06 May 2014 In Pregnant Women

OBJECTIVE: To examine the effects of low to moderate maternal alcohol consumption and binge drinking in early pregnancy on behaviour in children at the age of 5 years.

DESIGN: Prospective cohort study.

SETTING: Neuropsychological testing in four Danish cities, 2003-2008.

POPULATION: A total of 1628 women and their children sampled from the Danish National Birth Cohort.

METHODS: Participants were sampled based on maternal alcohol drinking patterns during early pregnancy. When the children were 5 years of age the parent and teacher versions of the Strengths and Difficulties Questionnaire (SDQ) were completed by the mothers and a preschool teacher, respectively. The full statistical model included the following potential confounding factors: maternal binge drinking or low to moderate alcohol consumption, respectively; parental education; maternal IQ; prenatal maternal smoking; the child's age at testing; the child's gender; maternal age; parity; maternal marital status; family home environment; postnatal parental smoking; prepregnancy maternal body mass index (BMI); and the child's health status.

MAIN OUTCOME MEASURE: Behaviour among children assessed by the SDQ parent and teacher forms.

RESULTS: Adjusted for all potential confounding factors, no statistically significant associations were observed between maternal low to moderate average weekly alcohol consumption and SDQ behavioural scores (OR 1.1, 95% CI 0.5-2.3; OR 1.1, 95% CI 0.6-2.1 for the total difficulties scores) or between binge drinking and SDQ behavioural scores (OR 1.2, 95% CI 0.8-1.7; OR 0.8, 95% CI 0.6-1.2).

CONCLUSION: This study observed no consistent effects of low to moderate alcohol consumption or binge drinking in early pregnancy on offspring behaviour at the age of 5 years.

06 May 2014 In Pregnant Women

OBJECTIVE: This study examines the relationships between the dose, pattern, and timing of prenatal alcohol exposure and achievement in reading, writing, spelling, and numeracy in children aged 8 to 9 years.

METHODS: Data from a randomly selected, population-based birth cohort of infants born to non-Indigenous women in Western Australia between 1995 and 1997 (n = 4714) (Randomly Ascertained Sample of Children born in Australia's Largest State Study cohort) were linked to the Western Australian Midwives' Notification System and the Western Australian Literacy and Numeracy Assessment statewide education testing program. The records for 86% (n = 4056) of the cohort were successfully linked with education records when the children were aged 8 to 9 years. The associations between prenatal alcohol exposure and achievement of national benchmarks in school numeracy, reading, spelling, and writing tests and nonattendance for the tests was examined. Logistic regression was used to generate adjusted odds ratios (aOR) and 95% confidence intervals (CI), adjusting for potential confounding factors. The referent group included children of mothers who previously drank alcohol but who abstained during pregnancy.

RESULTS: Children were twice as likely not to achieve the benchmark for reading after heavy prenatal alcohol exposure during the first trimester (aOR 2.26; 95% CI 1.10-4.65) and for writing when exposed to occasional binge drinking in late pregnancy (aOR 2.35; 95% CI 1.04-5.43). Low-moderate prenatal alcohol exposure was not associated with academic underachievement.

CONCLUSIONS: The type of learning problems expressed depends on the dose, pattern, and timing of prenatal alcohol exposure.

06 May 2014 In Pregnant Women

BACKGROUND: There has been limited research addressing whether behavioural change in relation to alcohol exposure in pregnancy results in better perinatal outcomes.

METHODS: A cohort study of 6725 women who booked for antenatal care and delivered in a large urban teaching hospital in 2010-2011. A detailed history of alcohol consumption pre-pregnancy and during early pregnancy was recorded at the first antenatal visit with follow-up of the mother and infant until discharge following birth. Adverse perinatal outcomes were compared for 'non-drinkers', 'ex-drinkers' and 'current drinkers'.

RESULTS: Of the 6017 (90%) women who reported alcohol consumption prior to pregnancy 3325 (55%) engaged in binge drinking and 266 (4.4%) consumed more than 14 units on average per week. At the time of booking 5649 (94%) women were ex-drinkers and of the 368 women who continued to drink 338 (92%) had a low intake (0-5 units per week), 30 (8%) an excess intake (6-20+ units per week) and 93 (25%) reported at least one episode of binge drinking. Factors associated with continuing to drink in early pregnancy included older maternal age (30-39 years), (OR 1.6; 95% CI 1.3 to 1.8), Irish nationality (OR 3.1; 95% CI 2.2 to 4.3) and smoking (OR 2.6; 95% CI 1.9 to 3.5). Ex-drinkers had similar perinatal outcomes to non-drinkers. Compared to non-drinkers current drinking was associated with an increased risk of intrauterine growth restriction (IUGR) (13% versus 19%, crude OR 1.6; 95% CI 1.1 to 2.2, adjusted OR 1.2; 95% CI 0.8 to 1.8). The greatest risk of IUGR was among women who continued to both drink and smoke, (9% versus 32%, crude OR 4.8; 95% CI 3.3 to 7.0, adjusted OR 4.5; 95% CI 3.1 to 6.7).

CONCLUSIONS: Public Health campaigns need to emphasise the potential health gains of abstaining from both alcohol and smoking in pregnancy.

06 May 2014 In Pregnant Women

Aim: The aim of the current study is to examine, using cross-sectional data, the role of maternal age, period (year of pregnancy) and cohort (year of birth) as predictors of alcohol consumption during pregnancy over a 10-year period.

Design: Four cross-sectional surveys were examined, both separately and together.

Setting: Using cross-sectional data, there does appear to be a positive relationship between maternal age and alcohol consumption during pregnancy; however, within any one survey period, it is difficult to determine if these patterns are due to period or cohort effects.

Participants: The National Drug Strategy Household Survey (NDSHS) is a large-scale survey administered to more than 20,000 respondents. Across four survey periods, 3,281 women reported being pregnant in the 12 months prior to the survey.

Measures: The section on pregnancy and alcohol in the NDSHS 2001, 2004, 2007 and 2010.

Findings: Age was a significant positive predictor of alcohol consumption during pregnancy in 2010. However, when the four data sets were combined, period appeared to be a stronger predictor, with younger groups and cohorts decreasing consumption at a faster rate over time than older groups and cohorts.

Conclusions: Although age and cohort do play a role in the likelihood of alcohol consumption among Australian women during pregnancy, period is the most important predictor, indicating that alcohol consumption among pregnant women is decreasing. Furthermore, knowledge of pregnancy results in a marked decrease in consumption, suggesting a possible focus for prevention campaigns.

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