol consumption declined from 29.6% (95% CI: 27.1 to 32.2) in 1980 to 5.4% (95% CI: 3.7 to 7.6) in 2014, mostly due to the reduction in regular intake. This decline was especially acute between 1980 and 1994. Sporadic and regular consumption increased among women working outside the home, born outside Spain, those whose pregnancy was unplanned, and those reporting using tobacco or other drugs. Comparing 1994 to 2004 versus 2005 to 2014, a stronger association was observed between regular alcohol consumption and tobacco consumption in the latter period (interaction p = 0.003). CONCLUSIONS Alcohol consumption among expectant mothers has declined substantially in the last 35 years. However, it is worth highlighting the significant and substantial associations between alcohol use and consumption of tobacco, which have become stronger in the most recent years.
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Affiliation(s)
- Esperanza Romero-Rodríguez
- From the, National Centre for Epidemiology, (ER-R, LS, IG), Instituto de Salud Carlos III, Madrid, Spain.,Maimonides Biomedical Research Institute of Cordoba (IMIBIC), (ER-R), Reina Sofia University Hospital, University of Cordoba, Cordoba, Spain
| | - Lourdes Cuevas
- ECEMC, Research Center on Congenital Anomalies (CIAC), (LC, EB-S), Instituto de Salud Carlos III, Madrid, Spain
| | - Lorena Simón
- From the, National Centre for Epidemiology, (ER-R, LS, IG), Instituto de Salud Carlos III, Madrid, Spain
| | | | - Eva Bermejo-Sánchez
- ECEMC, Research Center on Congenital Anomalies (CIAC), (LC, EB-S), Instituto de Salud Carlos III, Madrid, Spain.,Institute of Rare Diseases Research (IIER), (EB-S), Instituto de Salud Carlos III, Madrid, Spain
| | - Iñaki Galán
- From the, National Centre for Epidemiology, (ER-R, LS, IG), Instituto de Salud Carlos III, Madrid, Spain.,Universidad Autónoma de Madrid/IdiPAZ, (IG), Madrid, Spain
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24
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Ceulemans M, Van Calsteren K, Allegaert K, Foulon V. Health products' and substance use among pregnant women visiting a tertiary hospital in Belgium: A cross-sectional study. Pharmacoepidemiol Drug Saf 2019; 28:1231-1238. [PMID: 31342605 DOI: 10.1002/pds.4862] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 05/07/2019] [Accepted: 06/27/2019] [Indexed: 12/31/2022]
Abstract
PURPOSE To investigate the prevalence and type of health products used among pregnant women visiting a tertiary hospital in Belgium, as well as who advises these products, where women buy these products, which determinants are associated with medication and pregnancy vitamin intake, and preconception lifestyle changes such as folic acid intake and substance use. METHODS A cross-sectional study was performed at the outpatient obstetrics clinics of the University Hospital Leuven, Belgium between November 2016 and March 2017. All pregnant women 18 years and older and understanding Dutch, French, or English were asked to participate in an online survey. RESULTS In total, 379 pregnant women participated. Prevalence of medication use during the preceding week was 52%. Paracetamol (14%), levothyroxine (13%), and antacids (9%) were the most frequently used medicines. Pregnancy vitamins were used by 86% of women, and 97% had used a pregnancy vitamin somewhere during pregnancy. Only 56% initiated folic acid supplementation at least 1 month before pregnancy. Preconception use of folic acid among women following assisted reproductive technology was 73%. Inappropriate use of health products was observed among 3% of women. Prevalence of alcohol use and/or smoking during the preceding week was 6%. Alcohol and smoking cessation mainly occurred after pregnancy diagnosis. CONCLUSION Pregnant women living in Belgium frequently use medicines, pregnancy vitamins, and other health products. Preconception lifestyle changes such as folic acid intake and alcohol and smoking cessation are poorly implemented. Public campaigns and interventions are needed to improve preconception care and counselling.
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Affiliation(s)
- Michael Ceulemans
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
| | - Kristel Van Calsteren
- Department of Obstetrics and Gynecology, University Hospital Gasthuisberg Leuven, Leuven, Belgium.,Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, Woman and Child, KU Leuven, Leuven, Belgium.,Department of Pediatrics, Division of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Clinical Pharmacology and Pharmacotherapy, KU Leuven, Leuven, Belgium
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25
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Ramstedt M. Concurrent use of addictive substances among alcohol drinkers: Prevalence and problems in a Swedish general population sample. NORDIC STUDIES ON ALCOHOL AND DRUGS 2019; 36:402-412. [PMID: 32934575 PMCID: PMC7434143 DOI: 10.1177/1455072519853917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/06/2019] [Indexed: 11/20/2022] Open
Abstract
Aims: To examine concurrent use of addictive substances among alcohol drinkers in the Swedish general population and to assess to what extent this increases the risk of alcohol problems. Methods: Data were retrieved from a nationally representative survey from 2013 on use of and problems related to alcohol, tobacco, illicit drugs and non-prescribed use of analgesics and sedatives with 15,576 respondents. Alcohol users were divided into different groups on the basis of frequency of drinking overall and binge drinking. Tobacco use was measured in terms of daily use and use of illicit drugs and non-prescribed use of analgesics and sedatives were measured in terms of last 12 months prevalence. A dichotomous indicator of a DSM-IV dependence or abuse diagnosis was used. Logistic regression models were estimated to examine the relationship between various patterns of drinking in combination with other substance use and risk of alcohol abuse and/or dependence. Results: People who drink alcohol in Sweden were more likely to use other addictive substances than non-drinkers and such concurrent use becomes more common the more alcohol is consumed. Alcohol drinkers using other substances have a higher prevalence of alcohol abuse and dependence at all frequencies of drinking. Multivariate models controlling for sex, age and drinking frequency found that an elevated risk of harm remained for drinkers using addictive substances other than snuff. Conclusion: A large group of drinkers in the Swedish general population have an accumulation of risks as a result of using both alcohol and other addictive substances. Concurrent use of cigarettes, illicit drugs and non-prescribed use of analgesics and sedatives adds an independent risk of alcohol abuse/dependence in this group in addition to their drinking. The findings point at the importance of taking multiple substance-use patterns into account when combating drinking problems. Screening for concurrent use of other addictive substances could help healthcare providers to identify patients in need of treatment for alcohol problems.
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Affiliation(s)
- Mats Ramstedt
- The Swedish Council for Information on Alcohol and Other Drugs (CAN), Stockholm, Sweden
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26
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Mattson SN, Bernes GA, Doyle LR. Fetal Alcohol Spectrum Disorders: A Review of the Neurobehavioral Deficits Associated With Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2019; 43:1046-1062. [PMID: 30964197 DOI: 10.1111/acer.14040] [Citation(s) in RCA: 156] [Impact Index Per Article: 31.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/03/2019] [Indexed: 11/26/2022]
Abstract
In utero alcohol exposure can disrupt the development of the fetal brain and result in a wide range of neurobehavioral outcomes collectively known as fetal alcohol spectrum disorders (FASD). This paper provides a comprehensive review of the cognitive and behavioral outcomes of prenatal alcohol exposure, including domains of general intelligence, executive functioning, language development, learning and memory, adaptive functioning, academic performance, and concurrent psychopathology. In addition, the current status of the neurobehavioral profile of FASD and its potential as a diagnostic tool will be discussed.
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Affiliation(s)
- Sarah N Mattson
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
| | - Gemma A Bernes
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
| | - Lauren R Doyle
- Center for Behavioral Teratology and Department of Psychology, San Diego State University, San Diego, California
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27
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Schölin L, Hughes K, Bellis MA, Eriksson C, Porcellato L. Exploring practices and perceptions of alcohol use during pregnancy in England and Sweden through a cross-cultural lens. Eur J Public Health 2019; 28:533-537. [PMID: 29206945 DOI: 10.1093/eurpub/ckx208] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background Qualitative studies have aimed to understand why some women continue to drink during pregnancy; however, there is a lack of comparative cross-cultural research. We aimed to explore perceptions and practices of alcohol use during pregnancy in England and Sweden. Methods Semi-structured interviews were conducted with 21 parents in Merseyside, England and 22 parents in Örebro County, Sweden. Interviews were audio recorded, transcribed verbatim and translated. Data were analyzed using thematic analysis. Results The majority of women in both countries abstained from alcohol when they found out they were pregnant, despite alcohol being part of many social contexts before pregnancy. Nine of the seventeen English women drank at some point during pregnancy, typically on special occasions. Most parents felt women should modify their alcohol intake when they become mothers, though several English parents argued that responsible motherhood did not necessarily equate to abstinence. Swedish parents held strong opinions against drinking during pregnancy and argued that any amount of alcohol could harm the foetus. English parents' opinions were divided; some were skeptical of whether low to moderate drinking was associated with risks. Conclusions Practices and attitudes towards alcohol use during pregnancy and views on foetal rights and responsibilities of pregnant women differed in England and Sweden. Shared social norms around drinking may be shaped within the policy context of pregnancy drinking guidelines, determining whether women consume alcohol or not.
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Affiliation(s)
- Lisa Schölin
- Nursing Studies, School of Health in Social Science, University of Edinburgh, Edinburgh, UK.,Public Health Institute, Liverpool John Moores University, 15-21 Webster Street, Liverpool, UK
| | - Karen Hughes
- Public Health Wales, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, UK
| | - Mark A Bellis
- Public Health Wales, Hadyn Ellis Building, Cardiff University, Maindy Road, Cardiff, UK
| | - Charli Eriksson
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Lorna Porcellato
- Public Health Institute, Liverpool John Moores University, 15-21 Webster Street, Liverpool, UK
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28
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Guimarães VA, Fernandes KS, Lucchese R, Vera I, Martins BCT, Amorim TAD, Guimarães RA. [Prevalence and factors associated with alcohol use during pregnancy in a maternity hospital in Goiás, Central Brazil]. CIENCIA & SAUDE COLETIVA 2019; 23:3413-3420. [PMID: 30365860 DOI: 10.1590/1413-812320182310.24582016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Accepted: 10/05/2016] [Indexed: 11/22/2022] Open
Abstract
The scope of this article is to estimate the prevalence and factors associated with alcohol use during pregnancy. It involved a cross-sectional study in a sample of 361 pregnant women in a reference service for gynecological and prenatal care. The data related to socio-demographic characteristics, alcohol use and potential associated factors were collected through face-to-face interviews. Poisson regression with robust variance was used to identify factors associated with the outcome analyzed. The consumption of alcohol in the sample was 17.7% (95% CI: 95% CI: 14.1% to 22.0%). A history of pre-gestational or gestational diabetes, suicidal ideation and tobacco use in the last 30 days was associated with alcohol use during pregnancy (p < 0.05). The study showed a high prevalence of alcohol use during the current pregnancy and its association with important factors. Actions such as screening for alcohol and advice on problems associated with the use of this substance, especially during the prenatal period, can contribute to effective reduction of alcohol use in pregnant women and related maternal and fetal injuries.
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Affiliation(s)
- Vanessa Alves Guimarães
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Kelly Silveira Fernandes
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Roselma Lucchese
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Ivânia Vera
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Bruno César Teodoro Martins
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Thiago Aquino de Amorim
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
| | - Rafael Alves Guimarães
- Universidade Federal de Goiás. Av. Dr. Lamartine Pinto de Avelar 1120, Setor Universitário. 75704-020 Catalão GO Brasil.
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Edwards AC, Ohlsson H, Svikis DS, Sundquist J, Sundquist K, Kendler KS. Protective Effects of Pregnancy on Risk of Alcohol Use Disorder. Am J Psychiatry 2019; 176:138-145. [PMID: 30486670 PMCID: PMC6358475 DOI: 10.1176/appi.ajp.2018.18050632] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The authors sought to clarify the etiology of the association between pregnancy and reduced risk of alcohol use disorder. METHODS The authors used data from longitudinal population-wide Swedish medical, pharmacy, and criminal registries to evaluate whether rates of alcohol use disorder are lower during pregnancy. They compared pregnant women born between 1975 and 1992 (N=322,029) with matched population controls, with female relatives discordant for pregnancy, and with pre- and postpregnancy periods within individuals. They further compared rates of alcohol use disorder between pregnant women and their partners. RESULTS Pregnancy was inversely associated with alcohol use disorder across all analyses (odds ratios, 0.17-0.32). In co-relative analyses, the strength of the association increased among more closely related individuals. Within individuals, rates of alcohol use disorder were substantially decreased during pregnancy relative to the prepregnancy period (odds ratios, 0.25-0.26), and they remained reduced during postpartum periods (odds ratios, 0.23-0.31). Results were similar for second pregnancies (odds ratio, 0.23). The partners of pregnant women also exhibited reductions in alcohol use disorder (odds ratio, 0.45). Among women who became pregnant at earlier ages and those with a history of criminal behavior, the negative association between pregnancy and alcohol use disorder was especially pronounced, but no moderation was observed for a personal or maternal parental history of alcohol use disorder. CONCLUSIONS The findings suggest that pregnancy plays a critical, and likely causal, motivational role in reducing alcohol use disorder risk among women and, to a lesser extent, their partners. These results extend our understanding of the relationship between pregnancy and alcohol use, demonstrating that even a severe condition such as alcohol use disorder is subject to the protective effects of pregnancy.
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Affiliation(s)
- Alexis C. Edwards
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, US,Corresponding author: Alexis C. Edwards; VCU, PO Box 980126, Richmond, VA, 23298-0126; Ph: +1 804-828-8591; Fax: +1 804-828-1471;
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Dace S. Svikis
- Departments of Psychology, Psychiatry, and Obstetrics/Gynecology, Virginia Commonwealth University, Richmond, VA, US
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden,Icahn School of Medicine at Mount Sinai, New York, NY, US,These authors jointly supervised this work
| | - Kenneth S. Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, US,These authors jointly supervised this work
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30
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Deutsch AR. The Importance of Intimate Partner Violence in Within-Relationship and Between-Person Risk for Alcohol-Exposed Pregnancy. Alcohol Clin Exp Res 2019; 43:679-689. [PMID: 30698820 DOI: 10.1111/acer.13968] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 01/21/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Preconceptual prevention programs geared toward reducing alcohol-exposed pregnancy (AEP) typically emphasize behavioral change of alcohol use and birth control exclusively, but rarely consider other important AEP predictors that may affect behavioral change. Intimate partner violence (IPV) substantially relates to AEP and to AEP predictors; however, few studies have tested if IPV is a unique indicator of prospective AEP risk, as both a main effect and a contextual influence on alcohol use or birth control. METHODS Using Waves II and III of the National Longitudinal Study of Adolescent to Adult Health, multilevel logistic regression models were estimated, in which IPV and birth control (both within-person and between-person) and adolescent alcohol use (between-person only) were examined as unique predictors of AEP compared to both nonpregnancy and non-AEP (nAEP) outcomes over up to 5 sexual relationships. Interactions between within-person and between-person IPV, and birth control or alcohol use were also tested. RESULTS Within-person and between-person IPV significantly related to higher odds of AEP compared to nonpregnancy and nAEP. Adolescent alcohol use had similarly increased odds for AEP when compared to nonpregnancy or nAEP outcomes. Only between-person birth control use related to higher odds for AEP compared to nonpregnancy and nAEP. Between-person IPV also moderated adolescent alcohol use on odds of AEP, such that infrequent adolescent drinkers had higher odds of AEP compared to nonpregnancy or nAEP if they experienced IPV over their relationships. CONCLUSIONS IPV is a substantial predictor for AEP as both a direct influence within relationships (within-person) and between individuals (between-person). Intervention and prevention programs focused on reducing AEP may benefit from including IPV-specific curricula.
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Affiliation(s)
- Arielle R Deutsch
- Population Health, Sanford Research, Sioux Falls, South Dakota.,Pediatrics, School of Medicine, University of South Dakota, Vermillion, South Dakota
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31
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Römer P, Reinelt T, Petermann F, Teickner C. Alkoholkonsum während der Schwangerschaft. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000267] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Kinder sind bereits im Mutterleib sensitiv für Umwelteinflüsse. Pränataler Alkoholkonsum zählt dabei zu den einflussreichsten Risikofaktoren für die frühkindliche Entwicklung. Das Ziel ist es, einen Überblick über die aktuelle Forschungslage zum Thema Alkoholkonsum während der Schwangerschaft zu geben. Darüber hinaus wird der Forschungsstand zu Belastungen und Folgeschäden für die frühkindliche Entwicklung durch pränatale Alkoholexposition, aber auch zu weiteren Risikofaktoren zusammengefasst. Es wird gezeigt, dass das Wissen um die Prävalenz für Alkoholkonsum während der Schwangerschaft sowohl für die Erforschung der Folgen als auch für das Umsetzen von präventiven Maßnahmen ausschlaggebend ist. Die Prävalenzen unterscheiden sich nicht nur regional, sondern können auch durch andere Faktoren beeinflusst werden. Es wird deutlich, dass der Risikofaktor Alkohol und dessen mögliche Auswirkungen auf die frühkindliche Entwicklung nicht isoliert, sondern in Abhängigkeit von weiteren genetischen und Umweltfaktoren betrachtet werden müssen. Denn auch Folgen von weiteren perinatalen Risikofaktoren machen sich in den ersten beiden Lebensjahren bemerkbar. Beispiele für Entwicklungsstörungen in dieser Entwicklungsspanne sind externalisierendes Verhalten und kognitive Beeinträchtigungen. Inwieweit sich perinatale Risikofaktoren jedoch auf Entwicklungsverläufe von Kindern, die durch pränatalen Alkoholkonsum belastet sind, auswirken, erfasst eine umfassende Diskussion. Diese Lücke gilt es zu schließen um das Zusammenspiel perinataler Risiken genauer zu verstehen und adäquat entgegenwirken zu können.
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Affiliation(s)
- Pia Römer
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Tilman Reinelt
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
| | - Claudia Teickner
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen
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Symons M, Pedruzzi RA, Bruce K, Milne E. A systematic review of prevention interventions to reduce prenatal alcohol exposure and fetal alcohol spectrum disorder in indigenous communities. BMC Public Health 2018; 18:1227. [PMID: 30390661 PMCID: PMC6215602 DOI: 10.1186/s12889-018-6139-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/22/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) is a preventable, lifelong neurodevelopmental disorder caused by prenatal alcohol exposure. FASD negatively impacts individual Indigenous communities around the world. Although many prevention interventions have been developed and implemented, they have not been adequately evaluated. This systematic review updates the evidence for the effectiveness of FASD prevention interventions in Indigenous/Aboriginal populations internationally, and in specific populations in North America and New Zealand, and offers recommendations for future work. METHOD The MEDLINE, Embase, CINAHL Plus, Web of Science, PsycINFO, SocINDEX, and Informit databases were searched from inception to 22/08/2017 for all prevention and intervention papers published in peer-reviewed scientific journals, with results, targeting prenatal alcohol exposure and FASD in Indigenous populations. This review was limited to studies published in English and excluded interventions focusing on the workforce. All steps were completed independently by two reviewers with discrepancies resolved via consensus with the senior author. RESULTS There was significant heterogeneity in the ten included studies. Populations targeted included non-pregnant women of child-bearing age, pregnant women, school children and the general public. Study designs included one randomised controlled trial, five cohort studies with pre-post design, one cross-sectional study with different pre- and post-intervention groups, and four studies collected post-intervention data. Studies assessed changes in knowledge, and/or changes in risk for prenatal alcohol exposure including self-reported alcohol consumption, use of birth control or a combination of both. One study was conducted in Australia and nine in the US. The methodological quality of all studies was rated as 'Poor' using the systematic review assessment tools developed by The National Heart, Lung and Blood Institute. Studies were subject to substantial bias due to issues such as high loss to follow-up, lack of control groups and the reliance on self-report measures to assess the main outcome. CONCLUSION Overall, there is little evidence that previous interventions aiming to reduce the risk of prenatal alcohol exposure or FASD in Indigenous populations have been effective. Future intervention studies should address the cultural factors and historical context that are fundamental to successful work with Indigenous populations, and be designed, implemented and evaluated using rigorous methods. This systematic review was registered with PROSPERO, CRD42018086212.
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Affiliation(s)
- Martyn Symons
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
- National Health and Medical Research Council FASD Research Australia Centre of Research Excellence, Perth, Australia
| | - Rebecca Anne Pedruzzi
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Kaashifah Bruce
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
| | - Elizabeth Milne
- Telethon Kids Institute, The University of Western Australia, PO Box 855, West Perth, Perth, WA 6872 Australia
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Prevalence and Factors Influencing Alcohol Use in Pregnancy among Women Attending Antenatal Care in Dodoma Region, Tanzania: A Cross-Sectional Study. J Pregnancy 2018; 2018:8580318. [PMID: 30420920 PMCID: PMC6211147 DOI: 10.1155/2018/8580318] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Revised: 09/19/2018] [Accepted: 09/26/2018] [Indexed: 11/18/2022] Open
Abstract
Background Alcohol use during pregnancy is high despite the well-established evidence on its adverse pregnancy outcomes and poor child development. Early identification and behavioural modification are of great significance. This study aimed to determine the prevalence and associated factors of alcohol use during pregnancy among women in Dodoma region. Methods 365 randomly selected pregnant women attending antenatal care services in Dodoma region were included. Structured questionnaires were used to assess sociodemographic characteristic and alcohol use. Both descriptive and inferential analyses were used to estimate the prevalence and independent relationships of factors associated with alcohol use in pregnancy, respectively. Results Results showed a prevalence of 15.1% out of the 365 women attending antenatal services in Dodoma region. Prepregnancy alcohol use and having relatives who use alcohol were associated with alcohol use (AOR= 5.19; 95% CI: 4.791-34.867 and AOR=1.57; 95% CI: 1.393-6.248), respectively. Moreover, other associated factors included low education status (AOR=10.636; 95% CI: 1.89-19.844), making local brews as a source of income (AOR=11.44; 95% CI: 1.008-19.86), and not having had complications in previous pregnancies (AOR=4.93; 95% CI: 1.031-23.59). Conclusion There is a significantly high prevalence of alcohol use during pregnancy in Dodoma. Social networks and low social, economic status were associated with alcohol use in pregnancy. There is a need for public health interventions to address alcohol use particularly targeting women of reproductive age with low socioeconomic status.
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Sarman I. Review shows that early foetal alcohol exposure may cause adverse effects even when the mother consumes low levels. Acta Paediatr 2018; 107:938-941. [PMID: 29341271 DOI: 10.1111/apa.14221] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/17/2017] [Accepted: 01/11/2018] [Indexed: 12/21/2022]
Abstract
AIM Studies are increasingly focusing on the effects of prenatal alcohol exposure (PAE) on child health. The aim of this review was to provide paediatricians with new insights to help them communicate key messages about avoiding alcohol during pregnancy. METHODS Inspired by the 7th International Conference on Fetal Alcohol Spectrum Disorder, which focused on integrating research, policy and practice, we studied English language papers published since 2010 on how early PAE triggered epigenetic mechanisms that had an impact on the development of some chronic diseases. We also report the findings of a human study using three-dimensional photography of the face to explore associations between PAE and craniofacial phenotyping. RESULTS Animal models with different alcohol exposure patterns show that early PAE may lead to long-term chronic effects, due to developmental programming for some adult diseases in cardiovascular, metabolic and renal systems. The study with three-dimensional photographing is very promising in helping paediatricians to understand how even small amounts of PAE can affect craniofacial phenotyping. CONCLUSION Even low levels of PAE can cause adverse foetal effects and not just in the brain. It is not currently possible to determine a safe period and level when alcohol consumption would not affect the foetus.
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Affiliation(s)
- Ihsan Sarman
- Department of Clinical Science and Education; Karolinska Institutet; Sachs’ Children's Hospital; Stockholm Sweden
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Correia-Branco A, Keating E, Martel F. Involvement of mTOR, JNK and PI3K in the negative effect of ethanol and metformin on the human first-trimester extravillous trophoblast HTR-8/SVneo cell line. Eur J Pharmacol 2018; 833:16-24. [PMID: 29807029 DOI: 10.1016/j.ejphar.2018.05.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 05/18/2018] [Accepted: 05/24/2018] [Indexed: 10/16/2022]
Abstract
Our aim was to investigate the effect of two xenobiotics to which pregnant woman may be exposed, the drug of abuse ethanol (EtOH) (and its metabolite acetaldehyde (ACA)) and the therapeutic agent metformin (METF), on placentation-related processes in an extravillous trophoblastic (EVTs) cell line (HTR-8/SVneo cells). EtOH, ACA and METF (24 h) significantly reduced cell proliferation rates, culture growth, viability and migratory capacity of HTR-8/SVneo cells. Moreover, both EtOH (100 μM) and METF (1 mM) increased the apoptosis index and inhibited 3H-deoxy-D-glucose (3H-DG) and 3H-folic acid (3H-FA) uptake. mTOR, JNK and PI3K intracellular signaling pathways were involved in the effect of EtOH upon 3H-FA uptake and in the effect of METF upon cell viability, and mTOR and JNK in the effect of EtOH upon cell viability and 3H-DG uptake. We show that EtOH and METF have a detrimental effect in placentation-related processes of HTR-8/SVneo cells. Moreover, mTOR, JNK and PI3K appear to mediate some of these negative effects.
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Affiliation(s)
- Ana Correia-Branco
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal
| | - Elisa Keating
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; CINTESIS, Center for Health Technology and Services Research, University of Porto, Porto, Portugal
| | - Fátima Martel
- Unit of Biochemistry, Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; I3S, Instituto de Investigação e Inovação em Saúde, University of Porto, Porto, Portugal.
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McCormack C, Hutchinson D, Burns L, Youssef G, Wilson J, Elliott E, Allsop S, Najman J, Jacobs S, Rossen L, Olsson C, Mattick R. Maternal and partner prenatal alcohol use and infant cognitive development. Drug Alcohol Depend 2018; 185:330-338. [PMID: 29499553 DOI: 10.1016/j.drugalcdep.2017.12.038] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 12/19/2017] [Accepted: 12/21/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Teratogenicity of heavy prenatal alcohol exposure is established, but uncertainty remains regarding the impact of moderate alcohol exposure on cognitive deficits in infants. Separating in utero effects from environmental confounding is a challenge for observational studies; consideration of alcohol use by partners as well as mothers may help clarify this. This study examined associations between prenatal alcohol use by both mothers and their partners and infant cognitive developmental outcomes at 12-months. METHODS Pregnant women (n = 1331) and their partners (n = 699) were recruited from antenatal clinics of three metropolitan public hospitals in Australia, and completed detailed interviews about alcohol consumptions throughout pregnancy. Infants were assessed with the Bayley Scales of Infant Development - Third edition (Bayley) at 12-months of age. RESULTS Alcohol use during pregnancy was reported by 65.7% of mothers and 84.1% of partners. Using multiple methods to adjust for confounding factors, no evidence for impaired cognitive ability associated with alcohol use by mothers or their partners was observed. Children born to women who drank low-levels of alcohol had slightly higher Bayley cognitive scores than those born to abstaining women. There was some evidence for an interaction between sociodemographic factors and prenatal alcohol exposure on infant cognitive outcomes. CONCLUSION This finding corroborates existing evidence to suggest there are no detrimental effects to infant cognitive development at 12-months of age following low-level prenatal alcohol exposure. Future prospective studies involving families of a broad range of backgrounds would be informative to clarify interaction between alcohol exposure and environmental factors on developmental outcomes.
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Affiliation(s)
- Clare McCormack
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St., Randwick, NSW 2031, Australia; Department of Psychiatry, Columbia University Medical Center, 622 West 168th St., New York, NY 10032, USA.
| | - Delyse Hutchinson
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St., Randwick, NSW 2031, Australia; Centre for Social and Early Emotional Development, Deakin University, 221 Burwood Hwy., Burwood, VIC 3125, Australia; Centre for Adolescent Health, Royal Children's Hospital, 50 Flemington Rd., Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Royal Children's Hospital, 50 Flemington Rd., Parkville, VIC 3052, Australia
| | - Lucy Burns
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St., Randwick, NSW 2031, Australia
| | - George Youssef
- Centre for Social and Early Emotional Development, Deakin University, 221 Burwood Hwy., Burwood, VIC 3125, Australia; Centre for Adolescent Health, Royal Children's Hospital, 50 Flemington Rd., Parkville, VIC 3052, Australia
| | - Judy Wilson
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St., Randwick, NSW 2031, Australia
| | - Elizabeth Elliott
- Paediatrics and Child Health, University of Sydney, NSW 2006, Australia
| | - Steve Allsop
- National Drug Research Institute, Curtin University, Kent St., Bentley, Perth 6102, Australia
| | - Jake Najman
- Queensland Alcohol and Drug Research Education Centre, University of Queensland, Brisbane, St. Lucia, QLD 4072, Australia
| | - Sue Jacobs
- Dept of Obstetrics, Royal Prince Alfred Hospital,Missenden Rd., Camperdown, NSW 2050, Australia
| | - Larissa Rossen
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St., Randwick, NSW 2031, Australia
| | - Craig Olsson
- Centre for Social and Early Emotional Development, Deakin University, 221 Burwood Hwy., Burwood, VIC 3125, Australia; Centre for Adolescent Health, Royal Children's Hospital, 50 Flemington Rd., Parkville, VIC 3052, Australia; Department of Paediatrics, University of Melbourne, Royal Children's Hospital, 50 Flemington Rd., Parkville, VIC 3052, Australia
| | - Richard Mattick
- National Drug and Alcohol Research Centre, University of New South Wales, 22-32 King St., Randwick, NSW 2031, Australia
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Comasco E, Rangmar J, Eriksson UJ, Oreland L. Neurological and neuropsychological effects of low and moderate prenatal alcohol exposure. Acta Physiol (Oxf) 2018; 222. [PMID: 28470828 DOI: 10.1111/apha.12892] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 02/17/2017] [Accepted: 04/27/2017] [Indexed: 01/18/2023]
Abstract
Several explanations for the diverse results in research on foetal alcohol spectrum disorders or alcohol-related neurodevelopmental disorder might be at hand: timing, amount and patterns of alcohol exposure, as well as complex epigenetic responses. The genetic background of the offspring and its interaction with other prenatal and post-natal environmental cues are likely also of importance. In the present report, key findings about the possible effects of low and moderate doses of maternal alcohol intake on the neuropsychological development of the offspring are reviewed and plausible mechanisms discussed. Special focus is put on the serotonergic system within developmental and gene-environment frameworks. The review also suggests guidelines for future studies and also summarizes some of to-be-answered questions of relevance to clinical practice. Contradictory findings and paucity of studies on the effects of exposure to low alcohol levels during foetal life for the offspring's neuropsychological development call for large prospective studies, as well as for studies including neuroimaging and multi-omics analyses to dissect the neurobiological underpinnings of alcohol exposure-related phenotypes and to identify biomarkers. Finally, it remains to be investigated whether any safe threshold of alcohol drinking during pregnancy can be identified.
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Affiliation(s)
- E. Comasco
- Department of Neuroscience; Uppsala University; Uppsala Sweden
| | - J. Rangmar
- Department of Psychology; University of Gothenburg; Gothenburg Sweden
| | - U. J. Eriksson
- Department of Medical Cell Biology; Uppsala University; Uppsala Sweden
| | - L. Oreland
- Department of Neuroscience; Uppsala University; Uppsala Sweden
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Robinson M, Wilkinson RB, Fletcher R, Bruno R, Baker AL, Maher L, Wroe J, Dunlop AJ. Alcohol Text Messages: A Developmental Study. Int J Ment Health Addict 2017; 16:1125-1139. [PMID: 30416401 PMCID: PMC6208711 DOI: 10.1007/s11469-017-9835-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Risky paternal alcohol use is associated with maternal alcohol use during pregnancy, poor fetal and infant outcomes, domestic violence and depression. This study developed 30 SMS text messages about alcohol for fathers who drink at risky levels. The text messages were developed using two motivational styles: messages presented in a second person voice and the same messages presented in a child's voice. Fifty-one fathers were recruited through social media to complete an online survey rating the SMS text messages for message importance and likelihood of seeking further information and measuring risky alcohol use and psychosocial distress. Seventeen participants then participated in a semi-structured qualitative interview. Fathers rated the text messages presented in the child's voice as more important than messages presented in the second person. Qualitative data supported survey results that motivational SMS text messages could provide an acceptable way to raise awareness of risky alcohol consumption for future fathers.
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Affiliation(s)
- Maryanne Robinson
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
- 12 Alfred Street, Newcastle East, New South Wales 2300 Australia
| | - R. B. Wilkinson
- School of Psychology, Faculty of Science, University of Newcastle, Callaghan, New South Wales Australia
| | - R. Fletcher
- Family Action Centre, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - R. Bruno
- School of Medicine, University of Tasmania, Hobart, Australia
| | - A. L. Baker
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - L. Maher
- The Kirby Institute, University of New South Wales, Sydney, New South Wales Australia
| | - J. Wroe
- Family Action Centre, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
| | - A. J. Dunlop
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales Australia
- Drug and Alcohol Clinical Services, Hunter New England Local Health District, New Lambton, New South Wales Australia
- Centre for Brain and Mental Health, University of Newcastle, Callaghan, New South Wales Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
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Imam MU, Ismail M. The Impact of Traditional Food and Lifestyle Behavior on Epigenetic Burden of Chronic Disease. GLOBAL CHALLENGES (HOBOKEN, NJ) 2017; 1:1700043. [PMID: 31565292 PMCID: PMC6607231 DOI: 10.1002/gch2.201700043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 07/12/2017] [Indexed: 05/11/2023]
Abstract
Noncommunicable chronic diseases (NCCDs) are the leading causes of morbidity and mortality globally. The mismatch between present day diets and ancestral genome is suggested to contribute to the NCCDs burden, which is promoted by traditional risk factors like unhealthy diets, physical inactivity, alcohol and tobacco. However, epigenetic evidence now suggests that cumulatively inherited epigenetic modifications may have made humans more prone to the effects of present day lifestyle factors. Perinatal starvation was widespread in the 19th century. This together with more recent events like increasing consumption of western and low fiber diets, smoking, harmful use of alcohol, physical inactivity, and environmental pollutants may have programed the human epigenome for higher NCCDs risk. In this review, on the basis of available epigenetic data it is hypothesized that transgenerational effects of lifestyle factors may be contributing to the current global burden of NCCDs. Thus, there is a need to reconsider prevention strategies so that the subsequent generations will not have to pay for our sins and those of our ancestors.
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Affiliation(s)
- Mustapha U. Imam
- Precision Nutrition Innovation InstituteCollege of Public HealthZhengzhou UniversityZhengzhou450001China
| | - Maznah Ismail
- Laboratory of Molecular BiomedicineInstitute of BioscienceUniversiti Putra MalaysiaSerdangSelangor43400Malaysia
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Lange S, Probst C, Rehm J, Popova S. Prevalence of binge drinking during pregnancy by country and World Health Organization region: Systematic review and meta-analysis. Reprod Toxicol 2017; 73:214-221. [DOI: 10.1016/j.reprotox.2017.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2017] [Accepted: 08/04/2017] [Indexed: 10/19/2022]
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Singal D, Brownell M, Chateau D, Wall-Wieler E, Longstaffe S, Hanlon-Dearman A, Roos LL. Suicide and suicide attempts among women in the Manitoba Mothers and Fetal Alcohol Spectrum Disorder cohort: a retrospective matched analysis using linked administrative data. CMAJ Open 2017; 5:E646-E652. [PMID: 28830865 PMCID: PMC5621956 DOI: 10.9778/cmajo.20160127] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Women who give birth to children with fetal alcohol spectrum disorder (FASD) may be at increased risk for suicide; however, there are few data in this area. The objective of this study was to compare rates of suicide between women who had given birth to children with FASD and women who had not given birth to children with FASD during critical periods in their lives, including before pregnancy, during pregnancy, during the postpartum period (maternal death) and until the end of the study period. METHODS We conducted a retrospective cohort analysis of women with children born in Manitoba between Apr. 1, 1984, and Mar. 31, 2012 in whom FASD was diagnosed between Apr. 1, 1999, and Mar. 31, 2012, with follow-up until Dec. 1, 2013 (FASD group; n = 702). We generated a comparison group of women who had not given birth to children with FASD (n = 2097), matched up to 1:3 on date of birth of the index child, socioeconomic status and region of residence. We used linked administrative data to investigate suicide attempt and completion rates in the 2 groups. Regression modelling produced relative rates (RRs) adjusted for socioeconomic status and age at birth of the index child and was used to assess suicide risk. RESULTS The 2799 participants produced 40 390.21 person-years until the end of the study period. Compared to the comparison group, the FASD group had higher rates of suicide completion (adjusted RR 6.20 [95% confidence interval (CI) 2.36-16.31]), a higher number of women who attempted suicide after the postpartum period until the end of the study period (adjusted RR 4.62 [95% CI 2.53-8.43]) and a higher number of attempts after the postpartum period until the end of the study period (adjusted RR 3.92 [95% CI 2.30-6.09]). INTERPRETATION This study identified a group of women with increased rates of social complexities, mental disorders and alcohol use, which places them at risk for suicide. Interventions are needed that screen for suicidal behaviour in women who are at high risk to consume alcohol during pregnancy and have mental disorders.
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Affiliation(s)
- Deepa Singal
- Affiliations: Department of Community Health Sciences and the Manitoba Centre for Health Policy (Singal, Brownell, Chateau, Wall-Wieler, Roos) and Department of Pediatrics and Child Health (Longstaffe, Hanlon-Dearman), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Marni Brownell
- Affiliations: Department of Community Health Sciences and the Manitoba Centre for Health Policy (Singal, Brownell, Chateau, Wall-Wieler, Roos) and Department of Pediatrics and Child Health (Longstaffe, Hanlon-Dearman), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Dan Chateau
- Affiliations: Department of Community Health Sciences and the Manitoba Centre for Health Policy (Singal, Brownell, Chateau, Wall-Wieler, Roos) and Department of Pediatrics and Child Health (Longstaffe, Hanlon-Dearman), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Elizabeth Wall-Wieler
- Affiliations: Department of Community Health Sciences and the Manitoba Centre for Health Policy (Singal, Brownell, Chateau, Wall-Wieler, Roos) and Department of Pediatrics and Child Health (Longstaffe, Hanlon-Dearman), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Sally Longstaffe
- Affiliations: Department of Community Health Sciences and the Manitoba Centre for Health Policy (Singal, Brownell, Chateau, Wall-Wieler, Roos) and Department of Pediatrics and Child Health (Longstaffe, Hanlon-Dearman), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Ana Hanlon-Dearman
- Affiliations: Department of Community Health Sciences and the Manitoba Centre for Health Policy (Singal, Brownell, Chateau, Wall-Wieler, Roos) and Department of Pediatrics and Child Health (Longstaffe, Hanlon-Dearman), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
| | - Leslie L Roos
- Affiliations: Department of Community Health Sciences and the Manitoba Centre for Health Policy (Singal, Brownell, Chateau, Wall-Wieler, Roos) and Department of Pediatrics and Child Health (Longstaffe, Hanlon-Dearman), Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Man
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Consumption of alcohol during pregnancy—A multinational European study. Women Birth 2017; 30:e207-e213. [DOI: 10.1016/j.wombi.2017.01.003] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 01/02/2017] [Accepted: 01/03/2017] [Indexed: 11/20/2022]
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Ericson L, Magnusson L, Hovstadius B. Societal costs of fetal alcohol syndrome in Sweden. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2017; 18:575-585. [PMID: 27279344 PMCID: PMC5438823 DOI: 10.1007/s10198-016-0811-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Accepted: 05/24/2016] [Indexed: 05/14/2023]
Abstract
OBJECTIVE To estimate the annual societal cost of fetal alcohol syndrome (FAS) in Sweden, focusing on the secondary disabilities thought feasible to limit via early interventions. METHODS Prevalence-based cost-of-illness analysis of FAS in Sweden for 2014. Direct costs (societal support, special education, psychiatric disorders and alcohol/drug abuse) and indirect costs (reduced working capacity and informal caring), were included. The calculations were based on published Swedish studies, including a register-based follow-up study of adults with FAS, reports and databases, and experts. RESULTS The annual total societal cost of FAS was estimated at €76,000 per child (0-17 years) and €110,000 per adult (18-74 years), corresponding to €1.6 billion per year in the Swedish population using a prevalence of FAS of 0.2 %. The annual additional cost of FAS (difference between the FAS group and a comparison group) was estimated at €1.4 billion using a prevalence of 0.2 %. The major cost driver was the cost of societal support. CONCLUSIONS The cost burden of FAS on the society is extensive, but likely to be underestimated. A reduction in the societal costs of FAS, both preventive and targeted interventions to children with FAS, should be prioritized. That is, the cost of early interventions such as placement in family homes or other forms of housing, and special education, represent unavoidable costs. However, these types of interventions are highly relevant to improve the individual's quality of life and future prospects, and also, within a long-term perspective, to limit the societal costs and personal suffering.
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Affiliation(s)
- Lisa Ericson
- Department of Medicine and Optometry, eHealth Institute, Linnaeus University, 391 82, Kalmar, Sweden.
| | - Lennart Magnusson
- Department of Health and Caring Sciences, The Swedish Family Care Competence Centre, Linnaeus University, Kalmar, Sweden
| | - Bo Hovstadius
- Department of Medicine and Optometry, eHealth Institute, Linnaeus University, 391 82, Kalmar, Sweden
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Ulrich F, Petermann F. Consequences and Possible Predictors of Health-damaging Behaviors and Mental Health Problems in Pregnancy - A Review. Geburtshilfe Frauenheilkd 2016; 76:1136-1156. [PMID: 27904164 PMCID: PMC5123885 DOI: 10.1055/s-0042-118180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/13/2016] [Accepted: 09/25/2016] [Indexed: 12/29/2022] Open
Abstract
In recent decades, the understanding of the short and longer term effects of health-damaging behaviors and mental health problems in pregnant women and the underlying mechanisms of these behaviors and illnesses has significantly increased. In contrast, little is known about the factors affecting individual pregnant women which contribute to health-damaging behaviors and mental illness. The aim of this paper was therefore to summarize the current state of research into the consequences of nicotine and alcohol consumption, malnutrition, excessive weight gain or obesity, and impaired mental health (depression and anxiety) during pregnancy. In addition, the characteristics of pregnant women which increase their risk of developing such behaviors or mental disorders are described. A better knowledge of these risks should make it easier for clinicians to identify cases at risk early on and put measures of support in place. A review of the literature has shown that certain characteristics of pregnant women (e.g. her relationship with her partner, a previous history of mental illness prior to pregnancy) are associated with various health-damaging behaviors as well as with impaired mental health. Affected women often show an accumulated psychosocial stress which was already present prior to the pregnancy and which may persist even after the birth of the child.
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Affiliation(s)
- F. Ulrich
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, Bremen, Germany
| | - F. Petermann
- Zentrum für Klinische Psychologie und Rehabilitation der Universität Bremen, Bremen, Germany
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Onwuka CI, Ugwu EO, Dim CC, Menuba IE, Iloghalu EI, Onwuka CI. Prevalence and Predictors of Alcohol Consumption during Pregnancy in South-Eastern Nigeria. J Clin Diagn Res 2016; 10:QC10-QC13. [PMID: 27790525 DOI: 10.7860/jcdr/2016/21036.8449] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2016] [Accepted: 07/04/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Alcohol consumption during pregnancy is a major public health problem because of the enormous deleterious effects on a developing fetus. Sub-Saharan Africa (SSA) is among the highest per capita rates of alcohol consumption in the world, thus suggesting a high burden of Fetal Alcohol Syndrome Disorder (FASD) in the sub-region. Despite this, there is limited data on alcohol exposed pregnancies for most SSA countries including Nigeria. AIM To determine the prevalence and predictors of alcohol consumption during pregnancy in Enugu, South-Eastern Nigeria. MATERIALS AND METHODS It was a cross-sectional study of 380 consecutive consenting parturients accessing antenatal care at the University of Nigeria Teaching Hospital, Enugu, Nigeria. The information sought for, included the women's socio-demographic characteristics, alcohol use in pregnancy, awareness of the harmful effects of alcohol on the babies including FASD, sources of initial information on awareness, type and quantity of alcohol ingested, reasons for taking alcohol and willingness to stop alcohol ingestion in pregnancy after counseling on the risk of alcohol use in pregnancy. Statistical analysis was both descriptive and inferential at 95% confidence level. A p-value of less than 0.05 was considered statistically significant. RESULTS The prevalence of alcohol consumption in pregnancy was 22.6%. The most common brand of alcoholic beverage consumed was stout beer (62.8%, 54/86). A total of 135 (35.5%) respondents were aware that alcohol is harmful to the fetus. Maternal age 30 years or less, nulliparity, less than tertiary education, pre-pregnancy alcohol consumption and lack of awareness of the harmful effect of alcohol on the fetus, were associated with alcohol consumption during pregnancy (p< 0.05). CONCLUSION The prevalence of alcohol consumption during pregnancy among women in Enugu, South-Eastern Nigeria is high and lack of awareness of harmful effect of alcohol on fetus was a major predictor. There is need for a concerted public health campaign to improve the awareness of harmful effects of alcohol on the fetus.
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Affiliation(s)
- Chidinma Ifechi Onwuka
- Lecturer 1/Honorary Consultant, Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital , Ituku/Ozalla, Enugu, Nigeria
| | - Emmanuel Onyebuchi Ugwu
- Senior Lecturer/Honorary Consultant, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria , Enugu Campus, Enugu, Nigeria
| | - Cyril Chukwudi Dim
- Professor/Honorary Consultant, Department of Obstetrics and Gynaecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria , Enugu Campus, Enugu, Nigeria
| | - Ifeanyi Emmanuel Menuba
- Lecturer 1/Honorary Consultant, Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital , Ituku/Ozalla, Enugu, Nigeria
| | - Emeka Ifeanyi Iloghalu
- Post-Fellowship Senior Registrar, Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital , Ituku/Ozalla, Enugu, Nigeria
| | - Chidozie Ifechi Onwuka
- Lecturer 1/Honorary Consultant Oral & Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, University of Nigeria Teaching Hospital , Ituku/Ozalla, Enugu, Nigeria
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Högberg H, Skagerström J, Spak F, Nilsen P, Larsson M. Alcohol consumption among partners of pregnant women in Sweden: a cross sectional study. BMC Public Health 2016; 16:694. [PMID: 27484750 PMCID: PMC4971635 DOI: 10.1186/s12889-016-3338-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 07/21/2016] [Indexed: 11/29/2022] Open
Abstract
Background Antenatal care in Sweden involves a visit in pregnancy week 6–7 for counseling about lifestyle issues, including alcohol. The aim of this study was to investigate alcohol consumption among partners of pregnant women, their motives for changing drinking patterns when becoming a parent and their perceptions of the midwife’s counseling about alcohol. Method The study was conducted at 30 antenatal care centers across Sweden in 2009–2010. All partners who accompanied a pregnant women in pregnancy week >17 were asked to participate. The questionnaire included questions on alcohol consumption. Results Questionnaires from 444 partners were analyzed. Most, 95 %, of the partners reported alcohol consumption before pregnancy; 18 % were binge drinking (6 standard drinks or more per occasion, each drink containing 12 grams of pure alcohol) at least once every month during the last year. More than half, 58 %, of all partners had decreased their alcohol consumption following pregnancy recognition and a higher proportion of binge drinkers decreased their consumption compared to non-frequent binge drinkers (p = 0.025). Their motives varied; the pregnancy itself, fewer social gatherings (potentially involving alcohol consumption) and a sense of responsibility for the pregnant partner were reported. Of the partners, 37 % reported support for decreased drinking from others (pregnant partner, parents, friend or workmates). Further, most partners appreciated the midwife’s counseling on alcohol. Conclusion A majority of partners decreased their alcohol consumption in transition to parenthood, which also appears to be a crucial time for changing alcohol-drinking patterns. The partners with higher AUDIT-C scores reported more support for decreased drinking. Most partners appreciated the midwife’s talk about alcohol and pregnancy and those who filled out AUDIT in early pregnancy reported that the counseling was more engaging. During pregnancy it is possible to detect partners with high alcohol consumption, and promote interventions for decreased drinking, also for the partners. Written information addressing alcohol use and directed to partners is needed.
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Affiliation(s)
- Hjördis Högberg
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. .,Psykiatri Skåne, Divisionsledningen, Baravägen 1, S-22185, Lund, Sweden.
| | - Janna Skagerström
- Department of Health and Medical Science, Division of Community Medicine, Linköping University, Linköping, Sweden
| | - Fredrik Spak
- Social medicine, University of Gothenburg, Göteborg, Sweden
| | - Per Nilsen
- Department of Health and Medical Science, Division of Community Medicine, Linköping University, Linköping, Sweden
| | - Margareta Larsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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47
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Hoyme HE, Kalberg WO, Elliott AJ, Blankenship J, Buckley D, Marais AS, Manning MA, Robinson LK, Adam MP, Abdul-Rahman O, Jewett T, Coles CD, Chambers C, Jones KL, Adnams CM, Shah PE, Riley EP, Charness ME, Warren KR, May PA. Updated Clinical Guidelines for Diagnosing Fetal Alcohol Spectrum Disorders. Pediatrics 2016; 138:peds.2015-4256. [PMID: 27464676 PMCID: PMC4960726 DOI: 10.1542/peds.2015-4256] [Citation(s) in RCA: 444] [Impact Index Per Article: 55.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/27/2016] [Indexed: 11/24/2022] Open
Abstract
The adverse effects of prenatal alcohol exposure constitute a continuum of disabilities (fetal alcohol spectrum disorders [FASD]). In 1996, the Institute of Medicine established diagnostic categories delineating the spectrum but not specifying clinical criteria by which diagnoses could be assigned. In 2005, the authors published practical guidelines operationalizing the Institute of Medicine categories, allowing for standardization of FASD diagnoses in clinical settings. The purpose of the current report is to present updated diagnostic guidelines based on a thorough review of the literature and the authors' combined expertise based on the evaluation of >10 000 children for potential FASD in clinical settings and in epidemiologic studies in conjunction with National Institute on Alcohol Abuse and Alcoholism-funded studies, the Collaborative Initiative on Fetal Alcohol Spectrum Disorders, and the Collaboration on FASD Prevalence. The guidelines were formulated through conference calls and meetings held at National Institute on Alcohol Abuse and Alcoholism offices in Rockville, MD. Specific areas addressed include the following: precise definition of documented prenatal alcohol exposure; neurobehavioral criteria for diagnosis of fetal alcohol syndrome, partial fetal alcohol syndrome, and alcohol-related neurodevelopmental disorder; revised diagnostic criteria for alcohol-related birth defects; an updated comprehensive research dysmorphology scoring system; and a new lip/philtrum guide for the white population, incorporating a 45-degree view. The guidelines reflect consensus among a large and experienced cadre of FASD investigators in the fields of dysmorphology, epidemiology, neurology, psychology, developmental/behavioral pediatrics, and educational diagnostics. Their improved clarity and specificity will guide clinicians in accurate diagnosis of infants and children prenatally exposed to alcohol.
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Affiliation(s)
- H. Eugene Hoyme
- Sanford Research and Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota;,Center for Applied Genetics and Genomic Medicine and Department of Pediatrics, University of Arizona College of Medicine, Tucson, Arizona
| | - Wendy O. Kalberg
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico
| | - Amy J. Elliott
- Sanford Research and Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota
| | - Jason Blankenship
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico
| | - David Buckley
- Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico
| | - Anna-Susan Marais
- Stellenbosch University Faculty of Medicine and Health Sciences, Stellenbosch, South Africa
| | - Melanie A. Manning
- Departments of Pathology and Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Luther K. Robinson
- Department of Pediatrics, State University of New York at Buffalo School of Medicine and Biomedical Sciences, Buffalo, New York
| | - Margaret P. Adam
- Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
| | - Omar Abdul-Rahman
- Department of Pediatrics, University of Mississippi School of Medicine, Jackson, Mississippi
| | - Tamison Jewett
- Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Claire D. Coles
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Christina Chambers
- Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, California
| | - Kenneth L. Jones
- Department of Pediatrics, University of California, San Diego School of Medicine, La Jolla, California
| | - Colleen M. Adnams
- Department of Psychiatry and Mental Health, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Prachi E. Shah
- Department of Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan
| | - Edward P. Riley
- Department of Psychology, San Diego State University, San Diego, California
| | - Michael E. Charness
- VA Boston Healthcare System, Department of Neurology, Harvard Medical School, and Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
| | - Kenneth R. Warren
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland; and
| | - Philip A. May
- Sanford Research and Department of Pediatrics, Sanford School of Medicine, University of South Dakota, Sioux Falls, South Dakota;,Center on Alcoholism, Substance Abuse and Addictions, University of New Mexico, Albuquerque, New Mexico;,Department of Nutrition, Gillings School of Global Public Health, Nutrition Research Institute, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Niemelä S, Niemelä O, Ritvanen A, Gissler M, Bloigu A, Werler M, Surcel HM. Fetal Alcohol Syndrome and Maternal Alcohol Biomarkers in Sera: A Register-Based Case-Control Study. Alcohol Clin Exp Res 2016; 40:1507-14. [DOI: 10.1111/acer.13101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 04/11/2016] [Indexed: 12/13/2022]
Affiliation(s)
- Solja Niemelä
- Research Unit of Clinical Neuroscience; Faculty of Medicine; University of Oulu; Oulu Finland
- Department of Psychiatry; Lapland Hospital District; Rovaniemi Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit; Seinäjoki Central Hospital; Seinäjoki Finland
- University of Tampere; Seinäjoki Finland
| | - Annukka Ritvanen
- Finnish Register of Congenital Malformations; National Institute for Health and Welfare; Helsinki Finland
| | - Mika Gissler
- National Institute for Health and Welfare; Helsinki Finland
- Nordic School of Public Health; Gothenburg Sweden
| | - Aini Bloigu
- Department of Health Protection; National Institute of Health and Welfare; Oulu Finland
| | - Martha Werler
- Department of Epidemiology; Boston University School of Public Health; Boston Massachusetts
| | - Heljä-Marja Surcel
- Department of Health Protection; National Institute of Health and Welfare; Oulu Finland
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Iversen ML, Sørensen NO, Broberg L, Damm P, Hedegaard M, Tabor A, Hegaard HK. Alcohol consumption and binge drinking in early pregnancy. A cross-sectional study with data from the Copenhagen Pregnancy Cohort. BMC Pregnancy Childbirth 2015; 15:327. [PMID: 26645438 PMCID: PMC4673744 DOI: 10.1186/s12884-015-0757-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 11/20/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since 2007 the Danish Health and Medicines Authority has advised total alcohol abstinence from the time of trying to conceive and throughout pregnancy. The prevalence of binge drinking among pregnant Danish women has nevertheless been reported to be up to 48 % during early pregnancy. Since the introduction of the recommendation of total abstinence, no studies have examined pre-pregnancy lifestyle and reproductive risk factors associated with this behaviour in a Danish context. The aims of this study were therefore to describe the prevalence of weekly alcohol consumption and binge drinking in early pregnancy among women living in the capital of Denmark. Secondly to identify pre-pregnancy lifestyle and reproductive risk factors associated with binge drinking during early pregnancy. METHODS Data were collected from September 2012 to August 2013 at the Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark. Self-reported information on each woman's socio-demographic characteristics, medical history, and lifestyle factors including alcohol habits was obtained from an electronic questionnaire filled out as part of the individual medical record. Descriptive analysis was conducted and multivariate logistic regression analysis was used to assess the potential associated risk factors (adjusted odds ratio (aOR)). RESULTS Questionnaires from 3,238 women were included. A majority of 70 %, reported weekly alcohol consumption before pregnancy. The prevalence decreased to 3 % during early pregnancy. The overall proportion of women reporting binge drinking during early pregnancy was 35 % (n = 1,134). The following independent risk factors for binge drinking in early pregnancy were identified: lower degree of planned pregnancy, smoking and alcohol habits before pregnancy ((1 unit/weekly aOR 4.48, CI: 3.14 - 6.40), (2-7 units aOR 10.23, CI: 7.44-14.06), (≥8 units aOR 33.18, CI: 19.53-56.36)). Multiparity and the use of assisted reproductive technology were associated with lower odds of binge drinking in early pregnancy. CONCLUSION The prevalence of weekly alcohol consumption decreased considerably during early pregnancy compared with pre-pregnancy levels. Nevertheless one third of the pregnant women engaged in binge drinking. Identification of risk factors for this behaviour renders it possible not only to design prevention strategies, but also to target those most at risk.
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Affiliation(s)
- Mette Langeland Iversen
- The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. .,Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Nina Olsén Sørensen
- The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. .,Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
| | - Lotte Broberg
- Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
| | - Peter Damm
- Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
| | | | - Ann Tabor
- Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Center of Fetal Medicine, Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark.
| | - Hanne Kristine Hegaard
- The Research Unit Women's and Children's Health, the Juliane Marie Centre for Women, Children and Reproduction, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark. .,Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. .,Department of Obstetrics, Rigshospitalet, Copenhagen, Denmark. .,Child, Family, and Reproductive Health, Department of Health Science, Faculty of Medicine, Lund University, Lund, Sweden.
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50
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Melchior M, Chollet A, Glangeaud-Freudenthal N, Saurel-Cubizolles MJ, Dufourg MN, van der Waerden J, Sutter-Dallay AL. Tobacco and alcohol use in pregnancy in France: the role of migrant status: the nationally representative ELFE study. Addict Behav 2015; 51:65-71. [PMID: 26233939 DOI: 10.1016/j.addbeh.2015.07.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 07/06/2015] [Accepted: 07/22/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Tobacco and alcohol use in pregnancy are modifiable yet frequent risk factors of poor perinatal outcomes. We examined whether characteristics associated with substance use in pregnancy vary between native and migrant women, who often differ in terms of socio-demographic characteristics. METHODS Data come from a nationally representative sample of children born in France in 2011 (ELFE study, n=18,014). Maternal substance use in pregnancy (tobacco: ≥1 cigarette/day, alcohol: ≥1 time, binge drinking: ≥3 units of alcohol on one occasion) was assessed using survey methodology by a) trained interviewers and b) self-reports. Migration status was determined based on country of birth (native-born vs. migrant). The sample included 2330 migrant women, predominantly from North Africa (35.4% - primarily Algeria and Morocco), Sub-Saharan Africa (27.3% - primarily Senegal, Ivory Coast, the Congo and Cameroun), Europe (20.2% - primarily Portugal and Germany) and Asia (10.2% - primarily Turkey). Characteristics potentially associated with substance use included socio-demographics (maternal age, number of children, relationship status, educational attainment, employment status), health (psychological difficulties, incomplete prenatal care) and partner's characteristics (migration status, employment). RESULTS Compared to the native-born, migrant women had lower levels of tobacco smoking (8.8 vs. 21.9%) and alcohol use (23.4 vs. 40.7%), but not binge drinking (2.9 vs. 3.3%). Unfavorable socioeconomic circumstances were associated with tobacco smoking in native-born women only. Single parenthood was associated with alcohol use only in migrant women. In migrant women, co-occurring use of another substance and psychological difficulties were more strongly associated with use of tobacco, alcohol or binge drinking than in native-born women. CONCLUSIONS Migrant women have less favorable socioeconomic characteristics than native women but are generally less likely to use tobacco and alcohol in pregnancy. However those who experience single-parenthood need special attention, as they are disproportionately likely to use psychoactive substances which put them and their children at risk of poor health outcomes.
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