Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study

Abstract

BackgroundCohort studies have noted associations between hazardous alcohol use during pregnancy and infant growth outcomes, but many have not controlled for potential psychosocial confounders. To assess the unique contribution of hazardous alcohol use, we examined its effect on infant growth outcomes while controlling for maternal psychosocial stressors and hazardous tobacco and drug use in a cohort of 986 pregnant South African women enrolled into the Drakenstein Child Health Study between 2012 and 2015.MethodsData on psychosocial stressors and maternal risk behaviors were collected between 28 and 32 weeks of gestation. Participants were categorized as hazardous alcohol users if they obtained moderate or high scores (>10) on the Alcohol, Smoking and Substance Involvement Screening Test at this assessment or retrospectively reported drinking at least 2 drinks weekly during any trimester of pregnancy. Infant growth outcomes were recorded at delivery. Multivariable regression models examined correlates of hazardous alcohol use and associations between hazardous alcohol use and birth outcomes.ResultsOverall, 13% of mothers reported hazardous alcohol use. Recent exposure to intimate partner violence (adjusted odds ratio (aOR) = 2.08; 95% confidence interval (CI): 1.37, 3.18) and hazardous tobacco use (aOR = 5.03; 95% CI: 2.97, 8.52) were significant correlates of hazardous alcohol use. After controlling for potential psychosocial confounders, hazardous alcohol use remained associated with lower infant weight‐for‐age (B = −0.35, 95% CI: −0.56, −0.14), height‐for‐age (B = −0.46, 95% CI: −0.76, −0.17), and head‐circumference‐for‐age z‐scores (B = −0.43, 95% CI: −0.69, −0.17).ConclusionsInterventions to reduce hazardous alcohol use among pregnant women in South Africa are needed to prevent alcohol‐related infant growth restrictions. As these growth deficits may lead to neurodevelopmental consequences, it is critical to identify alcohol‐related growth restrictions at birth and link exposed infants to early interventions for neurodevelopment.

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

“…In the final review, articles were published from 10 countries among 46 countries were included. Of these studies, eleven studies were found from Ethiopia [13,19,[30][31][32][33][34][35][36][37][38], nine articles were from South Africa [20,22,[39][40][41][42][43][44][45][46], five articles were from Nigeria [18,[47][48][49][50], two studies were from Ghana [51,52], one article was from Kenya [53], three articles were from Tanzania [54][55][56], two studies were from Uganda [21,57] one study was from Burkina Faso [58], and one article was from Zambia [59]. Regarding the study designs, twenty-five (83%) of them were cross-sectional, three studies (3.5%) were cohort and three articles (3.5%) were case-control.…”

“…In all studies, alcohol consumption data were taken from the self-report of pregnant women, which means no data was collected using biomarkers or meconium tests. Lists of self-reporting questionnaires were: Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) [22,40,55], Tolerance, Worried, Eye-opener, Amnesia and, K/Cut-down (TWEAK) [57], Alcohol Use Disorders Identification Test (AUDIT) [39,41], Cutting down, Annoyance, Guilt, and Eye-opener (CAGE) [21], Alcohol Smoking and Substance Involvement Test (ASSIST) [44,50], Tolerance-Annoyed, Cut off, Eyeopening (T-ACE) [19], and 1-Question screen strategy [60]. Structured questionnaires were used in the rest of all studies (64%) to screen alcohol consumption during pregnancy.…”

Thyroid Function in Pregnant Women With Moderate to Severe Alcohol Consumption Is Related to Infant Developmental Outcomes

“…In this pilot study, 21 mothers and their children with moderate–severe (PAE, as defined by mothers drinking at least twice a week and at least two drinks per occasion during any stage of pregnancy prior to recruitment) and 19 mothers and their children with no alcohol exposure (controls) were assessed for maternal thyroid function and child growth and developmental outcomes ( 61 ).…”

Maternal psychosocial risk factors and offspring gestational epigenetic age acceleration in a South African birth cohort study

“…We have previously reported a high burden of maternal psychosocial risk factors (eg. traumatic stress exposure/posttraumatic stress disorder (PTSD), alcohol and tobacco use); and significant associations between these factors and adverse offspring birth and neurodevelopmental outcomes in this cohort [19][20][21][22][23] . In the current analysis, we aimed to investigate associations between maternal psychosocial risk factors and offspring EA acceleration at birth.…”