Fetal Alcohol Syndrome Diagnosis, Epidemiology, Prevention, and Treatment (1996) / Chapter Skim
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6 Epidemiology of Women's Drinking
6 Epidemiology of Women's Drinking
Pages 100-111
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From page 100... ...
Much of this research, however, has paid relatively little attention to psychological and social determinants of maternal drinking behavior. Although surveillance studies have monitored trends in alcohol consumption among women of childbearing age (e.g., the Behavioral Risk Factors Surveys of the Centers for Disease Control and Prevention tCDC]
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From page 101... ...
Very few, if any, teratogens have "attack rates" of loom. A better understanding of biological and life-style characteristics associated with variations in fetal risk at comparable levels of maternal alcohol consumption is needed to understand the diversity in fetal outcome and might suggest prevention strategies that could strengthen naturally occurring protection against adverse fetal effects (Faden and Hanna, 1994~.
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From page 102... ...
While this striking reduction in alcohol consumption during pregnancy may reduce fetal risk, the small numbers of heavier drinkers in most clinic-based studies, and the limited variation in drinking levels among pregnant women who do drink, reduce the statistical "power" to detect predictors of maternal drinking behavior. A final limitation of many clinic-based studies is that most have measured only a few demographic characteristics as predictors of maternal drinking and its effects.
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From page 103... ...
Some very large national data sets are available that include information on women's drinking behavior, drinking-related problems, and a variety of other health behaviors (see NIAAA, 1994~. Unfortunately, many of the largest national alcohol and health surveys (some with samples of more than 40,000 respondents)
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From page 105... ...
; the 1991 CDC Behavioral Risk Factors Surveillance Survey (BRFSS; 14 percent) ; and the 1994 National Institute on Drug Abuse (NIDA)
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From page 106... ...
This downward shift in drinking distributions in pregnancy helps explain why alcohol and pregnancy research typically uses lower cutoffs for moderate and heavy drinking (e.g., one or more standard drinks per day to define heavy drinking) than do general population surveys (which in turn use lower cutoffs than many popular images of "heavy" drinking)
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From page 107... ...
Other studies tend to support that general profile of pregnant women who drink (Day et al., 1993; Waterson and Murray-Lyon, 1990~. Correlates of continued drinking during pregnancy despite information on the risks and referral for intervention include onset of drinking behaviors at a young age, heavy drinking on the part of parents and siblings (especially female relatives)
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From page 108... ...
, or violent behavior by their partners, might suggest interpersonal and environmental approaches for reducing these women's alcohol use (Masts and May, 1991; Weiner et al., 1989~. Increased Secondary Analysis of National Health and Alcohol Use Surveys Several large national data sets that contain information on both alcohol use and reproductive history may be of value for examining correlates of drinking and heavy drinking among women of childbearing age, and correlates of drinking and heavy drinking among women pregnant at the time of the surveys.
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From page 109... ...
The lack of such data severely limits the ability to predict which women are most likely to engage in high-risk drinking during pregnancy or to give birth to a child with FAS, ARND, or ARBD. Therefore, the committee recommends special attention to the following research questions and issues: · expand studies of pregnant women, where possible, to include measurement of psychological, social-environmental, dietary, and other factors that may influence women's drinking behavior or fetal outcome; · inclusion of questions regarding alcohol consumption and pregnancy status in appropriate future national health surveys; · standardization of questions added to health surveys regarding the quantity, frequency, and variability of alcohol consumption so as to permit comparisons across multiple surveys; · studies focused on protective factors that may decrease women's drinking or prevent fetal injury from alcohol consumption;
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From page 110... ...
Frequent alcohol consumption among women of childbearing age Behavioral risk factor surveillance system, 1991. Journal of the American Medical Association 1994; 271:1820-1821.
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From page 111... ...
A comprehensive local program for the prevention of fetal alcohol syndrome. Public Health Reports 1991; 106:484-489.
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