Changes in drinking patterns during and after pregnancy among mothers of children with fetal alcohol syndrome: A study in three districts of South Africa

Urban, Michael; Olivier, Leana; Louw, Jacobus G.; Lombard, Chanelle; Viljoen, Denis; Scorgie, Fiona; Chersich, Matthew

doi:10.1016/j.drugalcdep.2016.08.629

Cited by 16 publications

(28 citation statements)

References 30 publications

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“…Alcohol use was similar among HIV positive and negative mothers during pregnancy, 6 months post birth, and 3 years post birth. The drop in alcohol consumption seen among all mothers upon pregnancy discovery and throughout pregnancy has been demonstrated in other studies (12, 65). …”

Section: Discussionsupporting

confidence: 76%

Patterns of Alcohol Abuse, Depression, and Intimate Partner Violence Among Township Mothers in South Africa Over 5 Years

et al. 2017

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Introduction Alcohol is a major contributor to the global burden of disease. In South Africa, alcohol abuse is hypothesized to correlate with women’s HIV status, mental health, and partner relationships over time. Methods All pregnant women in 12 urban, low-income, Cape Town neighborhoods were interviewed at baseline, post-birth, and at 6, 12, 36, and 60 months following delivery with retention rates from 84.9%–96%. Women were assessed for any alcohol use, problematic drinking, depression, intimate partner violence, and HIV status. Results Prior to pregnancy discovery and five years after giving birth, alcohol use was 25.8% and 24.7%, respectively. Most women decreased their alcohol use during pregnancy. Twenty-one percent reported alcohol use on two or more assessments, and only 15% of the mothers drinking alcohol at five years were also drinking at baseline. Mothers with depression had a higher likelihood of drinking alcohol compared to mothers who were not depressed only at baseline and 6-months post-birth. Mothers who experienced IPV had more than twice the likelihood of drinking alcohol compared to non-IPV mothers at all assessments. HIV positive mothers were more likely to drink alcohol compared to mothers without HIV prior to pregnancy discovery and at 5-years post-birth. Conclusions These longitudinal trends in alcohol use among young women in South Africa represent a large economic, social, and health burden and must be addressed in a comprehensive manner.

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Section: Discussionsupporting

confidence: 76%

Patterns of Alcohol Abuse, Depression, and Intimate Partner Violence Among Township Mothers in South Africa Over 5 Years

et al. 2017

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“…One possible reason is that women are a crucial part of the alcohol market, as has been pointed out in relation to alcohol consumption and breast cancer risk ( Connor, 2017 ). Pregnancy, therefore, may represent a significant commercial threat, if it means that women’s long-term drinking patterns change as a result of initially drinking less while planning a pregnancy and then during the 9 months of pregnancy—for example, if the initial reduction leads to longer term reductions in their drinking ( Urban et al, 2016 ). This could represent a significant loss to the alcohol market, with the added risk that in such women abstention may become normalized.…”

Section: Discussionmentioning

confidence: 99%

Pregnancy, Fertility, Breastfeeding, and Alcohol Consumption: An Analysis of Framing and Completeness of Information Disseminated by Alcohol Industry–Funded Organizations

Lim

Schalkwyk

Maani

et al. 2019

J. Stud. Alcohol Drugs

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Objective: Alcohol use during pregnancy can harm the developing fetus. The exact amount, pattern, and critical period of exposure necessary for harm to occur are unclear, although official guidance often emphasizes precautionary abstention. The impacts on fertility and breastfeeding are also unclear. Information on alcohol and pregnancy is disseminated by the alcohol industry–funded organizations, and there are emerging concerns about its accuracy, suggesting the need for detailed analysis. Method: Information on alcohol consumption in relation to fertility, pregnancy, and breastfeeding was extracted from the websites of 23 alcohol industry–funded bodies (e.g., Drinkaware [United Kingdom] and DrinkWise [Australia]), and 19 public health organizations (e.g., Health.gov and NHS Choices). Comparative qualitative and quantitative analysis of the framing and completeness of this information was undertaken. Results: Alcohol industry–funded organizations were statistically significantly less likely than public health websites to provide information on fetal alcohol spectrum disorder and less likely to advise that no amount of alcohol is safe during pregnancy. They were significantly more likely to emphasize uncertainties and less likely to use direct language (e.g., “don’t drink”). Some alcohol industry–funded (and no public health) websites appear to use “alternate causation” arguments, similar to those used by the tobacco industry, to argue for causes of alcohol harms in pregnancy other than alcohol. Conclusions: Alcohol industry–funded websites omit and misrepresent the evidence on key risks of alcohol consumption during pregnancy. This may “nudge” women toward continuing to drink during pregnancy. These findings suggest that alcohol industry–funded bodies may increase risk to pregnant women by disseminating misinformation. The public should be made widely aware of the risks of obtaining health information from alcohol industry–funded sources.

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“…There is, however, significant income inequality and an unemployment rate of 17% [30]. FARR has previously conducted a prevalence study in this area, where a prevalence rate of FASD of 64.2 per 1000 was found [31]. FARR subsequently implemented a comprehensive prevention and awareness program between 2013 and 2016 and is currently running an awareness program in the SBM area.…”

Section: Methodsmentioning

confidence: 99%

Evaluation of a Custom-Developed Computer Game to Improve Executive Functioning in 4- to 6-Year-Old Children Exposed to Alcohol in Utero: Protocol for a Feasibility Randomized Controlled Trial

Louw¹,

Olivier²,

Skeen³

et al. 2019

JMIR Res Protoc

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BackgroundFetal alcohol spectrum disorder (FASD) is one of the most common causes of preventable intellectual disability, and the key associated deficits are in executive function (EF). Aspects of EF can be improved using cognitive training interventions. The highest prevalence of FASD globally (at a rate of 135.1 per 1000) has been found in a South African population in the Western Cape province. There is a shortage of specialized health service personnel, and there are limited remedial services. Computer-based cognitive training, if age and culturally appropriate, could be an effective way to provide the interventions with minimal need for skilled personnel and other resources. The Foundation for Alcohol Related Research has developed such a program for the South African context.ObjectiveThis protocol aimed to evaluate whether it is feasible to use computerized cognitive training in a resource-poor context to improve cognitive function in children exposed to alcohol in utero.MethodsWe are conducting a randomized controlled trial in the Saldanha Bay Municipal area, evaluating a custom-developed cognitive training program to improve the cognitive function of children aged between 4 and 6 years who were exposed to alcohol in the prenatal stage. Participants will be recruited from local Early Childhood Development centers. Community workers will interview biological mothers to identify alcohol-exposed pregnancies. Alcohol-exposed children will be randomized into an intervention or a control group of 40 participants each using block randomization. A group of 40 children not exposed to alcohol will be included in a normative group using individual randomization. The intervention group will play the game for 6 months (40 sessions). Normative and control groups will receive no intervention. Neurodevelopmental assessments will be done at baseline and upon completion of the study with all participants.ResultsThe intervention has started, and all baseline assessments have been done at the time of submission.ConclusionsThis study will provide insight into whether computerized cognitive training is viable and effective in the South African context. It has the potential to provide a means of intervention globally and in other resource-poor context and expand the knowledge base regarding executive functioning and FASD. This paper presents the research protocol and intervention design of the study.Trial RegistrationISRCTN Registry ISRCTN17244156; http://www.isrctn.com/ISRCTN17244156.International Registered Report Identifier (IRRID)DERR1-10.2196/14489

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Changes in drinking patterns during and after pregnancy among mothers of children with fetal alcohol syndrome: A study in three districts of South Africa

Cited by 16 publications

References 30 publications

Patterns of Alcohol Abuse, Depression, and Intimate Partner Violence Among Township Mothers in South Africa Over 5 Years

Patterns of Alcohol Abuse, Depression, and Intimate Partner Violence Among Township Mothers in South Africa Over 5 Years

Pregnancy, Fertility, Breastfeeding, and Alcohol Consumption: An Analysis of Framing and Completeness of Information Disseminated by Alcohol Industry–Funded Organizations

Evaluation of a Custom-Developed Computer Game to Improve Executive Functioning in 4- to 6-Year-Old Children Exposed to Alcohol in Utero: Protocol for a Feasibility Randomized Controlled Trial

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