Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders

ObjectivesFetal alcohol spectrum disorders (FASD) is a worldwide problem. Maternal alcohol consumption is an important risk factor for FASD. It remains unknown which alcohol consumption patterns most strongly predict FASD. The objective of this study was to identify these.DesignSystematic literature review.MethodsWe searched in PubMed, PsychINFO, PsycARTICLES, ERIC, CINAHL, Embase and MEDLINE up to August 2018. The query consisted of keywords and their synonyms related to FASD, pregnancy and behaviour. Studies were excluded when not published in English, were reviews or involved non-human subjects. Substantial heterogeneity precluded aggregation or meta-analysis of the data. Instead, data were qualitatively inspected.ResultsIn total, 21 studies were eligible for further data analysis. All studies that measured both maternal alcohol drinking behaviours and FASD reported retrospective data on maternal drinking patterns, employing both continuous and categorical measures and exhibiting substantial heterogeneity in measures of alcohol consumption (eg, timing of exposure, quantification of alcohol measure and definition of a standard drink). Study quality improved over time and appeared higher for studies based on active case ascertainment, especially when conducted in schools and when behaviour was assessed through interviews.ConclusionsWe aimed to identify specific maternal drinking behaviour(s) related to FASD. The state of the literature precludes such conclusions. Evidence-based preventive measures necessitate identifying which prenatal alcohol drinking behaviour(s) are most in need of intervention. Therefore, we formulate three recommendations for future research. First, future studies can optimise the value of the collected dataset through specifying measurements and reporting of maternal drinking behaviours and avoiding categorised measures (nominal or ordinal) whenever possible. Second, samples should not be selected based on FASD status, but instead, FASD status as well as maternal alcohol consumption should both be measured in a general population sample. Finally, we provide 10 reporting guidelines for FASD research.

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Commentary: Fetal Alcohol Spectrum Disorders

The International Journal of Alcohol and Drug Research ◽

10.7895/ijadr.v2i3.173 ◽

1969 ◽

Vol 2 (3) ◽

pp. 3-6 ◽

Cited By ~ 4

Author(s):

Larry Burd ◽

Jacob Kerbeshian

Keyword(s):

Alcohol Use ◽

Fetal Alcohol Spectrum Disorders ◽

Prenatal Alcohol Exposure ◽

Alcohol Exposure ◽

Childbearing Age ◽

Fetal Alcohol ◽

Effective Prevention ◽

Life Years ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum

Burd, L., & Kerbeshian, J. (2013). Commentary: Fetal Alcohol Spectrum Disorders. The International Journal Of Alcohol And Drug Research, 2(3), 3-6. doi:10.7895/ijadr.v2i3.173 (http://dx.doi.org/10.7895/ijadr.v2i3.173)Alcohol use is now the third leading risk factor for worldwide global disease burden, in terms of disability adjusted life years (Lim et al., 2012). In the developed world, about 40% of women of childbearing age drink alcohol, and many are drinking at or around the time of conception (Maier & West, 2001; Paintner, Williams, & Burd, 2012a). Rates of alcohol use among women are increasing across much of the world. Current prevalence estimates suggest that several hundred thousand individuals with fetal alcohol spectrum disorders (FASD) are born each year (May, Gossage, & Kalberg, 2009). This is especially tragic in light of the fact that we have effective prevention methods as well as office-based interventions for prenatal alcohol exposure.

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Identifying Maternal Self-Reported Alcohol Use Associated With Fetal Alcohol Spectrum Disorders

Alcoholism Clinical and Experimental Research ◽

10.1111/j.1530-0277.2001.tb02210.x ◽

2001 ◽

Vol 25 (2) ◽

pp. 283-287 ◽

Cited By ~ 115

Author(s):

Helen M. Barr ◽

Ann P. Streissguth

Keyword(s):

Alcohol Use ◽

Fetal Alcohol Spectrum Disorders ◽

Fetal Alcohol ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum

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Prenatal Alcohol Use and Fetal Alcohol Spectrum Disorders: Diagnosis, Assessment and New Directions in Research and Multimodal Treatment

10.2174/97816080503141110101 ◽

2012 ◽

Keyword(s):

Alcohol Use ◽

Multimodal Treatment ◽

Fetal Alcohol Spectrum Disorders ◽

Fetal Alcohol ◽

Prenatal Alcohol Use ◽

New Directions ◽

Prenatal Alcohol ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum

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Australia plays ‘catch-up’ with Fetal Alcohol Spectrum Disorders

The International Journal of Alcohol and Drug Research ◽

10.7895/ijadr.v3i1.177 ◽

2014 ◽

Vol 3 (1) ◽

pp. 121-125 ◽

Cited By ~ 4

Author(s):

Elizabeth Jane Elliott

Keyword(s):

Alcohol Use ◽

Health Professionals ◽

Common Good ◽

Fetal Alcohol Spectrum Disorders ◽

Diagnostic Tools ◽

Fetal Alcohol ◽

Catch Up ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum ◽

In Pregnancy

Elliott, E. (2014). Australia plays ‘catch-up’ with Fetal Alcohol Spectrum Disorders. The International Journal Of Alcohol And Drug Research, 3(1), 121-125. doi:http://dx.doi.org/10.7895/ijadr.v3i1.177Australians are amongst the highest consumers of alcohol worldwide, and "risky" drinking is increasing in young women. Contrary to the advice in national guidelines, drinking in pregnancy is common. Many women don’t understand the potential for harm to the unborn child and 20% have a "tolerant" attitude to drinking during pregnancy. As attitude, rather than knowledge, predicts risk of drinking in a future pregnancy, this presents a challenge for public health campaigns. Alcohol is teratogenic, crosses the placenta, and contributes to a range of physical, developmental, learning and behavioural problems, including fetal alcohol spectrum disorders (FASD). As nearly half of all pregnancies in Australia are unplanned, inadvertent exposure to alcohol is common. Good-quality prevalence data on FASD are lacking in Australia, although alcohol use at "risky" levels is well documented in some disadvantaged communities. In the last decade, clinicians, researchers, governments and non-governmental organizations have shown renewed interest in addressing alcohol use in pregnancy and FASD. This has included a parliamentary inquiry into FASD, provision of targeted funding for FASD, and development of educational materials for health professionals and the general public. Key challenges for the future are to prevent FASD and to offer timely diagnosis and help to children and families living with FASD. The implementation of evidence-based interventions known to decrease access to, and excessive use of, alcohol in our society will aid in the prevention of FASD. The development of national diagnostic tools for screening and diagnosis, and the training of health professionals in the management of FASD, are urgently needed.

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Vascular effects of maternal alcohol consumption

AJP Heart and Circulatory Physiology ◽

10.1152/ajpheart.00127.2012 ◽

2012 ◽

Vol 303 (4) ◽

pp. H414-H421 ◽

Cited By ~ 24

Author(s):

Jayanth Ramadoss ◽

Ronald R. Magness

Keyword(s):

Alcohol Consumption ◽

Vascular Reactivity ◽

Fetal Alcohol Spectrum Disorders ◽

Vascular System ◽

Fetal Alcohol ◽

Paracrine Factors ◽

Maternal Alcohol ◽

Maternal Alcohol Consumption ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum

Maternal alcohol consumption during pregnancy is a significant field of scientific exploration primarily because of its negative effects on the developing fetus, which is specifically defined as fetal alcohol spectrum disorders. Though the effects on the mother are less explored compared with those on the fetus, alcohol produces multiple effects on the maternal vascular system. Alcohol has major effects on systemic hemodynamic variables, endocrine axes, and paracrine factors regulating vascular resistance, as well as vascular reactivity. Alcohol is also reported to have significant effects on the reproductive vasculature including alterations in blood flow, vessel remodeling, and angiogenesis. Data presented in this review will illustrate the importance of the maternal vasculature in the pathogenesis of fetal alcohol spectrum disorders and that more studies are warranted in this field.

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Systematic literature review on which maternal alcohol behaviors are related to Fetal Alcohol Spectrum Disorders

10.31234/osf.io/7ft8e ◽

2018 ◽

Author(s):

Sylvia Roozen ◽

Gjalt - Jorn Ygram Peters ◽

Gerjo Kok ◽

David Townend ◽

Jan Nijhuis ◽

...

Keyword(s):

Alcohol Consumption ◽

Fetal Alcohol Spectrum Disorders ◽

Drinking Behavior ◽

Fetal Alcohol ◽

Maternal Alcohol ◽

Maternal Alcohol Consumption ◽

Drinking Behaviors ◽

Spectrum Disorders ◽

Fetal Alcohol Spectrum ◽

Substantial Heterogeneity

Objectives: Fetal Alcohol Spectrum Disorders (FASD) is a worldwide problem. Maternal alcohol consumption is an important risk factor for FASD. It remains unknown which alcohol consumption patterns most strongly predict FASD. The objective of this study was to identify these.Design: Systematic literature review.Methods: We searched in PubMed, PsychINFO, PsycARTICLES, ERIC, CINAHL, EMBASE and MEDLINE upto August 2018. The query consisted of keywords and their synonyms related to FASD, pregnancy, and behavior. Studies were excluded when not published in English, were reviews, or involved non-human subjects. Substantial heterogeneity precluded aggregation or meta-analysis of the data. Instead, data were qualitatively inspected.Results: In total, 21 studies were eligible for further data analysis. All studies that measured both maternal alcohol drinking behaviors and FASD reported retrospective data on maternal drinking patterns, employing both continuous and categorical measures and exhibiting substantial heterogeneity in measures of alcohol consumption (e.g., timing of exposure, quantification of alcohol measure,definition of a standard drink). Study quality improved over time and appeared higher for studies based on active case ascertainment, especially when conducted in schools, and when behavior was assessed through interviews.Conclusions: We aimed to identify specific maternal drinking behavior(s) related to FASD. The state ofthe literature precludes such conclusions. Evidence-based preventive measures necessitate identifying which prenatal alcohol drinking behavior(s) are most in need of intervention. Therefore, we formulate three recommendations for future research. First, future studies can optimize the value of the collected dataset through specifying measurements and reporting of maternal drinking behaviors, and avoiding categorized measures (nominal or ordinal) whenever possible. Second, samples should not be selected based on FASD status, but instead, FASD status as well as maternal alcohol consumption should both be measured in a general population sample. Finally, we provide ten reporting guidelines for FASD research.

Download Full-text