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Many woman drink during pregnancy
[Posted: Mon 11/04/2011 by Deborah Condon www.irishhealth.com]
Large numbers of Irish women continue to drink during pregnancy, despite concerns over the effects this may have on their unborn babies, the results of a new study indicate.
Researchers questioned 61,241 women who attended the Coombe Women's Hospital in Dublin between 2000 and 2007. Their aim was to investigate the prevalence, predictors and perinatal outcomes associated with alcohol use during pregnancy.
In other words, they wanted to see how much alcohol the women consumed during pregnancy and what, if any, effects this had on the babies born.
According to the researchers, while many women continue to consume alcohol in pregnancy ‘despite an increasing body of evidence suggesting harm to the foetus', the advice offered to women on this topic can be confusing.
They noted that the advice from the Department of Health is that alcohol should be avoided during pregnancy. This is similar to the advice of the surgeon general in the US and the chief medical officer of the UK.
However, in 2008, the National Institute for Health and Clinical Excellence (NICE) in the UK said that if women choose to drink alcohol during pregnancy ‘they should be advised to drink no more than one to two units once or twice a week. Although there is uncertainty regarding a safe level of alcohol consumption in pregnancy, at this low level there is no evidence of harm to the unborn baby'.
"This conflicting information is likely to be confusing for women who may wish to continue ‘social' drinking in pregnancy," the researchers said.
They questioned the 61,241 pregnant women during their hospital booking interview, which usually occurred 10-12 weeks after conception. The women were asked about their home life, whether they worked, what their nationality was, as well as their drinking habits prior to their antenatal booking visit. This data was compared to data from birth records and to records from the special care baby unit.
The study found that while about one in five women said that they never drank, 71% claimed to be occasional drinkers (up to five units of alcohol per week). Within this low-alcohol group there was one case of foetal alcohol syndrome (FAS), so it is likely that some of the women were underestimating or under reporting the amount they drank.
FAS refers to a number of defects a baby can be born with, as a result of their mother's alcohol abuse during pregnancy, including mental disability, behavioural problems, a cleft palate and cardiac defects, such as a heart murmur. The exact amount of alcohol that causes this condition is unknown, although binge drinking is known to be particularly harmful.
The researchers noted that in general, FAS occurred less frequently than expected in this study, suggesting that it is either not recognised by medical staff or only becomes apparent after the mother and baby have left the hospital.
Meanwhile, 10% of the pregnant women drank a moderate amount of alcohol (between six and 20 units per week). These women were more likely to smoke, be employed and to have private health insurance compared to those who never drank.
Only two in 1,000 admitted to being heavy drinkers (more than 20 units per week). These women were most likely to be young and to have used illegal drugs.
The study found that moderate and heavy drinkers were often first time mothers. Not surprisingly, unplanned pregnancies were associated with heavy drinking.
Heavy drinking was also related to very premature birth. In fact, ‘the proportions of preterm birth (less than 37 weeks), very preterm birth ( less than 32 weeks), low birth weight (less than 2,500g) and birth weight below the 10th centile were highest among women with a high consumption of alcohol'.
According to the researchers, it is clear from this study that large numbers of women are drinking during pregnancy - some at high levels - despite health warnings.
"There is a need for more accurate documentation of alcohol consumption so that at-risk drinkers can be identified early in pregnancy and offered appropriate interventions to reduce the risk to the developing foetus. Very preterm birth is one of the main causes of neonatal mortality, morbidity and functional impairment," they said.
They noted that the prevention of high-risk drinking in pregnancy could ‘reduce adverse perinatal outcomes with implications for the affected families and cost to the healthcare system'.
They also said that as it is likely that FAS is under-recognised in Ireland, babies born to women who drink alcohol during pregnancy should be followed in order to more accurately determine the incidence of this syndrome in the population.
"This study emphasises the need for improved detection of alcohol misuse in pregnancy and for early intervention in order to minimise the risks to the developing foetus. We would recommend that further research is required before even low amounts of alcohol can be considered safe," commented researcher, Prof Deirdre Murphy of Trinity College Dublin and the Coombe.
Details of these findings are published in the journal, BMC Pregnancy and Childbirth.
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