Alcohol consumption and its associated factors among pregnant women in Sub-Saharan Africa: a systematic review and meta-analysis' as given in the submission system

The role of alcohol consumption in the lives of older Australian women: qualitative insights and an agenda for further research, policy and practice

BACKGROUND

Alcohol consumption presents a threat to the health and wellbeing of women. The alcohol industry often pushes back at global efforts to prioritise the prevention of alcohol harms to women. Qualitative researchers have investigated how younger and midlife women conceptualise their alcohol consumption, but there is very limited research relating to older women (those 60 years and over).

METHODS

Using data collected from an online qualitative survey, this paper explored the factors that influence how older Australian women drinkers (n = 144. 60-88 years) conceptualised the role of alcohol in their lives. The study used a 'Big Q' reflexive approach to thematic analysis, drawing upon sociological theories of risk and symbolic interactionism to construct four themes from the data.

RESULTS

First, alcohol consumption was viewed by participants as an accepted and normalised social activity, that was part of Australian culture. Second, alcohol played a role for some participants as a way to cope with life changes (such as retirement), as well as managing stressful or challenging life circumstances (such as loneliness). Third, alcohol was part of the routines and rituals of everyday life for some women. For example, women discussed the consumption of wine with their evening meal as an important part of the structure of their day. Fourth, participants had clear personal expectancies about what it meant to be a 'responsible drinker'. They had clear narratives about personal control and moral obligation, which in some cases created a reduced perception of their own risk of alcohol-caused harm.

CONCLUSIONS

This research provides a starting point for future public health research examining the factors that may shape older women's alcohol consumption beliefs and practices. Public health activities should consider the unique needs and potential vulnerabilities of older women drinkers, and how these may be potentially exploited by the alcohol industry.

Sleep pattern and disorders among pregnant women in Ibadan, Southwest Nigeria

BACKGROUND

Sleep is essential for pregnant women's and the offspring's health and wellbeing. Poor sleep and disorders have been linked with adverse fetal outcomes and delivery conditions. However, pregnant women often experience several forms of sleep disruption, which has been scarcely reported in low and middle-income countries (LMIC), including Nigeria where the influence of lifestyle factors has also been lacking. We investigated sleep patterns and disorders and the associated factors among pregnant women in Southwest, Nigeria.

METHOD

A cross-sectional study was conducted among five hundred (500) pregnant women attending Adeoyo Maternity Teaching Hospital. A semi-structured questionnaire was used to examine different domains of sleep and associated disorders, namely sleep quality (Pittsburgh Sleep Quality Index (> 5 and ≤ 5)), insomnia (Insomnia Severity Index (> 8 and ≤ 8)), restless leg syndrome (Restless Leg Syndrome Rating Scale (> 10 and ≤ 10). Significant covariates such as physical activity, minimum dietary diversity, smoking and alcohol intake were also assessed. We conducted bivariate and multivariate analysis at p < 0.05 significance level.

RESULTS

The mean age of participants was 30.4 ± 4.8 years. The pattern of sleep disorder in pregnant were poor sleep quality (50%), restless leg syndrome (58.2%) and insomnia (33.4%). Being currently married (AOR = 6.13; 95% CI: (1.65-22.23)), increasing gestational age: second trimester (AOR = 8.25;95% CI: (1.78-38.17)) to third trimester (AOR = 10.98; 95% CI: (2.44-49.48)) increased the odds of poor sleep quality. Factors associated with restless leg syndrome were marital status [AOR = 3.60; 95% CI; (1.25-10.35)], religion, rigorous physical activities [AOR = 1.52; 95% CI: (1.05-2.21)] and alcohol consumption [AOR = 3.51; 95% CI: (1.00-12.27)]. Factors associated with insomnia were maternal age [AOR = 1.83; 95% CI: (1.11-3.01)], income [AOR = 2.99 (1.26-7.16)] and rigorous physical activity [AOR = 2.55 (1.61-4.02)].

CONCLUSION

Poor sleep quality, restless leg syndrome and insomnia were typical among pregnant women in Ibadan, Southwest Nigeria. Thus, awareness and education on the importance of sleep and its risk and protective factors, such as alcohol consumption, smoking, rigorous activity and spousal and family support, should be increased to reduce poor sleep quality and sleep disorders (restless leg syndrome and insomnia) during the pregnancy period.

Practices of pregnant women regarding tobacco and alcohol use during pregnancy at one primary health care clinic in Southern Namibia

Tobacco and alcohol use during pregnancy has negative consequences, to the fetus. The study purpose was to investigate the practices of pregnant women regarding the use of tobacco and alcohol during pregnancy. A quantitative research approach with a descriptive, cross-sectional, analytical design was used. The population were all pregnant women aged 18 years and above attending antenatal care at Mariental clinic. Written informed consent was obtained from all respondents prior to data collection. Data was collected from 211 respondents selected through a systematic sampling. Data was analysed using Statistical Package of the Social Sciences version 27. Descriptive statistics were used for frequencies and percentages. Fisher's Exact test at 0.05 alpha level was used to determine the association between variables. The mean age was 28.8 with a standard deviation of 6.9 years. Most participants, 92 (43.6%) were aged between 18 and 24 years. Majority, 186 (88.15%) were in third trimester of pregnancy and 154 (73%) were single. Most 148 (70.14%) respondents have good practices towards alcohol use during pregnancy. Moreover, 190 (90%) of the respondents were classified as having good practices towards tobacco use in pregnancy. Educational levels showed a significant association with practices towards tobacco smoking (P=0.042). The study concluded good practices among pregnant women on alcohol and tobacco smoking during pregnancy. It is recommended that health facilities should introduce awareness campaign on the dangers of alcohol and tobacco use during pregnancy. Moreover, educational materials should be developed in local languages and distributed to community.

A mixed-methods comparison of gender differences in alcohol consumption and drinking characteristics among patients in Moshi, Tanzania

Excessive alcohol use stands as a serious threat to individual and community well-being, having been linked to a wide array of physical, social, mental, and economic harms. Alcohol consumption differs by gender, a trend seen both globally and in Moshi, Tanzania, a region with especially high rates of intake and few resources for alcohol-related care. To develop effective gender-appropriate treatment interventions, differences in drinking behaviors between men and women must be better understood. Our study aims to identify and explore gender-based discrepancies in alcohol consumption among Kilimanjaro Christian Medical Center (KCMC) patients. A systematic random sampling of adult patients presenting to KCMC's Emergency Department (ED) or Reproductive Health Center (RHC) was conducted from October 2021 until May 2022. Patients answered demographic and alcohol use-related questions and completed brief surveys, including the Alcohol Use Disorder Identification Test (AUDIT). Through purposeful sampling, 19 individuals also participated in in-depth interviews (IDIs) that focused on identifying gender differences in alcohol use. Quantitative data was analyzed in RStudio through descriptive frequencies, proportions, ANOVA, and Chi-squared tests, while IDIs were analyzed in Nvivo following a grounded theory approach. During the 8-month data collection timeline, 676 patients were enrolled. Men and women patients at KCMC's ED and RHC were found to have significant differences in their alcohol use behaviors. For our quantitative data, this included lower average AUDIT scores among women (average [SD] AUDIT scores were 6.76 [8.16] among ED men, 3.07 [4.76] among ED women, and 1.86 [3.46] among RHC women). A subsequent IDI analysis revealed greater social restrictions around women's drinking and more secretive alcohol use behaviors for where and when women would drink. For men, excess drinking was normalized within Moshi, tied to men's social interactions with other men, and generally motivated by stress, social pressure, and despair over lack of opportunity. Significant gender differences in drinking behaviors were found, primarily influenced by sociocultural norms. These dissimilarities in alcohol use suggest that future alcohol-related programs should incorporate gender in their conceptualization and implementation.

A Mixed-Methods Comparison of Gender Differences in Alcohol Consumption and Drinking Characteristics among Patients in Moshi, Tanzania

Background

Excessive alcohol use stands as a serious threat to individual and community well-being, having been linked to a wide array of physical, social, mental, and economic harms. Alcohol consumption differs by gender, a trend seen both globally and in Moshi, Tanzania, a region with especially high rates of intake and few resources for alcohol-related care. To develop effective gender-appropriate treatment interventions, differences in drinking behaviors between men and women must be better understood. Our study aims to identify and explore gender-based discrepancies in alcohol consumption among Kilimanjaro Christian Medical Center (KCMC) patients.

Methods

A systematic random sampling of adult patients presenting to KCMC's Emergency Department (ED) or Reproductive Health Center (RHC) was conducted from October 2020 until May 2021. Patients answered demographic and alcohol use-related questions and completed brief surveys including the Alcohol Use Disorder Identification Test (AUDIT). Through purposeful sampling, 19 subjects also participated in in-depth interviews (IDIs) focused on identifying gender differences in alcohol use.

Results

During the 8-month data collection timeline, 655 patients were enrolled. Men and women patients at KCMC's ED and RHC were found to have significant differences in their alcohol use behaviors including lower rates of consumption among women, (average [SD] AUDIT scores were 6.76 [8.16] among ED men, 3.07 [4.76] among ED women, and 1.86 [3.46] among RHC women), greater social restrictions around women's drinking, and more secretive alcohol use behaviors for where and when women would drink. For men, excess drinking was normalized within Moshi, tied to men's social interactions with other men, and generally motivated by stress, social pressure, and despair over lack of opportunity.

Conclusion

Significant gender differences in drinking behaviors were found, primarily influenced by sociocultural norms. These dissimilarities in alcohol use suggest that future alcohol-related programs should incorporate gender in their conceptualization and implementation.

A harmonized analysis of five Canadian pregnancy cohort studies: exploring the characteristics and pregnancy outcomes associated with prenatal alcohol exposure

BACKGROUND

As a teratogen, alcohol exposure during pregnancy can impact fetal development and result in adverse birth outcomes. Despite the clinical and social importance of prenatal alcohol use, limited routinely collected information or epidemiological data exists in Canada. The aim of this study was to pool data from multiple Canadian cohort studies to identify sociodemographic characteristics before and during pregnancy that were associated with alcohol consumption during pregnancy and to assess the impact of different patterns of alcohol use on birth outcomes.

METHODS

We harmonized information collected (e.g., pregnant women's alcohol intake, infants' gestational age and birth weight) from five Canadian pregnancy cohort studies to consolidate a large sample (n = 11,448). Risk factors for any alcohol use during pregnancy, including any alcohol use prior to pregnancy recognition, and binge drinking, were estimated using binomial regressions including fixed effects of pregnancy cohort membership and multiple maternal risk factors. Impacts of alcohol use during pregnancy on birth outcomes (preterm birth and low birth weight for gestational) were also estimated using binomial regression models.

RESULTS

In analyses adjusting for multiple risk factors, women's alcohol use during pregnancy, both any use and any binge drinking, was associated with drinking prior to pregnancy, smoking during pregnancy, and white ethnicity. Higher income level was associated with any drinking during pregnancy. Neither drinking during pregnancy nor binge drinking during pregnancy was significantly associated with preterm delivery or low birth weight for gestational age in our sample.

CONCLUSIONS

Pooling data across pregnancy cohort studies allowed us to create a large sample of Canadian women and investigate the risk factors for alcohol consumption during pregnancy. We suggest that future pregnancy and birth cohorts should always include questions related to the frequency and amount of alcohol consumed before and during pregnancy that are prospectively harmonized to support data reusability and collaborative research.

Sexual Risk among Pregnant Women at Risk of HIV Infection in Cape Town, South Africa: What Does Alcohol Have to Do with It?

This study examines baseline associations between alcohol use and HIV sexual risk among a cohort of HIV-uninfected pregnant women (n = 1201) residing in a high HIV burdened community in Cape Town, South Africa. Alcohol use was measured using a modified version of the Alcohol Use Disorder Identification Test (AUDIT). HIV sexual risk was measured through a composite variable of four risk factors: diagnosis with a STI, self-report of > 1 recent sex partners, partner HIV serostatus (unknown or HIV+) and condomless sex at last sex. Any past year alcohol use prior to pregnancy was reported by half of participants (50%); 6.0% reported alcohol use during pregnancy. Alcohol use prior to pregnancy was associated with increased odds of being at high risk of HIV (aOR = 1.33, 95% CI 1.05-1.68, for 2 risks and aOR = 1.47, 95% CI 0.95-2.27 for 3 risks). In addition to reducing alcohol use, several other strategies to address HIV sexual risk were identified. Evidence-based interventions to address alcohol use and other HIV sexual risk behaviors during pregnancy in South Africa are desperately needed. Qualitative work exploring individual and community level drivers of alcohol use among pregnant and breastfeeding women in this setting could support development of a culturally tailored intervention to address these issues in this population.

Spatial distribution and determinants of alcohol consumption among pregnant women in Ethiopia: Spatial and multilevel analysis

BACKGROUND

Alcohol consumption during pregnancy is a known contributor to teratogen and causes a range of effects on pregnancy and birth outcomes. This study aimed to investigate the spatial variation and determinants of alcohol consumption among pregnant women in Ethiopia.

METHODS

A secondary data analysis was conducted using the 2016 Ethiopian Demographic and Health Survey data. A total of 1,135 pregnant women were included in the analysis. ArcGIS version 10.7 software was used to explore the spatial distribution of alcohol consumption, and SaTScan version 9.6 was employed to identify the significant spatial clusters of alcohol consumption. A mixed multi-level logistic regression analysis was employed to identify the determinant factors of alcohol consumption during pregnancy.

RESULTS

The result showed that the prevalence of alcohol consumption during pregnancy was 22.49% (with a 95% CI: 18.18 to 26.17). The spatial analysis showed that the spatial distribution of alcohol consumption significantly varied across the country [Global Moran's I value = 0.30 (P<0.001)]. The SaTScan analysis identified two most likely clusters with high rates of alcohol consumption such as northwest Ethiopia (Log-Likelihood Ratio (LLR) = 155.56, p<0.001) and central Ethiopia (LLR = 19.27, p<0.01). Never in union, divorced and/ widowed [Adjusted odds ratio (AOR) = 2.56; 95% CI: 1.07, 10.14], attended primary school [AOR = 0.45; 95% CI: 0.27, 0.95], having two or more lifetime sexual partners [AOR = 2.59; 95% CI: 1.11, 6.18], living in rural [AOR = 1.52; 95% CI: 1.12, 2.93] and higher community media exposure [AOR = 0.54; 95% CI: 0.28, 0.97] were the factors associated with alcohol consumption.

CONCLUSION

Alcohol consumption during pregnancy in Ethiopia was high. The spatial distribution of alcohol consumption was significantly varied across the country. Therefore, public health interventions targeting areas with high alcohol consumption are needed for drinking cessation and to prevent poor pregnancy outcomes related to alcohol use.

Association of alcohol consumption with abortion among ever-married reproductive age women in Ethiopia: A multilevel analysis

Background

A miscarriage or a spontaneous loss of a pregnancy that occurs before the 20th week is an abortion. Even though numerous recommendations state that pregnant women should abstain from alcohol at all stages of pregnancy, alcohol intake among pregnant women is common. However, there are few papers addressing the effect of alcohol use on miscarriage using nationally representative data. Moreover, the association of alcohol use with abortion and its mechanisms is not well studied in the Ethiopian region. Therefore, the objective of the current study was to estimate the association of alcohol use with abortion rates among reproductive age (15-49) women in Ethiopia.

Methods

Using the most recent findings of the Ethiopian Demographic and Health Survey (EDHS), secondary data analysis was performed among pregnant women in Ethiopia. A total of 11,396 women between the ages of 15 and 49 years who were of reproductive age were included in the research. To characterize the study population, descriptive statistics were used. The variability was considered using the multilevel binary logistic regression model. A multilevel binary logistic model was used to determine the effect of alcohol intake on abortion while controlling for potential confounders. In the multivariable analysis, variables with a P-value of less than 0.05 were considered statistically significant for the response variable.

Results

The proportion of women who had an abortion was 10.46% with a 95% CI of 9.92-11.03. In the final model of the multilevel analysis, age group [adjusted odds ratio (AOR) = 6.13; 95% CI: 3.86-9.73], education level (AOR = 1.29; 95 and CI: 1.10-1.51), alcohol consumption (AOR = 1.38; 95% CI: 1.18-1.61), age at first sex (AOR = 1.20; 95% CI: 1.03-1.39), media exposure (AOR = 1.28, CI: 1.10-1.48), contraceptive use (AOR = 1.34, CI: 1.16-1.56), and occupation of respondent (AOR = 1.21, CI: 1.06-1.38) were identified to be significant determinants of abortion in Ethiopia.

Conclusion

Sexual and reproductive health education and family planning programs should target older women in the reproductive age group, women with primary educational status, working women, and those who initiated sexual intercourse at a younger age considering it could reduce abortion and unintended pregnancy. Furthermore, as part of sexual and reproductive health education, the adverse effect of alcohol consumption on abortion should be emphasized.

Perception of safety and consumption of alcoholic beverages during pregnancy

This cross-sectional study of antenatal clinic attendees aimed to determine the proportions of pregnant women that consider different alcoholic beverages safe for their babies; and the proportions that took them in the index pregnancy. Five hundred and six women completed the questionnaires. Mean age was 30.07 ± 5.13 years. Mean parity was 1.44 ± 1.32. 478 (94.5%) were married. Three hundred and eighty-three (75.69%) had tertiary education. These proportions did not consider these alcoholic beverages harmful in pregnancy: palm wine 35.77%, stout 17.03%, beer 14.03%, alcoholic wine 13.83%, ogogoro (distilled fermented palm wine) 13.04% and gin/spirits 9.88%. The proportion that consumed different alcoholic beverages during pregnancy were: palm wine 17.20%, beer 5.33%, alcoholic wine 4.35%, stout 4.15%, ogogoro 1.58% and gin/spirits 0.59%. Pregnant women who considered various alcoholic beverages safe in pregnancy were significantly more likely to consume them during pregnancy. Healthcare providers should assess women's perception of the safety of different alcoholic beverages and offer counselling to discourage their consumption during pregnancy.Impact StatementWhat is already known on this subject? Babies exposed to alcohol in pregnancy are at increased risk of developing foetal alcohol spectrum disorders. No safe level of alcohol has been established for pregnancy. The level of alcohol consumption by pregnant women is still high in our practice environment.What do the results of this study add? The perception that a specific alcoholic beverage is safe and not harmful to the foetus, significantly increases the likelihood of the consumption of that alcoholic beverage by a pregnant woman.What are the implications of these findings for clinical practice and/or further research? Healthcare workers will need to enquire about specific alcoholic beverages especially those common within their practice environment. An enquiry should be made on the perception of safety and their consumption during pregnancy. Women who perceive certain alcoholic beverages are more likely to consume them during pregnancy and hence should receive specific counselling on the alcoholic content of these beverages and the risk to their babies to discourage the consumption of that alcoholic beverage during pregnancy.

Dietary patterns and associated factors among pregnant women in Ibadan, Nigeria: Evidence from Ibadan pregnancy cohort study

Background

Maternal nutrition is vital for an optimal intrauterine environment, foetal development, birth weight, pregnancy and neonatal outcomes. We assessed the maternal dietary patterns using a data-driven technique and the associated sociodemographic factors among pregnant women in Ibadan, Nigeria.

Methodology

Dietary assessment was performed during the enrolment of participants for the Ibadan Pregnancy Cohort Study, a prospective cohort study, conducted among 1745 pregnant women enrolled early in pregnancy (≤ 20 weeks) at four comprehensive obstetric facilities within the Ibadan metropolis. A qualitative food frequency questionnaire was used to assess the pregnant population’s intake of food and drinks three months prior to their enrollment. We determined dietary patterns by applying principal component analysis with a varimax rotation. Multivariate analysis was used to investigate the association between sociodemographic factors and dietary patterns at 5% statistical significance.

Results

Mean age and gestational age at enrolment were 29.8 (± 5.3) years and 16.4 (±4.2) weeks, respectively. White rice was the most frequently consumed meal [794 (45.5%) daily, 898 (51.4%)] weekly in our study population. Five major dietary patterns were identified, and they accounted for 28.8% of the total variation: "protein-rich diet with non-alcoholic beverages" (15.6%); "fruits" (4.1%); "typical diet with alcohol" (3.8%); "legumes" (2.8%), "refined grains" (2.6%). Maternal education and income were inversely associated with the consumption of a "protein-rich diet with non-alcoholic beverages", "typical diet with alcohol", and "legumes" in a dose-response fashion. Also, employed women had a higher mean intake of fruits [adjusted β: 0.33 (0.02; 0.65) p = 0.040] compared with women without employment.

Conclusions and recommendation

We described five dietary patterns of pregnant women using a data-driven technique, principal component analysis, in Nigeria. We also identified factors influencing maternal dietary patterns, which can inform public health interventions, especially behavioural change communication during antenatal care.

Alcohol consumption and tobacco exposure among pregnant women in Ibadan, Nigeria

BACKGROUND

Alcohol consumption and tobacco exposure during pregnancy are hazardous behaviours which are increasing significantly in low and middle-income countries, including sub-Saharan Africa. However, they have received little attention in Nigeria's maternal health research and services. The prevalence, pattern and predictors of alcohol consumption and tobacco exposure among pregnant women in Ibadan, Nigeria, were investigated.

METHODS

This is a part of a prospective cohort study among pregnant women in Ibadan, Nigeria (Ibadan Pregnancy Cohort Study (IbPCS), which investigated the associations between maternal obesity, lifestyle characteristics and perinatal outcomes in Ibadan. Alcohol consumption and tobacco exposure of 1745 pregnant women were assessed during enrollment by self-reports using an interviewer-administered questionnaire. Bivariate and multiple logistic regression analyses examined the associations at a 5% level of statistical significance.

RESULTS

The prevalence of pre-pregnancy alcohol consumption and alcohol consumption during pregnancy were 551 (31.7%) and 222 (12.7%), respectively, i.e. (one in every eight pregnancies is exposed to alcohol). Palm wine (52%) and beer (12%) were the most common alcohol consumed among pregnant women. The predictors of alcohol consumption during were pre-pregnancy alcohol use [AOR = 10.72, 95% CI: 6.88-16.70) and religion i.e. Muslims were less likely to consume alcohol during pregnancy compared to Christians: [AOR = 0.60, 95% CI: 0.40-0.92). The prevalence of tobacco exposure in the index pregnancy was 64 (3.7%), i.e. one in every 27 pregnancies is exposed to tobacco. In contrast, cigarette smoking, second-hand smoke and smokeless tobacco were 0.4, 1.7 and 1.8%, respectively. Pre-pregnancy cigarette smoking was reported by 33(1.9%) and was the most significant predictor [AOR = 12.95; 95% CI: 4.93, 34.03) of tobacco exposure during pregnancy in our study population.

CONCLUSIONS

Alcohol consumption and tobacco exposure are not uncommon and have been an ongoing but neglected threat to maternal and child health in Nigeria. Alcohol and tobacco control policy and programmes to prevent the use among pregnant and reproductive-age women in Nigeria should be implemented primarily during antenatal care.

Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities

Background

Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations.

Methods

A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being.

Findings

Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians’ prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being.

Conclusion

This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.

Alcohol use during pregnancy and associated factors among pregnant women in Sub-Saharan Africa: further analysis of the recent demographic and health survey data

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.

Gender Differences in the Factors Associated with Alcohol Binge Drinking: A Population-Based Analysis in a Latin American Country

Alcohol consumption is a public health problem in Peru, fostered by traditional practices, where promoting social interaction in celebrations, facilitating field work as a source of energy and warmth, and achieving objectives in certain labor negotiations, play an important role. However, research on the risk factors of binge drinking according to gender is limited. The study aim was to determine the factors associated with binge drinking in the Peruvian adult population by gender. An analytical study of secondary data from the 2018 Peruvian Demographic and Family Health Survey was conducted. The dependent variable was binge drinking in the last 30 days. Adjusted prevalence ratios (aPR) were estimated for the association between sociodemographic and health-related variables with binge drinking. A total of 32,020 adults were included. Binge drinking was found in 22.4%. Men (32.6%; 95% confidence interval [CI]: 31.4–33.8) presented a higher consumption pattern compared to women (12.8%; 95% CI: 12.0–13.6). For both genders, differences were found in binge drinking according to sociodemographic characteristics (age and wealth quintile was associated in both genders while the educational level was associated only for men, and ethnic self-identification and marital status for women) and health- characteristics related (health insurance, smoking in the last 30 days, overweight and obesity were associated in both genders). Several factors are associated with binge drinking according to gender in the Peruvian population, including age and education level among men, as well as marital status and ethnic self-identification among women.

Is Public Health Response to the Phenomenon of Alcohol Use during Pregnancy Adequate to the Polish Women’s Needs?

Due to the risks it poses to a child’s health, drinking alcohol during pregnancy is a serious problem that the public health sector is struggling to deal with. The reasons why women who do not have alcohol problems do not give up drinking alcohol completely during pregnancy are still poorly understood. And the knowledge available about them does not translate into communication strategies in Poland. The analysis of standards and examples of good practice allows to formulate proposals for improving the quality and effectiveness of social campaigns addressed to the general population and women of childbearing age in order to reduce the risk associated with the prenatal exposure to alcohol.

The effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: a prospective cohort study

BACKGROUND

The teratogenic effect of fetal alcohol exposure may lead to actual and potential problems, instantly after birth, at infancy; or even later, and mental impairment in life. This study aimed to investigate the effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes at Gondar town public health facilities, Northwest Ethiopia.

METHODS

A facility-based prospective cohort study was performed among 1778 pregnant women who were booked for antenatal care in selected public health facilities from 29 October 2019 to 7 May 2020 in Gondar town. We used a two-stage random sampling technique to recruit and include participants in the cohort. Data were collected using the Alcohol Use Disorders Identification Test - Consumption (AUDIT-C) standardized and pre-tested questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and interested adverse birth outcomes using log-binomial regression modeling. The burden of outcomes was reported using the adjusted risk ratio and population-attributable risk (PAR).

RESULTS

A total of 1686 pregnant women were included in the analysis, which revealed that the incidences of low birth weight, preterm, and stillbirth were 12.63% (95% CI: 11.12, 14.31), 6.05% (95% CI: 5.00, 7.29) and 4.27% (95% CI: 3.4, 5.35), respectively. Non-hazardous and hazardous alcohol consumption during pregnancy was significantly associated with low birth weight (ARR = 1.50; 95% CI: 1.31, 1.98) and (ARR = 2.34; 95% CI: 1.66, 3.30), respectively. Hazardous alcohol consumption during pregnancy was also significantly associated with preterm birth (ARR = 2.06; 95% CI: 1.21, 3.52). The adjusted PAR of low birth weight related to non-hazardous and hazardous alcohol drinking during pregnancy was 11.72 and 8.44%, respectively. The adjusted PAR of hazardous alcohol consumption was 6.80% for preterm.

CONCLUSIONS

Our findings suggest that there is an increasing risk of adverse birth outcomes, particularly preterm delivery and low birth weight, with increasing levels of alcohol intake. This result showed that the prevention of maternal alcohol use during pregnancy has the potential to reduce low birth weight and preterm birth. Hence, screening women for alcohol use during antenatal care visits and providing advice with rigorous follow-up of women who used alcohol may save the fetus from the potential risks of adverse birth outcomes.

Determinants of hazardous alcohol use among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: A nested case-control study

BACKGROUND

Alcohol use during pregnancy has a potential negative impact on the health of women and children. Binge or hazardous drinking may do greater alcohol-related damage to the developing fetus than drinking a comparable amount spread over several days or weeks. This study aimed to identify determinants of hazardous alcohol use among pregnant women attending antenatal care at Gondar town public health facilities, Northwest Ethiopia.

METHODS

An unmatched facility-based nested case-control study was carried out to identify the determinants of hazardous alcohol use among pregnant women within a prospective cohort study from 29 October 2019 to 7 May 2020. A two-stage random sampling technique was used to select 455 (113 cases and 342 controls) pregnant women. Data collection was performed using the AUDIT-C standardized and pretested questionnaire. Bivariable and multivariable logistic regression analyses were computed to identify the predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05.

RESULTS

Multivariable logistic regression model revealed that no formal education of the husbands [AOR = 2.79; 95%CI: 1.24, 6.29], being housewife[AOR = 2.43; 95%CI: 1.12, 5.26], poor household wealth index[AOR = 2.65; 95%CI: 1.07, 6.54], unplanned pregnancy [AOR = 4.36;95%CI: 2.44, 7.79], poor social support [AOR = 4.9;95%CI: 2.4, 10.04], depression[AOR = 3.84;95%CI: 2.16, 6.82], and not ever heard the risk of alcohol drinking during pregnancy [AOR = 1.97; 95%CI: 1.08, 3.58] were significantly associated with hazardous alcohol use.

CONCLUSIONS

Routine alcohol screening during ANC visits creates an appropriate referral system for clinical management and provides an opportunity for healthcare workers to offer information on the potential risks associated with alcohol use in pregnancy. Antenatal care providers have a special role to play in assuring that women receive adequate advice about alcohol use and care to manage the problems especially for pregnant women with depression, poor social support, unplanned pregnancy, low socioeconomic status, and for housewives during the antenatal visits. The warning marks on alcoholic beverages including an ongoing message about the risks of alcohol use during pregnancy could be public health good strategies to minimize preventable harms attributed to alcohol consumption during pregnancy.

Individual and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia: a multilevel logistic regression analysis

BACKGROUND

Prenatal alcohol consumption is a serious public health concern that is considered as one of the preventable risk factors for neonatal and childhood morbidity and several adverse pregnancy outcomes. This study aimed to determine the individual- and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia.

METHODS

A community-based cross-sectional study was conducted among pregnant women in Gondar town from 13 June to 24 August 2019. A cluster random sampling technique was used to select 1237 pregnant women. Data collection was carried out using the AUDIT-C pretested standard questionnaire. Bivariable and multivariable multilevel logistic regression analyses were computed to identify predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05.

RESULTS

The prevalence of alcohol consumption during pregnancy was found to be 30.26% (95% CI: 27.74%, 32.91%). The study revealed that pregnant women who have a low knowledge level on harmful effect of alcohol consumption (AOR = 3.2; 95% CI: 1.9, 5.4), positive attitude towards alcohol consumption (AOR = 7.5; 95% 5, 11), history of pre-pregnancy alcohol consumption (AOR = 4.8; 95% CI: 3.4, 6.9), whose partner consume alcohol (AOR = 3.9; 95% CI: 2.5, 6), a perception that alcohol consumption is culturally or socially acceptable (AOR = 3.6; 95% CI: 2.4, 5.3), who were encouraged by their partners to consume alcohol (AOR = 4; 95% CI: 1.9, 8) were significantly associated with pregnancy alcohol consumption. Concerning the community-level characteristics, who had not ever heard/media exposure about the risk of alcohol drinking during pregnancy (AOR = 3; 95% CI: 1.7, 5.5), and who were from low community women's education attainment (AOR = 4; 95% CI: 2.2, 7.7) were statistically significant predictors of alcohol consumption during pregnancy.

CONCLUSIONS

The study revealed that alcohol consumption during pregnancy is prevalent in Gondar town. Both individual- and community-level predictors were found to be associated with alcohol consumption during pregnancy. Policymakers may take into account these predictors for individual and community-based interventions to which our results appear to point.

Partner influence as a factor in maternal alcohol consumption and depressive symptoms, and maternal effects on infant neurodevelopmental outcomes

BACKGROUND

Few studies have investigated the partner's influence on risk factors such as alcohol consumption and depression during pregnancy. Partner substance use and lower relationship satisfaction predict higher maternal alcohol use and depressive symptoms. Because prenatal alcohol use and maternal depression affect infant outcomes, it is imperative to examine how the partner affects these maternal risk factors. The current study examined the effect of a latent construct of partner influence on maternal alcohol use and depressive symptoms, and the effects on infant development of these maternal factors.

METHODS

Participants were 246 pregnant women from 2 sites in Western Ukraine from whom longitudinal data were collected as part of a multisite study. In the first trimester, mothers reported on relationship satisfaction, partner substance use, and socioeconomic status (SES). In the third trimester, they reported on alcohol use and depressive symptoms. Infants were assessed using the Bayley Scale of Infant Development (average age = 6.93 months). A latent construct titled partner influence was formed using partner substance use and measures of relationship satisfaction, including the frequency of quarreling, happiness in the relationship, and the ease of talking with the partner. Using structural equation modeling, a model was specified in which partner influence and SES predicted maternal alcohol use and depressive symptoms, which in turn predicted infant neurodevelopmental outcomes.

RESULTS

Higher partner influence significantly predicted lower prenatal alcohol use and lower depressive symptoms, controlling for the effect of SES. Higher maternal prenatal alcohol use significantly predicted lower infant mental and psychomotor development. Maternal depressive symptoms did not predict infant development over and above the effect of alcohol use.

CONCLUSIONS

Partner influence is an important contributor to prenatal alcohol use and maternal depressive symptoms, over and above the effect of SES. The significant paths from prenatal alcohol exposure to infant neurodevelopmental outcomes underscore the importance of partner influence during pregnancy.

Maternal Tobacco and Alcohol Use in Relation to Child Malnutrition in Gauteng, South Africa: A Retrospective Analysis

Tobacco and alcohol use among mothers is associated with numerous adverse consequences for affected offspring, including poor growth and development. This study determined the association between maternal tobacco and alcohol use, and malnutrition, among infants aged ≤ 12 months (n = 300), in selected health facilities situated in Gauteng, South Africa. Data on alcohol and tobacco use were collected using a validated questionnaire, in addition to mothers’ socio-demographic characteristics and obstetric history. Stunting (low height/length-for-age), underweight (low weight-for-age) and thinness (low body mass index-for-age) were calculated using z-scores based on the World Health Organization child growth standards. The association of tobacco and alcohol use with stunting, underweight and thinness was analysed using logistic regression analysis. The results showed a mean age of 29 years (24.0; 35.0) for mothers and 7.6 ± 3 months for infants, and over half of the mothers were unemployed (63%). Approximately 18.7% of mothers had used tobacco and 3% had used alcohol during pregnancy. The prevalence of current tobacco and alcohol use among mothers were estimated at 14.3% and 49.7%, respectively, and almost three-quarters (67.3%) of them were still breastfeeding during the study period. Stunting (55%) was the most prevalent malnutrition indicator among infants, while underweight was 41.7%, and thinness was 22%. Current tobacco use was associated with increased odds of being thin [OR = 2.40, 95% CI: 1.09–5.45), and after adjusting for confounders, current alcohol use was associated with the likelihood of being underweight [AOR = 1.96, 95% CI: 1.06–3.63] among infants. Future prospective cohort studies that examine growth patterns among infants who are exposed to maternal tobacco and alcohol use from the intrauterine life to infancy are necessary to inform, partly, the public health programmes, to reduce malnutrition among children.