The effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes among pregnant women attending antenatal care at public health facilities in Gondar town, Northwest Ethiopia: a prospective cohort study

Background The teratogenic effect of fetal alcohol exposure may lead to actual and potential problems, instantly after birth, at infancy; or even later, and mental impairment in life. This study aimed to investigate the effects of maternal alcohol consumption during pregnancy on adverse fetal outcomes at Gondar town public health facilities, Northwest Ethiopia. Methods A facility-based prospective cohort study was performed among 1778 pregnant women who were booked for antenatal care in selected public health facilities from 29 October 2019 to 7 May 2020 in Gondar town. We used a two-stage random sampling technique to recruit and include participants in the cohort. Data were collected using the Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) standardized and pre-tested questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and interested adverse birth outcomes using log-binomial regression modeling. The burden of outcomes was reported using the adjusted risk ratio and population-attributable risk (PAR). Results A total of 1686 pregnant women were included in the analysis, which revealed that the incidences of low birth weight, preterm, and stillbirth were 12.63% (95% CI: 11.12, 14.31), 6.05% (95% CI: 5.00, 7.29) and 4.27% (95% CI: 3.4, 5.35), respectively. Non-hazardous and hazardous alcohol consumption during pregnancy was significantly associated with low birth weight (ARR = 1.50; 95% CI: 1.31, 1.98) and (ARR = 2.34; 95% CI: 1.66, 3.30), respectively. Hazardous alcohol consumption during pregnancy was also significantly associated with preterm birth (ARR = 2.06; 95% CI: 1.21, 3.52). The adjusted PAR of low birth weight related to non-hazardous and hazardous alcohol drinking during pregnancy was 11.72 and 8.44%, respectively. The adjusted PAR of hazardous alcohol consumption was 6.80% for preterm. Conclusions Our findings suggest that there is an increasing risk of adverse birth outcomes, particularly preterm delivery and low birth weight, with increasing levels of alcohol intake. This result showed that the prevention of maternal alcohol use during pregnancy has the potential to reduce low birth weight and preterm birth. Hence, screening women for alcohol use during antenatal care visits and providing advice with rigorous follow-up of women who used alcohol may save the fetus from the potential risks of adverse birth outcomes.

Individual and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia: a multilevel logistic regression analysis

Background Prenatal alcohol consumption is a serious public health concern that is considered as one of the preventable risk factors for neonatal and childhood morbidity and several adverse pregnancy outcomes. This study aimed to determine the individual- and community-level predictors of maternal alcohol consumption during pregnancy in Gondar town, Northwest Ethiopia. Methods A community-based cross-sectional study was conducted among pregnant women in Gondar town from 13 June to 24 August 2019. A cluster random sampling technique was used to select 1237 pregnant women. Data collection was carried out using the AUDIT-C pretested standard questionnaire. Bivariable and multivariable multilevel logistic regression analyses were computed to identify predictors of alcohol consumption using the odds ratio, 95% CI, and p-value < 0.05. Results The prevalence of alcohol consumption during pregnancy was found to be 30.26% (95% CI: 27.74%, 32.91%). The study revealed that pregnant women who have a low knowledge level on harmful effect of alcohol consumption (AOR = 3.2; 95% CI: 1.9, 5.4), positive attitude towards alcohol consumption (AOR = 7.5; 95% 5, 11), history of pre-pregnancy alcohol consumption (AOR = 4.8; 95% CI: 3.4, 6.9), whose partner consume alcohol (AOR = 3.9; 95% CI: 2.5, 6), a perception that alcohol consumption is culturally or socially acceptable (AOR = 3.6; 95% CI: 2.4, 5.3), who were encouraged by their partners to consume alcohol (AOR = 4; 95% CI: 1.9, 8) were significantly associated with pregnancy alcohol consumption. Concerning the community-level characteristics, who had not ever heard/media exposure about the risk of alcohol drinking during pregnancy (AOR = 3; 95% CI: 1.7, 5.5), and who were from low community women’s education attainment (AOR = 4; 95% CI: 2.2, 7.7) were statistically significant predictors of alcohol consumption during pregnancy. Conclusions The study revealed that alcohol consumption during pregnancy is prevalent in Gondar town. Both individual- and community-level predictors were found to be associated with alcohol consumption during pregnancy. Policymakers may take into account these predictors for individual and community-based interventions to which our results appear to point.

Preconception alcohol consumption and risk of miscarriage in over 4.5 million Chinese women aged 20–49 years

ObjectiveTo assess the impact of preconception alcohol consumption on risk of miscarriage incidence, and further evaluate the association between maternal periconception drinking abstinence and miscarriage.MethodsWe performed a population-based, retrospective cohort study in China between 1 January 2013 and 31 December 2016. Alcohol intake and potential confounding factors were reported in standard questionnaires. Participants who became pregnant were recontacted for pregnancy outcome information within 1 year. A total 4 531 680 women with available data on preconception alcohol intake and miscarriage were included in the final analyses. Multivariable logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs).ResultsThe prevalence of miscarriage was 2.70% among 4 531 680 women. Compared with non-drinkers, the adjusted OR of miscarriage was 1.06 (95% CI 1.02 to 1.10) and 1.59 (95% CI 1.15 to 2.20) in maternal occasional drinkers and regular drinkers, respectively. Compared with couples in which neither the male nor the female consumed alcohol, the adjusted OR for miscarriage among women was 1.09 (95% CI 1.07 to 1.10), 1.13 (95% CI 1.06 to 1.21) and 1.12 (95% CI 1.07 to 1.17) in the couples in which only the female drank alcohol, only the male drank alcohol, and both drank alcohol, respectively. The adjusted OR was 0.58 (95% CI 0.51 to 0.65) in women with alcohol abstinence compared with alcohol drinkers.ConclusionsPreconception alcohol consumption was associated with higher odds of miscarriage, and an increasing risk was found with paternal and maternal alcohol drinking. Periconception alcohol abstinence was inversely associated with miscarriage.

Maternal drinking and smoking. Can it explain the exceptional academic performance of LBOTE children? A preliminary analysis

Objective Although children from language backgrounds other than English (LBOTE) may be disadvantaged in English-reliant exams, they outperform children from an English language background (ELB) on many Australian National Assessment Program–Literacy and Numeracy (NAPLAN) assessments. Maternal alcohol and tobacco use during pregnancy and/or breastfeeding have been associated with poorer cognitive and academic performance. Using data from the Growing Up in Australia Study, this paper aimed to identify demographic, lifestyle, and prenatal and perinatal risk differences related to maternal tobacco and alcohol use between LBOTE and ELB groups, as a first step in trying to understand the academic performance differences. Results Only data from breastfed babies was included in the current analyses. Although LBOTE children were disadvantaged in several demographic areas, their NAPLAN performance was the same or superior to ELB children across all Grade 3 and 5 NAPLAN assessments. The LBOTE group were, however, breastfed for longer, and their mothers smoked fewer cigarettes and drank less alcohol on fewer occasions throughout their pregnancy. The LBOTE mothers also had lower or less risky patterns of alcohol consumption while breastfeeding. The longer breastfeeding duration of LBOTE children combined with lower maternal use of alcohol and cigarettes during pregnancy and/or breastfeeding may partially contribute to their exceptional NAPLAN performance.

Impacts of Maternal Diet and Alcohol Consumption during Pregnancy on Maternal and Infant Gut Microbiota

(1) Background: Maternal diet and alcohol consumption can influence both maternal and infant’s gut microbiota. These relationships are still not examined in the Chinese population. The purpose of this study was to explore the effect of alcohol consumption and maternal diet during pregnancy on maternal and infant’s gut microbiota. (2) Methods: Twenty-nine mother-child dyads were enrolled in central China. Fecal samples of mothers during late pregnancy and of newborns within 48 h were collected. The V3–V4 regions of 16S rRNA sequences were analyzed. A self-administrated questionnaire about simple diet frequency in the past week was completed by mothers before childbirth. The demographic information was finished by mothers at 24 h after childbirth. (3) Results: Among these 29 mothers, 10 mothers reported alcohol consumption during pregnancy. The PCoA (β-diversity) showed significant difference in maternal gut microbiota between the alcohol consumption group vs. the non-alcohol consumption group (abund-Jaccard, r = 0.2, p = 0.006). The same phenomenon was observed in newborns (unweighted-UniFrac full tree, r = 0.174, p = 0.031). Maternal alcohol consumption frequency showed positive associations with maternal Phascolarctobacterium (p = 0.032) and Blautia (p = 0.019); maternal Faecalibacterium (p = 0.013) was negatively correlated with frequency of alcohol consumption. As for newborns, a positive relationship showed between Megamonas (p = 0.035) and newborns with maternal alcohol consumption. The diet was not associated with both maternal and infant’s gut microbiota. (4) Conclusions: Maternal alcohol consumption during pregnancy influenced the gut microbiota on both mothers and the newborns. Future research is needed to explore these relationships in a lager birth cohort. Understanding the long-term effect of alcohol consumption on maternal and newborns’ gut microbiota is needed.