What Do We Know About Prevalence and Management of Intoxicated Women During Labor and Delivery?

Schaff, Elizabeth; Moreno, Marcos; Foster, Katrina L.; Klug, Marilyn G.; Burd, Larry

doi:10.1177/2333794x19894799

Cited by 11 publications

(5 citation statements)

References 18 publications

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“…The majority of people who may have met the diagnostic criteria for FASD die before they get a chance to be diagnosed. Deaths from stillbirth, sudden infant death syndrome and infectious illness are examples [103][104][105].…”

Section: Fetal Alcohol Spectrum Disorder and Mortalitymentioning

confidence: 99%

Alcohol’s Impact on the Fetus

et al. 2021

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Background: Alcohol is a teratogen and prenatal exposure may adversely impact the developing fetus, increasing risk for negative outcomes, including Fetal Alcohol Spectrum Disorder (FASD). Global trends of increasing alcohol use among women of childbearing age due to economic development, changing gender roles, increased availability of alcohol, peer pressure and social acceptability of women’s alcohol use may put an increasing number of pregnancies at risk for prenatal alcohol exposure (PAE). This risk has been exacerbated by the ongoing COVID-19 pandemic in some countries. Method: This literature review presents an overview on the epidemiology of alcohol use among childbearing age and pregnant women and FASD by World Health Organization regions; impact of PAE on fetal health, including FASD; associated comorbidities; and social outcomes. Results/Conclusion: The impact of alcohol on fetal health and social outcomes later in life is enormous, placing a huge economic burden on countries. Prevention of prenatal alcohol exposure and early identification of affected individuals should be a global public health priority.

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Section: Fetal Alcohol Spectrum Disorder and Mortalitymentioning

confidence: 99%

Alcohol’s Impact on the Fetus

et al. 2021

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“…Among women of child-bearing age, 53.6% used alcohol in the past month and 18.2% binge drank [ 4 ]. Because up to 50% of pregnancies are unplanned, many of these women will have children with prenatal alcohol exposure [ 5 ]. Upon confirmation of pregnancy, most women quit or reduce alcohol use but 10.2% continue to drink [ 4 ] and recent studies indicate that over 8% of pregnant women are drinking at the end of pregnancy [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Screening for fetal alcohol spectrum disorder in infants and young children

Fleming

Sheridan

Waite

et al. 2023

Adv. Drug Alcohol Res.

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Introduction: With an estimated prevalence of up to five percent in the general population, fetal alcohol spectrum disorders (FASD) are the most common neurodevelopmental disorder and more prevalent than autism. Early identification and subsequent early intervention have the potential to improve developmental trajectory of children with FASD. In addition, new research suggests supplementation with choline may ameliorate the developmental impairments associated with prenatal alcohol exposure. Availability of a screening tool with acceptable epidemiologic performance criteria may be clinical useful in identification of young children at increased risk for FASD. In this paper we describe the Early Fetal Alcohol Spectrum Disorder Screening Test (E-FAST) to identify young children at increased risk for an FASD.Methods: We developed the E-FAST dataset from previously published studies, comprised of 281 children under 5 years of age, 180 (64.1%) were diagnosed with FASD and 101 (35.9%) were non-FASD.Analysis: The analysis identified seven useful variables (prenatal alcohol exposure, ADHD (Attention Deficit Hyperactivity Disorder), foster care or adopted, small OFC (occipital frontal circumference), communication impairments, impaired social skills, and cognitive deficits. All variables were categorized as yes/no for ease of use in a screening tool. Risk ratios for each of the seven indicators were estimated using two-way table analyses. Weights for each variable were estimated based on the relative strength of their odds ratios.Results: The average age was 2.7 years of age (S.D. 1.29) and ranged from infant (6.4%) to 4 years old (35.9%). Maternal alcohol use alone had a sensitivity of 0.97, specificity 0.65, and accuracy 0.86. For the combined seven variables, sensitivity was 0.94, specificity 0.74, and accuracy 0.87. Thus, the seven-item E-FAST screen had acceptable epidemiologic screening characteristics.Discussion: In the United States, up to 547 infants with FASD are born each day which far exceeds the capacity of multidisciplinary diagnostic clinics. During routine clinical management of infants and young children the use of an evidence-based screening tool provides a time efficient means to exclude large numbers of young children from further follow-up for FASD. Conversely, a positive screen identifies a smaller number of children at increased risk for FASD requiring more intensive evaluation and follow-up.

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“…We identified 12 studies reporting on 16 women who had a positive blood alcohol concentration at delivery and where it was also measured in their infant. 3 We felt that a positive blood alcohol concentration in the infant eliminated the possibility that they had consumed alcohol in the hospital after delivery. We found that women who are drinking at labor and delivery are rarely reported.…”

mentioning

confidence: 99%

“…We found that women who are drinking at labor and delivery are rarely reported. 3 We then estimated that in the United States every year 34,285 women (93 per day) are drinking on the day of delivery. 3 Thus drinking at the end of pregnancy or during labor is not rare.…”

mentioning

confidence: 99%