Recognized spontaneous abortion in mid-pregnancy and patterns of pregnancy alcohol use

Abstract

Alcohol consumption during pregnancy is one potential risk factor for spontaneous abortion (SAb). Prior research suggested that heavy drinking during pregnancy was associated with significantly increased rates of SAb, but results for lower levels of drinking have been inconsistent. We examined the association between different levels and patterns of prenatal alcohol consumption and SAb in a high-risk inner-city sample. We hypothesized that higher levels, binge patterns, and more frequent drinking would be associated with increased rates of SAb. The quantity and frequency of self-reported peri-conceptional and repeated in-pregnancy maternal drinking volumes per beverage type were assessed with semi-structured interviews in a prospective subsample of 302 African-American mothers. Relations between various measures of prenatal alcohol exposure and SAb were assessed using logistic regression. After controlling for various potential confounders, there was a significant positive relation between average absolute alcohol use per day across pregnancy and SAb. Greater frequency of drinking episodes also predicted SAb: an average of even one day of drinking per week across pregnancy was associated with an increase in the incidence of SAb. However, contrary to our hypothesis, neither the amount of alcohol drunk per drinking day nor a measure of binge drinking were significantly related to SAb after controlling for confounders. Differences in when women who drank at risk levels initiated antenatal care may have under-estimated the impact of alcohol on SAb in this low-SES urban African American sample. Some drinking measures averaged across pregnancy may have underestimated consumption and overestimated risk of SAb, but others risk-drinking measures that avoid this limitation show similar relations to SAb. Identifying fetal risk drinking in pregnant women is critical to increasing the effectiveness of interventions that reduce risk-level alcohol consumption and protect from pregnancy loss.

Volume and Type of Alcohol During Early Pregnancy and the Risk of Miscarriage

“…However, the literature has yielded inconsistent results regarding the existence of an association. Several studies have found an association between alcohol consumption during pregnancy and miscarriage(Andersen, Andersen, Olsen, Gronbaek, & Strandberg-Larsen, 2012; Armstrong, McDonald, & Sloan, 1992; Chiodo et al, 2012; Harlap & Shiono, 1980; Henriksen et al, 2004; Kesmodel, Wisborg, Olsen, Henriksen, & Secher, 2002; Kline, Shrout, Stein, Susser, & Warburton, 1980; Maconochie, Doyle, Prior, & Simmons, 2007; Rasch, 2003; Windham, Von Behren, Fenster, Schaefer, & Swan, 1997). However, others, including two systematic reviews published in 2006 and 2007, have not(Cavallo, Russo, Zotti, Camerlengo, & Ruggenini, 1995; Henderson, Gray, & Brocklehurst, 2007; Parazzini et al, 1994; Tolstrup et al, 2003; Zhang & Bracken, 1996).…”

“…Studies evaluating alcohol consumption in continuous or discrete levels of intake have produced more mixed results(Andersen, et al, 2012; Armstrong, et al, 1992; Cavallo, et al, 1995; Chiodo, et al, 2012; Harlap & Shiono, 1980; Henriksen, et al, 2004; Kesmodel, et al, 2002; Kline, et al, 1980; Maconochie, et al, 2007; Parazzini, et al, 1994; Rasch, 2003; Windham, Fenster, & Swan, 1992; Windham, et al, 1997). Most research examining levels of alcohol use has found evidence of a threshold between two to four drinks per week at which alcohol use during pregnancy is related to miscarriage(Andersen, et al, 2012; Armstrong, et al, 1992; Harlap & Shiono, 1980; Henriksen, et al, 2004; Kesmodel, et al, 2002; Kline, et al, 1980; Maconochie, et al, 2007; Rasch, 2003; Windham, et al, 1992; Windham, et al, 1997).…”

GABAA overactivation potentiates the effects of NMDA blockade during the brain growth spurt in eliciting locomotor hyperactivity in juvenile mice

“…It has been demonstrated that treatment with NMDA blockers and GABAA agonists can lead to respiratory depression in neonates (Fregosi et al, 2004;Poon et al, 2000), which in turn, is commonly associated with hypoxia, a lack of adequate oxygen supply that can cause death or severely affect brain development (Nyakas et al, 1996). Moreover, it is well known in humans that the number of miscarriages (Chiodo et al, 2012) as well as the severity of pathological phenotypes in the newborn (Riley and McGee, 2005) increase as the amount of ethanol consumed increases. Thus, it may be unclear as to whether the behavioral changes observed in the MK HIGH and MK LOW +MU HIGH groups were a result of the diminished health of the animal, a direct effect of the drug on the brain, or some combination of these factors.…”

Padrão do consumo de álcool em gestantes atendidas em um hospital público universitário e fatores de risco associados

“…O efeito tardio se manifesta por mudanças na capacidade intelectual, de aprendizagem, atenção e comportamento 2 . Estudos recentes [3][4][5] mostram que não existe uma quantidade de consumo alcoólico que possa ser considerada segura durante a gravidez, e que as mulheres deveriam ser aconselhadas à abstinência alcoólica desde a concepção e durante todo o período de gravidez.…”