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The World Health Organization’s regional office for Europe has published Prevention of harm caused by alcohol exposure in pregnancy: Rapid review and case studies from Member States.
In this report it is stated that Europe has the highest level of alcohol consumption in the world, and that the gender gap in drinking, and in binge drinking, among young people has narrowed.
Looking over the past decade, the report features a review of 29 research studies and details current FASD prevention efforts of Finland, Germany, Lithuania, Luxembourg, Norway, Poland, Slovenia and Sweden. Studies included in the report were based on Recommendation 2 of the WHO Guidelines for the identification and management of substance use and substance use disorder in pregnancy, which calls for prevention of alcohol consumption in the general population of pregnant women through brief interventions. Consequently, the review excluded studies of alcohol-dependent women.
For women who may become pregnant, interventions related to both risky drinking and contraception were reviewed, such as CHOICES, EARLY and BALANCE.
For pregnant women, interventions to abstain from or reduce alcohol use, or to raise awareness were reviewed. Two of the studies with pregnant women included their partners and showed positive results regarding women reducing their drinking and partners supporting non-drinking.
Case studies of prevention efforts from the 8 profiled countries describe national awareness campaigns; screening and specialized treatment in clinical practice guidelines; national strategy/policy planning and implementation; and post-partum support including for those affected by FASD. The report features a table that illustrates country-specific levels of FASD awareness, which can assist in developing focused strategies.
For more on related topics, see earlier blogs:
HOLISTIC AND SPECIALIZED SUPPORT FOR PREGNANT WOMEN: LEVEL 3 PREVENTION, November 21, 2016
Most interventions and programs to prevent alcohol use during pregnancy focus on encouraging pregnant women to abstain from alcohol use. However, one of the most consistent predictors of alcohol use during pregnancy is women’s drinking patterns before pregnancy. As well, a large majority of women have been drinking alcohol for many years prior to getting pregnant.
A recent journal article published in the Maternal and Child Health Journal (April 2015) looks at data from the National Survey of Family Growth in the United States to estimate the number of women during a one month period who are at risk of having an alcohol-exposed pregnancy. (An “alcohol-exposed pregnancy” means that a woman is drinking alcohol, sexually active and not using contraception).
The study found that during a one-month period, nearly 2 million women in the United States were at risk of an alcohol-exposed pregnancy, including 600,000 who were binge drinking. This translates to 3.4%, or 1 in 30, non-pregnant women being at risk of an alcohol-exposed pregnancy.
Interestingly, being at risk for an alcohol-exposed pregnancy was not clearly associated with most demographic and behavioral characteristics (e.g., income level, tobacco use, ethnicity, education level, etc).
That said, women in this study who were planning to get pregnant were the ones who were at highest risk of an alcohol-exposed pregnancy – because they often continue to drink until they find our they are pregnant (and thus exposing the fetus to alcohol for several weeks or even months).
As a recent report on alcohol use in OECD countries describes how rates of alcohol use (including binge drinking) continue to rise in young women in many parts of the world. This suggests the importance of strategies to improve women’s overall health in relation to alcohol (e.g., emphasizing a culture of moderation with low risk drinking guidelines) and FASD prevention activities that target alcohol and contraception use prior to pregnancy and in the preconception period.
Cannon, M.J., Guo, J., Denny, C.H., Green, P.P., Miracle, H., Sniezek, J.E., Floyd, R.L. (2015). Prevalence and Characteristics of Women at Risk for an Alcohol-Exposed Pregnancy (AEP) in the United States: Estimates from the National Survey of Family Growth. Maternal and Child Health Journal, 19:776–782. DOI 10.1007/s10995-014-1563-3.