Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study

Background: Cohort studies have noted associations between hazardous alcohol use during pregnancy and infant growth outcomes, but many have not controlled for potential psychosocial confounders. To assess the unique contribution of hazardous alcohol use, we examined its effect on infant growth outco...

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Main Authors: Myers-Franchi, Bronwyn, Koen, N., Donald, K.A., Nhapi, R.T., Workman, L., Barnett, W., Hoffman, N., Koopowitz, S., Zar, H.J., Stein, D.J.
Format: Journal Article
Language:English
Published: WILEY 2018
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/85725
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author Myers-Franchi, Bronwyn
Koen, N.
Donald, K.A.
Nhapi, R.T.
Workman, L.
Barnett, W.
Hoffman, N.
Koopowitz, S.
Zar, H.J.
Stein, D.J.
author_facet Myers-Franchi, Bronwyn
Koen, N.
Donald, K.A.
Nhapi, R.T.
Workman, L.
Barnett, W.
Hoffman, N.
Koopowitz, S.
Zar, H.J.
Stein, D.J.
author_sort Myers-Franchi, Bronwyn
building Curtin Institutional Repository
collection Online Access
description Background: Cohort studies have noted associations between hazardous alcohol use during pregnancy and infant growth outcomes, but many have not controlled for potential psychosocial confounders. To assess the unique contribution of hazardous alcohol use, we examined its effect on infant growth outcomes while controlling for maternal psychosocial stressors and hazardous tobacco and drug use in a cohort of 986 pregnant South African women enrolled into the Drakenstein Child Health Study between 2012 and 2015. Methods: Data on psychosocial stressors and maternal risk behaviors were collected between 28 and 32 weeks of gestation. Participants were categorized as hazardous alcohol users if they obtained moderate or high scores (>10) on the Alcohol, Smoking and Substance Involvement Screening Test at this assessment or retrospectively reported drinking at least 2 drinks weekly during any trimester of pregnancy. Infant growth outcomes were recorded at delivery. Multivariable regression models examined correlates of hazardous alcohol use and associations between hazardous alcohol use and birth outcomes. Results: Overall, 13% of mothers reported hazardous alcohol use. Recent exposure to intimate partner violence (adjusted odds ratio (aOR) = 2.08; 95% confidence interval (CI): 1.37, 3.18) and hazardous tobacco use (aOR = 5.03; 95% CI: 2.97, 8.52) were significant correlates of hazardous alcohol use. After controlling for potential psychosocial confounders, hazardous alcohol use remained associated with lower infant weight-for-age (B = −0.35, 95% CI: −0.56, −0.14), height-for-age (B = −0.46, 95% CI: −0.76, −0.17), and head-circumference-for-age z-scores (B = −0.43, 95% CI: −0.69, −0.17). Conclusions: Interventions to reduce hazardous alcohol use among pregnant women in South Africa are needed to prevent alcohol-related infant growth restrictions. As these growth deficits may lead to neurodevelopmental consequences, it is critical to identify alcohol-related growth restrictions at birth and link exposed infants to early interventions for neurodevelopment.
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spelling curtin-20.500.11937-857252021-10-06T05:14:14Z Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study Myers-Franchi, Bronwyn Koen, N. Donald, K.A. Nhapi, R.T. Workman, L. Barnett, W. Hoffman, N. Koopowitz, S. Zar, H.J. Stein, D.J. Science & Technology Life Sciences & Biomedicine Substance Abuse Antenatal Alcohol Exposure Infant Growth Outcomes South Africa Cohort INTIMATE PARTNER VIOLENCE IRON-DEFICIENCY ANEMIA MATERNAL RISK-FACTORS FOR-GESTATIONAL-AGE PRETERM BIRTH SUBSTANCE USE CAPE-TOWN WOMEN EXPOSURE WEIGHT Background: Cohort studies have noted associations between hazardous alcohol use during pregnancy and infant growth outcomes, but many have not controlled for potential psychosocial confounders. To assess the unique contribution of hazardous alcohol use, we examined its effect on infant growth outcomes while controlling for maternal psychosocial stressors and hazardous tobacco and drug use in a cohort of 986 pregnant South African women enrolled into the Drakenstein Child Health Study between 2012 and 2015. Methods: Data on psychosocial stressors and maternal risk behaviors were collected between 28 and 32 weeks of gestation. Participants were categorized as hazardous alcohol users if they obtained moderate or high scores (>10) on the Alcohol, Smoking and Substance Involvement Screening Test at this assessment or retrospectively reported drinking at least 2 drinks weekly during any trimester of pregnancy. Infant growth outcomes were recorded at delivery. Multivariable regression models examined correlates of hazardous alcohol use and associations between hazardous alcohol use and birth outcomes. Results: Overall, 13% of mothers reported hazardous alcohol use. Recent exposure to intimate partner violence (adjusted odds ratio (aOR) = 2.08; 95% confidence interval (CI): 1.37, 3.18) and hazardous tobacco use (aOR = 5.03; 95% CI: 2.97, 8.52) were significant correlates of hazardous alcohol use. After controlling for potential psychosocial confounders, hazardous alcohol use remained associated with lower infant weight-for-age (B = −0.35, 95% CI: −0.56, −0.14), height-for-age (B = −0.46, 95% CI: −0.76, −0.17), and head-circumference-for-age z-scores (B = −0.43, 95% CI: −0.69, −0.17). Conclusions: Interventions to reduce hazardous alcohol use among pregnant women in South Africa are needed to prevent alcohol-related infant growth restrictions. As these growth deficits may lead to neurodevelopmental consequences, it is critical to identify alcohol-related growth restrictions at birth and link exposed infants to early interventions for neurodevelopment. 2018 Journal Article http://hdl.handle.net/20.500.11937/85725 10.1111/acer.13566 English http://creativecommons.org/licenses/by/4.0/ WILEY fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Substance Abuse
Antenatal Alcohol Exposure
Infant Growth Outcomes
South Africa
Cohort
INTIMATE PARTNER VIOLENCE
IRON-DEFICIENCY ANEMIA
MATERNAL RISK-FACTORS
FOR-GESTATIONAL-AGE
PRETERM BIRTH
SUBSTANCE USE
CAPE-TOWN
WOMEN
EXPOSURE
WEIGHT
Myers-Franchi, Bronwyn
Koen, N.
Donald, K.A.
Nhapi, R.T.
Workman, L.
Barnett, W.
Hoffman, N.
Koopowitz, S.
Zar, H.J.
Stein, D.J.
Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study
title Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study
title_full Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study
title_fullStr Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study
title_full_unstemmed Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study
title_short Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study
title_sort effect of hazardous alcohol use during pregnancy on growth outcomes at birth: findings from a south african cohort study
topic Science & Technology
Life Sciences & Biomedicine
Substance Abuse
Antenatal Alcohol Exposure
Infant Growth Outcomes
South Africa
Cohort
INTIMATE PARTNER VIOLENCE
IRON-DEFICIENCY ANEMIA
MATERNAL RISK-FACTORS
FOR-GESTATIONAL-AGE
PRETERM BIRTH
SUBSTANCE USE
CAPE-TOWN
WOMEN
EXPOSURE
WEIGHT
url http://hdl.handle.net/20.500.11937/85725