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Jacobsen B, Lindemann C, Petzina R, Verthein U. The Universal and Primary Prevention of Foetal Alcohol Spectrum Disorders (FASD): A Systematic Review. JOURNAL OF PREVENTION (2022) 2022; 43:297-316. [PMID: 35286547 PMCID: PMC9114092 DOI: 10.1007/s10935-021-00658-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 10/24/2022]
Abstract
Foetal alcohol spectrum disorder (FASD) comprises multiple neurodevelopmental disorders caused by alcohol consumption during pregnancy. With a global prevalence rate of 7.7 per 1000 population, FASD is a leading cause of prenatal developmental disorders. The extent of physical, mental, and social consequences for individuals with FASD can be vast and negatively affect their social environment, daily life, school, relationships, and work. As treatment for FASD is labour- and cost-intensive, with no cure available, prevention is key in reducing FASD prevalence rates. As most systematic reviews conducted so far have focused on specific FASD risk groups, we investigated the effectiveness of universal FASD prevention and primary preventive strategies. We identified a total of 567 potentially pertinent records through PubMed, Cochrane Library, EBSCO, PubPsych, and DAHTA published from 2010 to May 2020, of which 10 studies were included in this systematic review. Results showed a substantial heterogeneity in the studies' quality, although all preventive measures, except one, proved effective in both increasing knowledge and awareness of FASD, as well as decreasing the risk of an alcohol exposed pregnancy. Limiting factors such as small sample sizes and a lack of behavioural change testing require further studies to support existing evidence for FASD prevention and its implementation, as well as detecting the best course of action for FASD prevention when creating and implementing prevention and intervention approaches.
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Affiliation(s)
- Britta Jacobsen
- Department of Psychiatry, Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany
| | - Christina Lindemann
- Department of Psychiatry, Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
- Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany
| | - Rainer Petzina
- Medical School Hamburg (MSH), University of Applied Sciences and Medical University, Hamburg, Germany
| | - Uwe Verthein
- Department of Psychiatry, Centre for Interdisciplinary Addiction Research of Hamburg University (ZIS), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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Mitchell TB, Shah S, Zink L. The Need for Nationwide Electronic Cigarette Smoking Cessation Curricula Across the Healthcare Spectrum. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8212. [PMID: 34965912 PMCID: PMC8715973 DOI: 10.5688/ajpe8212] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 03/09/2021] [Indexed: 06/14/2023]
Abstract
Using electronic nicotine delivery systems (ENDS) has become a stepping stone for smokers in their cessation of tobacco use. Students within Doctor of Pharmacy and other health care programs have expressed varying responses as to how likely they are to recommend ENDS based on their knowledge of these devices. Because the amount of education on these products provided by PharmD programs varies, one study shows student pharmacists were less likely to recommend the use of ENDS to current cigarette smokers. This commentary suggests why some student pharmacists support such recommendations and therefore require more adequate ENDS education to better equip themselves for future patient education counseling sessions.
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Affiliation(s)
- Taylor B Mitchell
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Spruha Shah
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | - Lindsay Zink
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, North Carolina
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Ingersoll K, Frederick C, MacDonnell K, Ritterband L, Lord H, Jones B, Truwit L. A Pilot RCT of an Internet Intervention to Reduce the Risk of Alcohol-Exposed Pregnancy. Alcohol Clin Exp Res 2018; 42:1132-1144. [PMID: 29741798 PMCID: PMC5984155 DOI: 10.1111/acer.13635] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 03/18/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND Preventing alcohol-exposed pregnancies (AEPs) could reduce the incidence of fetal alcohol spectrum disorders. Previous face-to-face interventions significantly reduced risk for AEP, but a scalable intervention is needed to reach more women at risk. METHODS This study compared a 6 Core automated, interactive, and tailored Internet intervention, the Contraception and Alcohol Risk Reduction Internet Intervention (CARRII), to a static patient education (PE) website for its effect on AEP risk. Participants were recruited online to a pilot randomized clinical trial (RCT) with baseline, 9 weeks posttreatment, and 6-month (6-M) follow-up assessments. Seventy-one women completed online questionnaires and telephone interviews and were randomized to CARRII (n = 36) or PE (n = 35). Primary outcomes were rates of risky drinking, unprotected sex episodes, and AEP risk, collected from online prospective diaries. RESULTS CARRII participants showed significant reductions in rate of unprotected sex from pretreatment (88.9%) to posttreatment (70.6%) (p < 0.04) and to 6-M follow-up (51.5%) (p = 0.001); rate of risky drinking from pretreatment (75.0%) to posttreatment (50.0%) (p < 0.02), but insignificant change from pretreatment to 6-M follow-up (57.6%) (p < 0.09); and rate of AEP risk from pretreatment (66.7%) to posttreatment (32.4%) (p = 0.001) and to 6-M follow-up (30.3%) (p = 0.005). PE participants demonstrated no significant changes on all 3 variables across all time points. Intent-to-treat group-by-time tests were not significant, but power was limited by missing diaries. Over 72% of CARRII participants completed all 6 Cores. Exploratory analyses suggest that higher program utilization is related to change. CONCLUSIONS These data show that CARRII was acceptable, feasible, promising to reduce AEP risk, and merits further testing in a fully powered RCT.
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Affiliation(s)
- Karen Ingersoll
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Christina Frederick
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Kirsten MacDonnell
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Lee Ritterband
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Holly Lord
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Brogan Jones
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
| | - Lauren Truwit
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, Virginia
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Bohora S, Chaffin M, Shaboltas A, Bonner B, Isurina G, Batluk J, Bard D, Tsvetkova L, Skitnevskaya L, Volkova E, Balachova T. Latent Class Analysis of HIV Risk Behaviors Among Russian Women at Risk for Alcohol-Exposed Pregnancies. AIDS Behav 2017; 21:243-252. [PMID: 29047000 DOI: 10.1007/s10461-017-1929-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The number of HIV cases attributed to heterosexual contact and the proportion of women among HIV positive individuals has increased worldwide. Russia is a country with the highest rates of newly diagnosed HIV infections in the region, and the infection spreads beyond traditional risk groups. While young women are affected disproportionately, knowledge of HIV risk behaviors in women in the general population remains limited. The objectives of this study were to identify patterns of behaviors that place women of childbearing age at high risk for HIV transmission and determine whether socio-demographic characteristics and alcohol use are predictive of the risk pattern. A total of 708 non-pregnant women, aged between 18 and 44 years, who were at risk for an alcohol-exposed pregnancy were enrolled in two regions in Russia. Participants completed a structured interview focused on HIV risk behaviors, including risky sexual behavior and alcohol and drug use. Latent class analysis was utilized to examine associations between HIV risk and other demographic and alcohol use characteristics and to identify patterns of risk among women. Three classes were identified. 34.93% of participants were at high risk, combining their risk behaviors, e.g., having multiple sexual partners, with high partner's risk associated with partner's drug use (class I). Despite reporting self-perceived risk for HIV/STI, this class of participants was unlikely to utilize adequate protection (i.e., condom use). The second high risk class included 13.19% of participants who combined their risky sexual behaviors, i.e., multiple sexual partners and having STDs, with partner's risk that included partner's imprisonment and partner's sex with other women (class II). Participants in this class were likely to utilize protection/condoms. Finally, 51.88% of participants were at lower risk, which was associated primarily with their partners' risk, and these participants utilized protection (class III). The odds of being in class I compared with class III were 3.3 (95% CI [1.06, 10.38]) times higher for those women who had Alcohol Use Disorders Identification Test scores ≥ 8 than those who had lower scores, and were 3.9 (95% CI [1.69, 8.97]) times higher for those who used alcohol before sex than those who did not. In addition, women who drank more days per week were 1.36 times more likely to be in class II than in class III. The study informs prevention by identifying specific population groups and targets for interventions. Alcohol use is a significant predictor and an overarching factor of HIV risk in women. Since at-risk drinking is common among young Russian women, alcohol risk reduction should be an essential component of HIV prevention efforts.
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Balachova T, Shaboltas A, Nasledov A, Chaffin M, Batluk J, Bohora S, Bonner B, Bryant K, Tsvetkova L, Volkova E. Alcohol and HIV Risk Among Russian Women of Childbearing Age. AIDS Behav 2017; 21:1857-1867. [PMID: 27605367 DOI: 10.1007/s10461-016-1542-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Russia has one of the fastest rising rates of HIV among women in the world. This study sought to identify key factors in HIV transmission among women in Russia. Data were collected as part of a larger clinical trial to prevent alcohol-exposed pregnancies (AEP). Women at risk for an AEP were recruited at women's clinics; 708 women, aged 18-44 (M = 29.04 years), completed HIV risk surveys. Structural Equation Modeling was used to test the relationships between alcohol use and sex behavior constructs with HIV/STI risk. While the model indicated that multiple factors are involved in women's HIV/STI risk, the independent alcohol use variable explains 20 % of the variance in women's HIV/STI risk. The findings suggest that alcohol use directly and indirectly predicts HIV/STI risk among women, and its effect is mediated by alcohol use before sex.
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Affiliation(s)
- Tatiana Balachova
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, 940 N.E. 13th Street, Nicholson Tower, Suite 4900, Oklahoma City, OK, 73104, USA.
| | - Alla Shaboltas
- Psychology Department, St. Petersburg State University, St. Petersburg, Russia
| | - Andrey Nasledov
- Psychology Department, St. Petersburg State University, St. Petersburg, Russia
| | - Mark Chaffin
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, 940 N.E. 13th Street, Nicholson Tower, Suite 4900, Oklahoma City, OK, 73104, USA
- School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Julia Batluk
- Psychology Department, St. Petersburg State University, St. Petersburg, Russia
| | - Som Bohora
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, 940 N.E. 13th Street, Nicholson Tower, Suite 4900, Oklahoma City, OK, 73104, USA
| | - Barbara Bonner
- Department of Pediatrics, The University of Oklahoma Health Sciences Center, 940 N.E. 13th Street, Nicholson Tower, Suite 4900, Oklahoma City, OK, 73104, USA
| | - Kendall Bryant
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, USA
| | - Larissa Tsvetkova
- Psychology Department, St. Petersburg State University, St. Petersburg, Russia
| | - Elena Volkova
- Psychology Department, St. Petersburg State University, St. Petersburg, Russia
- Nizhny Novgorod State Pedagogical University, Nizhny Novgorod, Russia
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Rowa-Dewar N, Rooke C, Amos A. Using e-cigarettes in the home to reduce smoking and secondhand smoke: disadvantaged parents' accounts. HEALTH EDUCATION RESEARCH 2017; 32:12-21. [PMID: 28087586 DOI: 10.1093/her/cyw052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/23/2016] [Indexed: 06/06/2023]
Abstract
Electronic cigarettes (e-cigarettes) are subject to considerable public health debate. Most public health experts agree that for smokers who find it particularly challenging to quit, e-cigarettes may reduce harm. E-cigarette use in the home may also reduce children's secondhand smoke (SHS) exposure, although e-cigarette vapour may pose risks. This is the first qualitative study to explore disadvantaged parents' views and experiences of e-cigarettes in relation to reducing SHS exposure in the home. Interviews with 25 disadvantaged parents from Edinburgh who smoked and had children aged 1-3 were conducted in 2013, with 17 re-interviewed in 2014. Accounts of e-cigarette perceptions and use were analysed thematically. E-cigarettes were seen by some as potentially valuable in helping quitting or reducing smoking in difficult circumstances, and protecting children from SHS when smoking outside is constrained. However, parents raised concerns about safety issues and continuing their nicotine addiction. In relation to children, concerns included possible health effects of the vapour, children playing with them and role-modelling e-cigarette use. While significant concerns remain about e-cigarettes, for some parents who find it challenging to quit or safely leave their children to smoke outside, e-cigarettes may offer potential for reducing the harm to them and their children.
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Affiliation(s)
- Neneh Rowa-Dewar
- UK Centre for Tobacco and Alcohol Studies, Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh EH9 8AS, UK
| | - Catriona Rooke
- UK Centre for Tobacco and Alcohol Studies, Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh EH9 8AS, UK
| | - Amanda Amos
- UK Centre for Tobacco and Alcohol Studies, Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh EH9 8AS, UK
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Petrenko CLM, Alto ME. Interventions in fetal alcohol spectrum disorders: An international perspective. Eur J Med Genet 2017; 60:79-91. [PMID: 27742482 PMCID: PMC5205562 DOI: 10.1016/j.ejmg.2016.10.005] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 10/03/2016] [Accepted: 10/11/2016] [Indexed: 12/21/2022]
Abstract
Fetal alcohol spectrum disorders (FASD) are present across countries and cultures, with prevalence rates threatening to rise in the coming years. In order to support children and families with FASD around the world, researchers must work to disseminate and implement evidence-based interventions. However, each cultural context presents unique elements and barriers to the implementation process. This review considers the challenges of addressing FASD in an international context. It summarizes existing FASD interventions that have empirical support in the domains of parenting and education, attention and self-regulation, adaptive functioning, and nutrition and medication. It then outlines cultural barriers pertaining to FASD that may impede the implementation process and makes suggestions for using purveyors as cultural liaisons between researchers and local stakeholders. The review concludes with recommendations for moving forward with international dissemination and implementation of FASD interventions.
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Balachova T, Sobell LC, Agrawal S, Isurina G, Tsvetkova L, Volkova E, Bohora S. Evaluating alcohol use among Russian women at risk for an alcohol-exposed pregnancy: A comparison of three measures of alcohol use. J Ethn Subst Abuse 2016; 17:324-334. [PMID: 27436415 DOI: 10.1080/15332640.2016.1201717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The Quick Drinking Screen (QDS) and Timeline Followback (TLFB), measures of alcohol use, have yielded similar reports of drinking with English speakers. The present study, a secondary data analysis, compared three measures of alcohol use (i.e., QDS, TLFB, and AUDIT) among Russian-speaking women. This is the first study to compare all three measures. This study replicated the findings of studies with English speakers and demonstrated that brief screening measures (QDS, AUDIT) provide reliable summary measures of alcohol use when compared to a detailed drinking measure (TLFB). The use of brief screening measures is recommended for use with Russian women.
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Affiliation(s)
- Tatiana Balachova
- a University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
| | | | | | - Galina Isurina
- d St. Petersburg State University , St. Petersburg , Russia
| | | | - Elena Volkova
- d St. Petersburg State University , St. Petersburg , Russia.,e Nizhny Novgorod State Pedagogical University , Nizhny Novgorod , Russia
| | - Som Bohora
- a University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
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Balachova T, Chaffin M, Bonner B, Isurina G, Tsvetkova L, Volkova E. A screening and brief intervention for women in OB/GYN care. Addict Sci Clin Pract 2015. [PMCID: PMC4597170 DOI: 10.1186/1940-0640-10-s2-o4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Balachova T, Sobell LC, Agrawal S, Isurina G, Tsvetkova L, Volkova E, Bohora S. Using a single binge drinking question to identify Russian women at risk for an alcohol-exposed pregnancy. Addict Behav 2015; 46:53-7. [PMID: 25800361 DOI: 10.1016/j.addbeh.2015.03.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 02/06/2015] [Accepted: 03/06/2015] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Low rates of contraception and at-risk drinking place many Russian women at risk of an alcohol-exposed pregnancy (AEP). The only realistic way to determine when women are at risk of AEP is by self-reports. A U.S. study found that a single binge-drinking question (SBD) effectively identified nearly all women whose drinking placed them at risk of AEP. METHODS The present study replicated the U.S. STUDY Participants were 689 non-pregnant Russian women of childbearing age who were at AEP risk. Their answers to SBD, "During the previous three months, how often did you have four or more drinks on one occasion", were compared with their reports of binge drinking on a 90-day Timeline Followback (TLFB) calendar. RESULTS The SBD identified 99% of at-risk Russian women as binge drinkers, replicating U.S. FINDINGS Only 8% of the women were identified at-risk using a second AEP criterion of ≥8 drinks on average per week. Although Russian women did not report heavy weekly drinking and two-thirds did not meet AUDIT criteria for problem drinking, when they did drink, 40% of the time it was binge drinking. CONCLUSIONS Almost all Russian women who were at risk of an AEP were identified by a single binge-drinking question. Results from this study suggest that Russian health care practitioners can use SBD to successfully screen women for AEP risk. SBD identified 99% of Russian women who were at AEP risk. Consequently, it is recommended that SBD be incorporated into routine health care screenings at OB/GYN clinic visits.
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Balachova TN, Batluk JV, Bryant KJ, Shaboltas AV. International collaboration in HIV prevention research: evidence from a research seminar in Russia. AIDS Res Hum Retroviruses 2015; 31:163-72. [PMID: 25430518 PMCID: PMC4313421 DOI: 10.1089/aid.2014.0078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
HIV transmission is a major health concern. Global efforts are necessary to control the spread of infection. International collaborative studies in countries with high rates of new infections are essential for increasing knowledge on the behavioral, social, and biomedical aspects of HIV/AIDS and HIV transmission. Statistics indicate a growing HIV epidemic in Russia. There are alarming proportions of new cases attributed to heterosexual contact, and HIV is increasingly affecting people in the general population who are not part of any traditional high-risk group. Despite recent advances in HIV prevention, data on effective behavioral prevention approaches are limited. There is minimal evidence to suggest which types of prevention will be effective in reducing the risk for HIV transmission among people at risk in the general population. This article presents a review and discussion of an international research seminar, HIV Prevention Research: Evidence-Based Behavioral Approaches. Local and international interdisciplinary researchers gathered for the purposes of exchanging research results and information about ongoing studies, identifying gaps in knowledge, and discussing promising prevention strategies. The overarching goal was to advance HIV prevention research through scientific integration. The seminar provided an excellent platform for building research capacity in interdisciplinary HIV research in Russia and integrating research efforts with the international research community to contribute to HIV prevention research throughout the world.
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Affiliation(s)
| | - Julia V. Batluk
- Psychology Department, St. Petersburg State University, St. Petersburg, Russia
| | - Kendall J. Bryant
- National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Rockville, Maryland
| | - Alla V. Shaboltas
- Psychology Department, St. Petersburg State University, St. Petersburg, Russia
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Chambers CD, Yevtushok L, Zymak-Zakutnya N, Korzhynskyy Y, Ostapchuk L, Akhmedzhanova D, Chan PH, Xu R, Wertelecki W. Prevalence and predictors of maternal alcohol consumption in 2 regions of Ukraine. Alcohol Clin Exp Res 2014; 38:1012-9. [PMID: 24834525 DOI: 10.1111/acer.12318] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Fetal alcohol spectrum disorders are thought to be a leading cause of developmental disabilities worldwide. However, data are lacking on alcohol use among pregnant women in many countries. The purpose of this study was to evaluate the prevalence and predictors of alcohol consumption by pregnant women in Ukraine. METHODS Cross-sectional screening of pregnant women was conducted in 2 regions of Ukraine during the recruitment phase of an ongoing clinical study that is part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders. Women attending a routine prenatal visit at 1 of 2 participating regional centers were asked about alcohol consumption. Quantity and frequency of alcoholic beverages consumed in the month around conception and in the most recent month of pregnancy were measured using a standard interview instrument. RESULTS Between 2007 and 2012, 11,909 pregnant women were screened on average in the second trimester of pregnancy. Of these, 92.7% reported being ever-drinkers. Among ever-drinkers, 54.8% reported drinking alcohol in the month around conception and 12.9% consumed at least 3 drinks on at least 1 day in that time period. In the most recent month of pregnancy, 46.3% continued to report alcohol use and 9.2% consumed at least 3 drinks per day. Significant predictors of average number of drinks or heavier drinking per day in either time period in pregnancy included lower gravidity, being single, unmarried/living with a partner, or separated, lower maternal education, smoking, younger age at initiation of drinking, and higher score on the TWEAK screening test for harmful drinking. CONCLUSIONS These findings support the need for education/intervention in women of childbearing age in Ukraine and can help inform targeted interventions for women at risk of an alcohol-exposed pregnancy. The initiation of a standard screening protocol in pregnancy is a step in the right direction.
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