Maternal Alcohol Use, Adverse Neonatal Outcomes and Pregnancy Complications in British Columbia, Canada: A Population-based Study

Abstract

BackgroundThe current study aimed to estimate the prevalence of alcohol use identified as a risk factor during pregnancies by the antenatal care providers, resulting in live births in British Columbia (BC) and to examine associations between alcohol use, adverse neonatal outcomes, and pregnancy complications.MethodsThis population-based cross-sectional study utilized linked obstetrical and neonatal records within the BC Perinatal Data Registry (BCDPR), for deliveries that were discharged between January 1, 2015 and March 31, 2018. The main outcome measures were alcohol use identified as a risk factor during pregnancy, associated maternal characteristics, pregnancy complications, and adverse neonatal outcomes. Estimates for the period and fiscal year prevalence were calculated. Chi-square tests were used to compare adverse neonatal outcomes and pregnancy complications by alcohol use during pregnancy. Logistic regression was used to examine the association between alcohol use during pregnancy and adverse neonatal outcomes and pregnancy complications, after adjusting for identified risk factors.ResultsA total of 144,779 linked records within the BCDPR were examined. The period prevalence of alcohol use during pregnancy identified as a risk factor was estimated to be 1.1% and yearly prevalence was 1.1%, 1.1%, 1.3% and 0.9% from the 2014/2015 fiscal year to 2017/2018, respectively. Indicated alcohol use was associated with younger maternal age, fewer antenatal visits, being nulliparous, a history of mental illness, substance use and smoking. Alcohol-exposed neonates had greater odds of being diagnosed with low birth weight (aOR = 1.25; 95% CI: 1.01, 1.53), other respiration distress of newborn (aOR = 2.57; 95% CI: 1.52, 4.07), neonatal difficulty in breastfeeding (aOR = 1.97; 95% CI: 1.27, 2.92) and unspecified feeding problems (aOR = 2.06; 95% CI: 1.31, 3.09)ConclusionsThe prevalence of alcohol use during pregnancy identified as a risk factor, estimated in this study, was comparable to the previous estimates within BCDPR. Prenatal alcohol exposure was associated with notable differences in maternal and neonatal characteristics and adverse neonatal outcomes. More consistent and thorough screening and prevention efforts targeting alcohol use in pregnancy are urgently needed in Canada.

Why do women consume alcohol during pregnancy or while breastfeeding?

“…Congruent with the theme of drinking due to stress, women who drink in pregnancy report more mental health problems and a greater incidence of abuse/violence compared to women who do not drink [21,32]. Not surprisingly, this review found that pre‐existing substance abuse/dependence problems influenced alcohol consumption in pregnant women (as they do in other groups), again highlighting the importance of early screening and addiction treatment for women of childbearing age.…”

“…For example, one study from Australia reported that being older and more educated are associated with a greater likelihood of alcohol use during pregnancy in the general population [22]. Another study from Canada found that being younger and having a history of mental illness are associated with alcohol use during pregnancy [32].…”

“…These risk and protective factors may be useful in identifying pregnant women who may need extra screening or access to brief interventions during pregnancy. For example, it has been shown that age cohorts and education levels affect alcohol use behaviour during pregnancy, though these effects vary based on country and subpopulation [23,32]. For example, one study from Australia reported that being older and more educated are associated with a greater likelihood of alcohol use during pregnancy in the general population [22].…”

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

“…Previously conducted studies in different parts of the world had an inconsistent association between prenatal alcohol exposure and adverse fetal outcomes to take appropriate interventions [9,[35][36][37][38][39]. Therefore, this study focused on determining the effects of alcohol use during pregnancy on adverse fetal outcomes such as preterm, stillbirth, and low birth weight, as they are one of the major causes of neonatal morbidity and mortality in low-and middle-income countries [40], including Ethiopia [41][42][43].…”

Internações por insuficiência renal no Brasil no ano de 2019

“…Paradoxalmente, o hábito de fumar determina tanto o baixo peso quanto o sobrepeso materno, vez que ocasiona, em geral, consumo alimentar impróprio na gravidez, favorecendo assim à condição nutricional inadequada (ACCIOLY; SAUNDERS; LACERDA, 2009;LEWANDOWSKA et al, 2020). Já o consumo de bebida alcoólica durante os três primeiros meses da gestação, pode estar associado ao maior risco de malformações (POPOVA et al, 2021). Neste sentido, aponta-se que cerca de um terço dos bebês de mães que fazem uso excessivo de álcool, pode desenvolver a "síndrome fetal pelo álcool" e apresentar problemas físicos e mentais (BRASIL, 2012).…”