scholarly journals Social predictors of alcohol use and cessation during pregnancy among Japanese women: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

2020 ◽  
Author(s):  
Keiko Murakami ◽  
Taku Obara ◽  
Mami Ishikuro ◽  
Fumihiko Ueno ◽  
Aoi Noda ◽  
...  
Keyword(s):  
Higher Education ◽  
Cohort Study ◽  
Alcohol Use ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
University Education ◽  
Work Status ◽  
Social Predictors ◽  
Miyagi Prefecture ◽  
Alcohol Cessation

Abstract Background: Most studies on social predictors of alcohol use have been conducted at one time point during pregnancy or using postpartum retrospective reports. Furthermore, the studies were mainly conducted in Western countries. We aimed to prospectively examine social predictors of alcohol use and cessation during pregnancy in Japan.Methods: This prospective study was part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. Pregnant women were recruited at approximately 50 obstetric clinics and hospitals in Miyagi Prefecture in Japan. We analyzed 11592 pregnant women who completed the questionnaires administered in early pregnancy and middle pregnancy. Women were dichotomized as current drinkers or non-drinkers in both early and middle pregnancy. Age, education, income, work status, and psychological distress were used as social predictors. Multivariate logistic regression analyses were conducted to examine associations between these predictors and alcohol use in early and middle pregnancy. Associations with alcohol cessation between early pregnancy and middle pregnancy were also examined.Results: Prevalence of alcohol use in early and middle pregnancy was 20.9% and 6.4%, respectively. Higher education was associated with alcohol use in early pregnancy and alcohol cessation during pregnancy; the odds ratios (ORs) of ≥university education compared with ≤high school education were 1.47 (95% confidence interval [CI], 1.30–1.66) and 1.31 (95% CI, 1.00–1.71), respectively. Work status was associated with alcohol use in both periods and alcohol cessation during pregnancy; for alcohol cessation, the OR of working in early pregnancy only compared with not working in both periods was 1.72 (95% CI, 1.03–2.88).Conclusions: Women with higher education were more likely to consume alcohol in early pregnancy and to cease between early pregnancy and middle pregnancy. Working women were more likely to consume alcohol throughout pregnancy in Japan.

scholarly journals Associations of education and work status with alcohol use and cessation among pregnant women in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

2020 ◽  
Author(s):  
Keiko Murakami ◽  
Taku Obara ◽  
Mami Ishikuro ◽  
Fumihiko Ueno ◽  
Aoi Noda ◽  
...  
Keyword(s):  
Higher Education ◽  
Cohort Study ◽  
Alcohol Use ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Working Women ◽  
University Education ◽  
Work Status ◽  
Miyagi Prefecture ◽  
Alcohol Cessation

Abstract Background: There is inconsistent evidence on the associations of education and work status with alcohol use during pregnancy. We aimed to examine the associations of education and work status with alcohol use in early and middle pregnancy and alcohol cessation between early and middle pregnancy in Japan.Methods: This prospective study was part of the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. Pregnant women were recruited at approximately 50 obstetric clinics and hospitals in Miyagi Prefecture in Japan. We analyzed 11592 pregnant women who completed the questionnaires administered in early pregnancy and middle pregnancy. Women were dichotomized as current drinkers or non-drinkers in both early and middle pregnancy. Multivariable logistic regression analyses were conducted to examine associations of education and work status with alcohol use in early and middle pregnancy, adjusting for age, income, psychological distress, and work status/education. Associations with alcohol cessation between early pregnancy and middle pregnancy were also examined.Results: Prevalence of alcohol use in early and middle pregnancy was 20.9% and 6.4%, respectively. Higher education was associated with alcohol use in early pregnancy and alcohol cessation during pregnancy; the odds ratios (ORs) of ≥university education compared with ≤high school education were 1.47 (95% confidence interval [CI], 1.30–1.66) and 1.31 (95% CI, 1.00–1.71), respectively. Work status was associated with alcohol use in both periods and alcohol cessation during pregnancy; for alcohol cessation, the OR of working in early pregnancy only compared with not working in both periods was 1.72 (95% CI, 1.03–2.88).Conclusions: Women with higher education were more likely to consume alcohol in early pregnancy and to cease between early pregnancy and middle pregnancy. Working women were more likely to consume alcohol throughout pregnancy in Japan.

scholarly journals Associations of education and work status with alcohol use and cessation among pregnant women in Japan: the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Keiko Murakami ◽  
Taku Obara ◽  
Mami Ishikuro ◽  
Fumihiko Ueno ◽  
Aoi Noda ◽  
...  
Keyword(s):  
Higher Education ◽  
Cohort Study ◽  
Alcohol Use ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Working Women ◽  
University Education ◽  
Work Status ◽  
Alcohol Cessation ◽  
Lower Education

Abstract Background There is inconsistent evidence on the associations of education and work status with alcohol use during pregnancy. Our aim was to examine the associations of education and work status with alcohol use and alcohol cessation during pregnancy in Japan. Methods Data were analyzed from 11,839 pregnant women who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017 in Japan. Women were dichotomized as current drinkers or non-drinkers in both early and middle pregnancy. Alcohol cessation was defined as alcohol use in early pregnancy, but not in middle pregnancy. Multivariable log-binomial regression analyses were conducted to examine associations of education and work status with alcohol use in early and middle pregnancy and alcohol cessation, adjusted for age and income. The prevalence ratios (PRs) and 95% confidence intervals (CIs) were calculated by work status and education. Results The prevalence of alcohol use in early and middle pregnancy was 20.9 and 6.4%, respectively. Higher education was associated with alcohol use in early pregnancy both among working and non-working women; the PRs of university education or higher compared with high school education or lower were 1.62 (95% CI, 1.34–1.96) and 1.29 (95% CI, 1.16–1.45), respectively. Higher education was associated with alcohol cessation during pregnancy among working women; the corresponding PR was 1.09 (95% CI, 1.01–1.17). Working was associated with alcohol use in early and middle pregnancy. Working was associated with a decreased probability of alcohol cessation among women with lower education but with an increased probability of alcohol cessation among women with higher education; the PRs of working compared with not working were 0.91 (95% CI, 0.82–1.00) and 1.10 (95% CI, 1.00–1.20), respectively. Conclusions Women with higher education were more likely to consume alcohol in early pregnancy and to cease alcohol use between early and middle pregnancy, especially working women. Working women were more likely to consume alcohol throughout pregnancy. Working women with lower education were less likely to cease alcohol use, whereas working women with higher education were more likely to cease alcohol use between early and middle pregnancy.

Associations of education and income with alcohol use among Japanese pregnant women

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K Murakami ◽  
T Obara ◽  
M Ishikuro ◽  
F Ueno ◽  
A Noda ◽  
...  
Keyword(s):  
Higher Education ◽  
Alcohol Use ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Household Income ◽  
University Education ◽  
Increased Risk ◽  
Current Drinker ◽  
Japanese Pregnant Women ◽  
Japanese Yen

Abstract Background Alcohol use during pregnancy can lead to adverse health consequences for the fetus. Identification of pregnant women who are most likely to drink is essential for targeting interventions. However, evidence on associations of education and income with alcohol use during pregnancy is inconsistent. Methods We analyzed data from 11484 pregnant women who agreed to participate in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan from 2013 to 2017. Women were dichotomized as current drinker and non-drinker (past drinker, never drinker, constitutionally never drinker) during early pregnancy and during middle pregnancy, respectively. Multivariate logistic regression analyses were conducted to examine whether educational attainment or equivalent household income was associated with alcohol use, after adjusting for women's age, work status, smoking, income/education, and their partners' education. Results Prevalence of alcohol use during early and middle pregnancy was 21.1% and 6.5%, respectively. Higher education and higher income were significantly associated with an increased risk of alcohol use during early pregnancy; the odds ratio (OR) of ≥university education compared with ≤high school education was 1.54 (95% confidence interval [CI], 1.35-1.76), and the OR of ≥ 4 million compared with <2 million Japanese yen was 1.39 (95% CI, 1.20-1.61). Education and income were not associated with alcohol use during middle pregnancy; the corresponding ORs were 1.08 (95% CI, 0.87-1.35) and 1.03 (95% CI, 0.82-1.29), respectively. Conclusions Associations of education and income with alcohol use were observed during early pregnancy, not during middle pregnancy. No amount of alcohol and no time to drink can be considered safe during pregnancy. More public health awareness is needed to prevent alcohol use during early pregnancy. Key messages Different strategies for preventing alcohol use are required during early pregnancy and during middle pregnancy. Interventions for alcohol use during early pregnancy should focus on women with higher education and/or higher income.

scholarly journals An Integrative Screening Tool of Alcohol Exposure During Early Pregnancy: Combining of the CDT Biomarker with Green Page Questionnaire

2019 ◽  
Author(s):  
María Luisa Azurmendi-Funes ◽  
Miriam Martínez-Villanueva ◽  
Juan Luís Delgado-Marín ◽  
Rebecca Ramis ◽  
Miguel Felipe Sánchez-Sauco ◽  
...  
Keyword(s):  
High Risk ◽  
Alcohol Use ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Characteristic Curve ◽  
Alcohol Exposure ◽  
First Trimester ◽  
Maternity Hospital ◽  
A Value ◽  
Risk Pregnancy

Abstract Aims In current clinical practice, prenatal alcohol exposure is usually assessed by interviewing the pregnant woman by applying questionnaires. An alternative method for detecting alcohol use is to measure the biomarker carbohydrate-deficient transferrin (CDT). However, few studies measure CDT during pregnancy. This study examines the utility of CDT biomarker in the screening of alcohol exposure during early pregnancy. Methods A cohort of 91, first-trimester pregnant women assigned to a public reference maternity hospital, was screened using the Green Page (GP) questionnaire, an environmental exposure tool. CDT levels and other biomarkers of alcohol use were measured and compared with questionnaire data. Results About 70% of the mothers in the study consumed alcohol during early pregnancy and 22% met high-risk criteria for prenatal exposure to alcohol. CDT measurement showed a statistically significant area under the receiver operating characteristic curve with a value of 0.70. For a value of 0.95% of CDT, a specificity of 93% was observed. The most significant predictors of CDT were the number of binge drinking episodes, women’s body mass index and European white race. Conclusion Pregnant women with a CDT value >0.95% would be good candidates for the performance of the GP questionnaire during early pregnancy in order to detect potential high-risk pregnancy due to alcohol exposure.

scholarly journals Social predictors of continued and indoor smoking among partners of non-smoking pregnant women: the TMM BirThree Cohort Study

2020 ◽  
Author(s):  
Keiko Murakami ◽  
Mami Ishikuro ◽  
Fumihiko Ueno ◽  
Aoi Noda ◽  
Tomomi Onuma ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Social Predictors ◽  
Indoor Smoking

scholarly journals Utility of second trimester beta HCG levels in prediction of gestational hypertension: a prospective cohort study

2017 ◽  
Vol 6 (3) ◽  
pp. 1040
Author(s):  
Heena Chowdhary ◽  
Rabia Khurshid ◽  
Shameema Parveen ◽  
Shagufta Yousuf ◽  
Showkat Hussain Tali ◽  
...  
Keyword(s):  
Cohort Study ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Predictive Value ◽  
Gestational Hypertension ◽  
Beta Hcg ◽  
Observational Cohort ◽  
Β Hcg ◽  
Sensitivity Specificity ◽  
High Beta

Background: Gestational hypertension is a significant threat both to maternal and fetal health. However, it is still a distant dream to predict accurately its occurrence in early pregnancy. Objective was to find out if β HCG levels determined between 13 to 20 weeks of gestation can be used as a predictor for gestational hypertension.Methods: This prospective observational cohort study was conducted from August 2014 to January 2016. Serum β HCG levels were determined at 13 to 20 weeks of gestation of 190 normotensive pregnant women attending the antenatal clinics. They were followed for the development of gestational hypertension till 40 weeks of gestation or delivery.Results: Out of the total 190 women, 25 (13.1%) developed gestation hypertension. Of those who developed gestational hypertension, 22 (88%) were having β HCG levels >2 MOM (p<0.001). Absolute β HCG levels (Mean±SD) were also significantly higher (54907±29509 V/S 41095±19103; p<0.001) in subjects who later developed gestational hypertension. Sensitivity, specificity, positive predictive value and the negative predictive value for β HCG at >2 MOM were 83.3, 96.9, 80.0 and 97.5 respectively (95% CI).Conclusions: Pregnant women with high Beta HCG levels in early pregnancy have significantly higher risk for development of gestational hypertension.

scholarly journals Non-alcoholic Fatty Liver Disease (NAFLD) as a major predictor of gestational diabetes mellitus (GDM) and early pregnancy miscarriage: a Prospective Cohort Study

2021 ◽  
Author(s):  
Iresha Koralagedara ◽  
Janith Warnasekara ◽  
Dayaratne Korale Gedara ◽  
Nirmani de Silva ◽  
Suneth Agampodi
Keyword(s):  
Cohort Study ◽  
Liver Disease ◽  
Fatty Liver ◽  
Pregnant Women ◽  
Early Pregnancy ◽  
Prospective Cohort ◽  
Fatty Liver Disease ◽  
Ultrasound Scan ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

Objective Determine the association of Non-alcoholic fatty liver disease(NAFLD) to the occurrence of GDM and miscarriages. Design Population-based prospective cohort study. Setting Anuradhapura district-Sri Lanka. Sample All pregnant women(gestational age<12 weeks) registered in the national pregnancy care programme(>98%coverage) during July to September-2019, recruited in the Rajarata Pregnancy Cohort(RaPCo)(included 80% of registered mothers). Method Clinical, biochemical parameters and ultrasound scan(USS) of liver were performed at the baseline to assess NAFLD. Excluding pregnant women who reported any type of hyperglycemia at the baseline, the cohort was followed up to assess the occurrence of GDM (using latest WHO criteria) during 24-28 weeks of gestation. Miscarriages were documented. Main outcome measures GDM and miscarriages. Results The prevalence of Fatty liver grade(FLG)-II and I was 14.2%(n=90), 37%(n=234), respectively. The incidence of GDM among the normoglycemic pregnant women with FLG-II, I, and 0 were 162.2, 43.9, 11 per 1000, respectively. After adjusting for age, BMI, and other known risk factors, women with FLG-II had a relative risk(RR) of 12.5(95%CI 2.2-66.4) for developing GDM compared to those with FLG-0. Pregnant women with FLG-I-(RR= 5.1,95%CI-1.7-15.1) and II-(RR=8.4,95%CI-2.6-27.1) had a very high risk of early pregnancy miscarriage compared to FLG-0. Conclusion FLG-2 is a significant risk factor for GDM and miscarriages. Incorporating pre-conceptional or early pregnancy identification of NAFLD using simple USS into routine care provision will enable early risk identification and appropriate action. Funding Accelerating Higher Education Expansion and Development(AHEAD) grant(World Bank-funded project through University grant commission-Sri Lanka) funded this study. Keywords–NAFLD, GDM, Pregnancy, Ultrasound-scan, Miscarriages

scholarly journals Associations of Education and Income With Secondhand Smoke Exposure Among Non-Smoking Pregnant Women in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study

2020 ◽  
Author(s):  
Keiko Murakami ◽  
Taku Obara ◽  
Mami Ishikuro ◽  
Fumihiko Ueno ◽  
Aoi Noda ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Pregnant Women ◽  
Secondhand Smoke ◽  
Household Income ◽  
Odds Ratio ◽  
Working Women ◽  
Work Status ◽  
Increased Risk ◽  
Shs Exposure

Abstract Background: Associations of education and income with secondhand smoke (SHS) exposure have been well documented in the general population. However, evidence among non-smoking pregnant women is limited, including in Japan. The purpose of the study was to examine the associations of education and income with SHS exposure among non-smoking pregnant women in Japan.Methods: We analyzed data from 17815 non-smoking pregnant women in Japan who participated in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study from 2013 to 2017. SHS exposure was defined as indoor exposure to someone else’s cigarette smoke ≥1 day/week during pregnancy. Multiple logistic regression analyses were conducted to examine whether pregnant women’s educational attainment or equivalent household income was associated with SHS exposure, adjusting for age, work status, smoking history, partners’ education, and income/education. Stratified analyses by work status were also conducted.Results: The prevalence of SHS exposure during pregnancy was 34.0%; 29.4% among non-working women and 37.1% among working women. Lower educational attainment was associated with an increased risk of SHS exposure; the odds ratio of high school education or lower compared with university education or higher was 1.78 (95% confidence interval, 1.59–1.99). Lower equivalent household income was associated with an increased risk of SHS exposure; the odds ratio of the lowest compared with the highest level of income was 1.67 (95% confidence interval, 1.51–1.84). These associations did not differ between non-working women and working women.Conclusions: Pregnant women with lower education and/or lower household income had higher risks of SHS exposure in Japan. These findings imply that educational interventions and financial incentives are needed for pregnant women and their household smokers in helping to reduce SHS exposure among non-smoking pregnant women.

Minimizing Sample Bias Due to Stigmatized Behaviours: the Representativeness of Participants in a Cohort Study of Alcohol in Pregnancy

2021 ◽  
Author(s):  
David Tappin ◽  
Daniel Mackay ◽  
Lucy Reynolds ◽  
Niamh Fitzgerald
Keyword(s):  
Cohort Study ◽  
Alcohol Use ◽  
Pregnant Women ◽  
Smoking Status ◽  
Routine Data ◽  
Sampling Bias ◽  
Maternal Blood ◽  
Chi Square ◽  
High Level ◽  
In Pregnancy

Abstract BackgroundStigmatized behaviours are often underreported, especially in pregnancy, making them challenging to address. The Alcohol and Child Development Study (ACDS) seeks to inform prevention of foetal alcohol harm, by examining links between a maternal blood biomarker and later child developmental outcomes. In order to minimize sampling bias, samples were given by pregnant women, using passive, generic consent. This paper examines the success of this approach, by comparing characteristics of women who provided samples to those who did not.MethodsAll pregnant women in the study city were sent a Patient Information Sheet (PIS) with their first NHS obstetric appointment letter. The PIS informed them that the NHS would like to take an extra blood sample for research purposes, unless they opted out. Neither the women nor the midwives were informed that the samples might be tested for an alcohol biomarker. This paper examines the extent to which women who provided the extra sample were representative of eligible women where no sample was provided, in terms of routinely collected information: age; body mass index; area based deprivation; previous pregnancies, abortions and caesarians; smoking status and carbon monoxide level; self-reported alcohol use, gestation and birth weight of their baby. Chi-square and Mann-Whitney U tests were used to compare groups. Results3,436 (85%) of the 4,049 pregnant women who attended their appointment provided the extra sample. Women who did not were significantly younger (p<0.001), less materially deprived (p<0.001), and less likely to be considered for intervention based on self-reported alcohol use (p<0.001). There were no significant differences between the two groups on other routine data.ConclusionsThe use of passive consent without disclosure of the specific research focus resulted in a high level of sample provision in this cohort study of alcohol use in pregnancy. There was no evidence that study blinding was breached, and women who provided a sample were more likely to report alcohol consumption. It is therefore likely that passive consent reduced sampling bias compared to asking women to give blood for an alcohol study, even if anonymity was assured in both cases.

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