Screening for Alcohol Use in Pregnancy: a Review of Current Practices and Perspectives

Dozet, Danijela; Burd, Larry; Popova, Svetlana

doi:10.1007/s11469-021-00655-3

Cited by 19 publications

(26 citation statements)

References 116 publications

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“…Both animal and human studies suggest prenatal choline may have larger effects on neurodevelopment than postnatal choline [ 121 ]. However, postnatal studies remain critical because, in the U.S., many alcohol-exposed pregnancies are only identified retrospectively, and nearly half of all pregnancies are unplanned—with rates of unplanned pregnancies even higher in developing countries [ 159 ]. In addition, there is a dearth of interventions available for individuals with FASD [ 8 , 160 ].…”

Section: Human Studies Also Demonstrate Choline Benefits Following Paementioning

confidence: 99%

Prenatal and Postnatal Choline Supplementation in Fetal Alcohol Spectrum Disorder

Ernst

Gimbel²,

Water³

et al. 2022

Nutrients

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Fetal alcohol spectrum disorder (FASD) is common and represents a significant public health burden, yet very few interventions have been tested in FASD. Cognitive deficits are core features of FASD, ranging from broad intellectual impairment to selective problems in attention, executive functioning, memory, visual–perceptual/motor skills, social cognition, and academics. One potential intervention for the cognitive impairments associated with FASD is the essential nutrient choline, which is known to have numerous direct effects on brain and cognition in both typical and atypical development. We provide a summary of the literature supporting the use of choline as a neurodevelopmental intervention in those affected by prenatal alcohol. We first discuss how alcohol interferes with normal brain development. We then provide a comprehensive overview of the nutrient choline and discuss its role in typical brain development and its application in the optimization of brain development following early insult. Next, we review the preclinical literature that provides evidence of choline’s potential as an intervention following alcohol exposure. Then, we review a handful of existing human studies of choline supplementation in FASD. Lastly, we conclude with a review of practical considerations in choline supplementation, including dose, formulation, and feasibility in children.

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Section: Human Studies Also Demonstrate Choline Benefits Following Paementioning

confidence: 99%

Prenatal and Postnatal Choline Supplementation in Fetal Alcohol Spectrum Disorder

Ernst

Gimbel²,

Water³

et al. 2022

Nutrients

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“…It is worth noting, however, that BIs can be as short as five minutes in length and computer-based/digital formats may decrease resources required for service delivery [ 28 ]. Ultimately, access to BIs begins with screening for alcohol use, which is underutilized in prenatal care settings globally [ 86 ]. However, even a single question about alcohol use during pregnancy has immense potential to change a woman’s alcohol use behaviours [ 66 , 80 ].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis

Popova

Dozet

Pandya

et al. 2023

BMC Pregnancy Childbirth

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Background Prenatal alcohol exposure (PAE) can result in a range of adverse neonatal outcomes, including Fetal Alcohol Spectrum Disorder (FASD). This systematic review and meta-analysis sought to investigate the effectiveness of brief interventions (BIs) in eliminating or reducing 1) alcohol consumption during pregnancy; and 2) PAE-related adverse neonatal outcomes; and 3) cost-effectiveness of BIs. Method We conducted a systematic literature search for original controlled studies (randomized control trials (RCTs); quasi-experimental) in any setting, published from 1987 to 2021. The comparison group was no/minimal intervention, where a measure of alcohol consumption was reported. Studies were critically appraised using the Centre for Evidence-based Medicine Oxford critical appraisal tool for RCTs (1). The certainty in the evidence for each outcome was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) (2). Meta-analysis of continuous and binary estimates of effect-size for similar outcome measures for BIs versus control groups were pooled and reported as mean difference (MD) Hedges’ g and odds ratios (ORs), respectively. Results In total, 26 studies, all from high income countries, met inclusion criteria. Alcohol abstinence outcome available in 12 studies (n = 2620) found modest effects in favor of BIs conditions by increasing the odds of abstinence by 56% (OR = 1.56, 95% confidence interval (CI) = 1.15–2.13, I2 = 46.75%; p = 0.04). BIs effects for reduction in mean drinks/week (Cohen’s d = − 0.21, 95%CI = - 0.78 to 0.36; p = 0.08) and AUDIT scores (g = 0.10, 95%CI = − 0.06 to 0.26; p = 0.17) were not statistically significant. Among seven studies (n = 740) reporting neonatal outcomes, BI receipt was associated with a modest and significant reduction in preterm birth (OR = 0.67, 95% CI = 0.46–0.98, I2 = 0.00%; p = 0.58). No statistically significant differences were observed for mean birthweight or lower likelihood of low birth weight (LBW). Certainty in the evidence was rated as ‘low’. No eligible studies were found on cost-effectiveness of BIs. Conclusion BIs are moderately effective in increasing abstinence during pregnancy and preventing preterm birth. More studies on the effectiveness of BIs are needed from low- and middle-income countries, as well as with younger mothers and with a broader range of ethnic groups.

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“…Fetal alcohol spectrum disorder (FASD) is an umbrella term which includes a wide range of neurological and behavioral problems that can affect a person who was born to a woman who had abused alcohol during pregnancy [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Relationship between Fetal Alcohol Spectrum Disorder (FASD) and Criminal Justice: A Systematic Review

et al. 2022

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Prenatal alcohol exposure is considered one of the main causes of preventable birth disorders; however, it represents the main form of developmental delay in the world. Among the so-called secondary disabilities related to fetal alcohol spectrum disorder (FASD), there is a close connection with criminal behavior. This systematic review aims to provide up-to-date information about the relationship between FASD subjects and criminal justice analyzing different aspects. In light of the results of this review, a further goal is to provide several suggestions in order to reduce the public cost impact of FASD. A systematic review of the literature was conducted according to the PRISMA guidelines, producing 20 articles that met the inclusion criteria. Based on the results published in the selected studies, fetal alcohol syndrome (FAS) is a leading cause of preventable birth disorders and developmental disabilities in newborns. Moreover, these subjects seem to be more inclined to criminal acts compared to others. In conclusion, it should be pointed out that FASD entails high public health costs, both regarding the support measures provided to the affected individual and to their family, as well as the cost and social impact of any criminal offenses committed.

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Screening for Alcohol Use in Pregnancy: a Review of Current Practices and Perspectives

Cited by 19 publications

References 116 publications

Prenatal and Postnatal Choline Supplementation in Fetal Alcohol Spectrum Disorder

Prenatal and Postnatal Choline Supplementation in Fetal Alcohol Spectrum Disorder

Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis

Understanding the Relationship between Fetal Alcohol Spectrum Disorder (FASD) and Criminal Justice: A Systematic Review

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