Maternal factors associated with heavy periconceptional alcohol intake and drinking following pregnancy recognition: A post‐partum survey of <scp>N</scp>ew <scp>Z</scp>ealand women

Mallard, Simonette R.; Connor, Jennie; Houghton, Lisa A

doi:10.1111/dar.12024

Cited by 24 publications

(28 citation statements)

References 38 publications

(42 reference statements)

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“…Existing studies on women's alcohol use during pregnancy have tended to take a retrospective approach to assess drinking behavior, asking women to report on pregnancy behaviors in the post-partum period and beyond [15,42], which increases the likelihood of recall bias. Moreover, a prospective design allows women to report their drinking levels and traumatic experiences before they are even pregnant, without being influenced by a desire for consistency with their current behaviors and experiences during pregnancy.…”

Section: Discussionmentioning

confidence: 99%

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Drinking before and after pregnancy recognition among South African women: the moderating role of traumatic experiences

Choi

Abler

Watt

et al. 2014

BMC Pregnancy Childbirth

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BackgroundSouth Africa has one of the world’s highest rates of fetal alcohol spectrum disorder (FASD) and interpersonal trauma. These co-occurring public health problems raise the need to understand alcohol consumption among trauma-exposed pregnant women in this setting. Since a known predictor of drinking during pregnancy is drinking behavior before pregnancy, this study explored the relationship between women’s drinking levels before and after pregnancy recognition, and whether traumatic experiences – childhood abuse or recent intimate partner violence (IPV) – moderated this relationship.MethodsWomen with incident pregnancies (N = 66) were identified from a longitudinal cohort of 560 female drinkers in a township of Cape Town, South Africa. Participants were included if they reported no pregnancy at one assessment and then reported pregnancy four months later at the next assessment. Alcohol use was measured by the Alcohol Use Disorders Identification Test (AUDIT), and traumatic experiences of childhood abuse and recent IPV were also assessed. Hierarchical linear regressions controlling for race and age examined childhood abuse and recent IPV as moderators of the effect of pre-pregnancy recognition drinking on post-pregnancy recognition AUDIT scores.ResultsFollowing pregnancy recognition, 73% of women reported drinking at hazardous levels (AUDIT ≥ 8). Sixty-four percent reported early and/or recent exposure to trauma. While drinking levels before pregnancy significantly predicted drinking levels after pregnancy recognition, t(64) = 3.50, p < .01, this relationship was moderated by experiences of childhood abuse, B = -.577, t(60) = -2.58, p = .01, and recent IPV, B = -.477, t(60) = -2.16, p = .04. Pregnant women without traumatic experiences reported drinking at levels consistent with levels before pregnancy recognition. However, women with traumatic experiences tended to report elevated AUDIT scores following pregnancy recognition, even if low-risk drinkers previously.ConclusionThis study explored how female drinkers in South Africa may differentially modulate their drinking patterns upon pregnancy recognition, depending on trauma history. Our results suggest that women with traumatic experiences are more likely to exhibit risky alcohol consumption when they become pregnant, regardless of prior risk. These findings illuminate the relevance of trauma-informed efforts to reduce FASD in South Africa.

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Section: Discussionmentioning

confidence: 99%

“…A woman who drinks heavily is more likely to continue to drink during her pregnancy [15], perhaps due to habit and/or alcohol dependence. Notably, among South African women who report alcohol consumption, those who do drink tend to drink heavily [9], and so may be at increased risk to engage in alcohol consumption during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Drinking before and after pregnancy recognition among South African women: the moderating role of traumatic experiences

Choi

Abler

Watt

et al. 2014

BMC Pregnancy Childbirth

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“…Drinking 3 months before pregnancy, a proxy for before-pregnancy recognition, has been a frequently recognized risk factor in many US and European studies. [56][57][58][59][60][61] Recruitment of mothers to obtain maternal risk data posed significant challenges for the interviewers. Therefore, variables that differentiate maternal risk in this population were not as evident or readily obtained in this US population or in our Italian studies 15,16 as elsewhere.…”

Section: Maternal Risk Measurementsmentioning

confidence: 99%

Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders

et al. 2014

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WHAT'S KNOWN ON THIS SUBJECT: Most studies of fetal alcohol syndrome and fetal alcohol spectrum disorders (FASD) prevalence in the general population of the United States have been carried out using passive methods (surveillance or clinicbased studies), which underestimate rates of FASD. WHAT THIS STUDY ADDS:Using active case ascertainment methods among children in a representative middle class community, rates of fetal alcohol syndrome and total FASD are found to be substantially higher than most often cited estimates for the general US population. abstract OBJECTIVES: To determine the prevalence and characteristics of fetal alcohol spectrum disorders (FASD) among first grade students (6-to 7-year-olds) in a representative Midwestern US community. METHODS:From a consented sample of 70.5% of all first graders enrolled in public and private schools, an oversample of small children (#25th percentile on height, weight, and head circumference) and randomly selected control candidates were examined for physical growth, development, dysmorphology, cognition, and behavior. The children's mothers were interviewed for maternal risk. RESULTS:Total dysmorphology scores differentiate significantly fetal alcohol syndrome (FAS) and partial FAS (PFAS) from one another and from unexposed controls. Alcohol-related neurodevelopmental disorder (ARND) is not as clearly differentiated from controls. Children who had FASD performed, on average, significantly worse on 7 cognitive and behavioral tests and measures. The most predictive maternal risk variables in this community are late recognition of pregnancy, quantity of alcoholic drinks consumed 3 months before pregnancy, and quantity of drinking reported for the index child's father. From the final multidisciplinary case findings, 3 techniques were used to estimate prevalence. FAS in this community likely ranges from 6 to 9 per 1000 children (midpoint, 7.5), PFAS from 11 to 17 per 1000 children (midpoint, 14), and the total rate of FASD is estimated at 24 to 48 per 1000 children, or 2.4% to 4.8% (midpoint, 3.6%). (Continued on last page) CONCLUSIONS:

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“…If prolonged, the time between conception and pregnancy recognition may be crucial (Parackal et al 2013) since pre-pregnancy behaviours are likely to persist. Pre-pregnancy drinking is strongly predictive of pregnancy drinking (Skagerstróm et al 2011, Mallard et al 2013), so it is important when taking an alcohol history in pregnancy to include pre-conceptual levels and patterns. …”

Section: Introductionmentioning

confidence: 99%

Peri‐conceptual and mid‐pregnancy drinking: a cross‐sectional assessment in two Scottish health board areas using a 7‐day Retrospective Diary

Symon

Rankin

Sinclair

et al. 2016

Journal of Advanced Nursing

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Aims The aim of this study was to evaluate the use of a 7‐day Retrospective Diary to assess peri‐conceptual and mid‐pregnancy alcohol consumption. Background Alcohol consumption among women has increased significantly and is of international concern. Heavy episodic (‘binge’) drinking is commonplace and is associated with unintended pregnancy. Pre‐pregnancy drinking is strongly associated with continued drinking in pregnancy. Routine antenatal assessment of alcohol history and current drinking is variable; potentially harmful peri‐conceptual drinking may be missed if a woman reports low or no drinking during pregnancy. Design Cross‐sectional study (n = 510) in two Scottish health board areas. Methods Face‐to‐face Retrospective Diary administration from February to June 2015 assessing alcohol consumption in peri‐conceptual and mid‐pregnancy periods. Women were recruited at the mid‐pregnancy ultrasound clinic. Results Of 510 women, 470 (92·0%) drank alcohol before their pregnancy; 187 (39·9%) drank every week. Retrospective assessment of peri‐conceptual consumption identified heavy episodic drinking (more than six units on one occasion) in 52·2% (n = 266); 19·6% (n = 100) reported drinking more than 14 units per week, mostly at the weekend; ‘mixing’ of drinks was associated with significantly higher consumption. While consumption tailed off following pregnancy recognition, 5·5% (n = 28) still exceeded the recommended daily two‐unit limit in pregnancy. Multivariable logistic regression identified that women who ‘binged’ peri‐conceptually were 3·2 times more likely to do this. Conclusion Statistically significant peri‐conceptual consumption levels suggest a substantial proportion of alcohol‐exposed pregnancies before pregnancy recognition. Not taking a detailed alcohol history, including patterns of consumption, will result in under‐detection of alcohol‐exposed pregnancies. The Retrospective Diary offers practitioners a detailed way of enquiring about alcohol history for this population.

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Maternal factors associated with heavy periconceptional alcohol intake and drinking following pregnancy recognition: A post‐partum survey of New Zealand women

Cited by 24 publications

References 38 publications

Drinking before and after pregnancy recognition among South African women: the moderating role of traumatic experiences

Drinking before and after pregnancy recognition among South African women: the moderating role of traumatic experiences

Prevalence and Characteristics of Fetal Alcohol Spectrum Disorders

Peri‐conceptual and mid‐pregnancy drinking: a cross‐sectional assessment in two Scottish health board areas using a 7‐day Retrospective Diary

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