Wine consumption by hazardous drinkers before and after pregnancy recognition.

OBJECTIVE: To investigate patterns of wine consumption among hazardous drinkers before and after pregnancy recognition. STUDY DESIGN: Using a standard alcohol survey, hazardous drinking was defined as either frequent or binge drinking with related consequences. Patients identified at our clinic during their first prenatal visit as being hazardous drinkers were interviewed during the prenatal and postpartum periods. The numbers of drinking days and drinks per drinking day were sought before and after pregnancy recognition. RESULTS: A total of 203 of 4494 women met the criteria as hazardous drinkers before pregnancy recognition and completed the prenatal and postpartum interviews. Wine was consumed by approximately one fourth (49, 24.1%) of these women, usually with other alcoholic beverages (45, 91.8%). Wine alone was not consumed heavily. Nearly half (46.9%) continued their wine consumption after pregnancy confirmation, although the numbers of drinking days and drinks per drinking day became significantly lower than before pregnancy awareness (p < 0.01). Thirty-five hazardous drinkers switched to wine after pregnancy recognition. CONCLUSION: Hazardous drinkers were inclined to drink wine with other alcoholic beverages yet tended to abstain or minimize consumption after pregnancy recognition.

Infant stress reactivity and prenatal alcohol exposure.

BACKGROUND: Animal studies have shown that prenatal alcohol exposure (PAE) is linked to alterations in the stress response systems. To date, little is known about the impact of PAE on stress systems in human infants. The current study examined PAE effects on the stress response, as evidenced by the activation of the limbic-hypothalamic-pituitary-adrenal (L-HPA) axis and autonomic system and changes in negative affect during a social-emotional challenge in human infants. We also examined whether the effects of PAE on infant responsiveness differed in boys and girls. METHODS: Measures of cortisol, heart rate, and negative affect were obtained during a modified version of Tronick's still-face procedure, a standardized developmental paradigm used to study emotion and stress regulation. Our sample included fifty-five 5- to 7-month-old infants whose mothers were enrolled in an alcohol intervention study. Measures of maternal alcohol consumption during pregnancy and after delivery were obtained using Timeline Followback interviewing methods. Relationships between prenatal alcohol consumption and infant outcomes were examined. In addition, mothers were divided into high and low-frequency drinkers, based on the mean percent of prenatal drinking days (PDD) to facilitate between-group comparisons of infant stress measures. RESULTS: Mothers enrolled in our study reported significant reductions in alcohol consumption after learning of their pregnancies. Nevertheless, PDD from conception to pregnancy recognition was related to increases in cortisol reactivity, elevated heart rate, and negative affect in their infants. The effects of PAE on infant responsiveness were significant after controlling for the effects of maternal depression and annual income. In addition, the effects of PAE on cortisol reactivity differed for boys and girls. CONCLUSIONS: Greater PAE was related to greater activation of stress response systems. Our findings suggest that PAE affects the development of infant stress systems and that these effects differ in boys and girls. This work supports the possibility that PAE is related to alterations in infant stress systems, which could underlie problems in cognitive and social-emotional functioning that are common among persons exposed prenatally to alcohol.

Impact of alcohol exposure after pregnancy recognition on ultrasonographic fetal growth measures.

BACKGROUND: More than 3 decades after Jones and Smith (1973) reported on the devastation caused by alcohol exposure on fetal development, the rates of heavy drinking during pregnancy remain relatively unchanged. Early identification of fetal alcohol exposure and maternal abstinence led to better infant outcomes. This study examined the utility of biometry for detecting alcohol-related fetal growth impairment. METHODS: We obtained fetal ultrasound measures from routine ultrasound examinations for 167 pregnant hazardous drinkers who were enrolled in a brief alcohol intervention study. The fetal measures for women who quit after learning of their pregnancies were compared with measures for women who continued some drinking throughout the course of their pregnancies. Because intensity of alcohol consumption is associated with poorer fetal outcomes, separate analyses were conducted for the heavy (average of >or=5 drinks per drinking day) alcohol consumers. Fetal measures from the heavy-exposed fetuses were also compared with measures from a nondrinking group that was representative of normal, uncomplicated pregnancies from our clinics. Analyses of covariance were used to determine whether there were differences between groups after controlling for influences of gestational age and drug abuse. RESULTS: Nearly half of the pregnant drinkers abstained after learning of their pregnancies. When women reportedly quit drinking early in their pregnancies, fetal growth measures were not significantly different from a non-alcohol-exposed group, regardless of prior drinking patterns. Any alcohol consumption postpregnancy recognition among the heavy drinkers resulted in reduced cerebellar growth as well as decreased cranial to body growth in comparison with women who either quit drinking or who were nondrinkers. Amphetamine abuse was predictive of larger cranial to body growth ratios. CONCLUSIONS: Alterations in fetal biometric measurements were observed among the heavy drinkers only when they continued drinking after becoming aware of their pregnancies. Although the reliance on self-reported drinking is a limitation in this study, these findings support the benefits of early abstinence and the potential for ultrasound examinations in the detection of fetal alcohol effects.

Beer consumption among hazardous drinkers during pregnancy.

OBJECTIVE: The objective of this study was to examine the prevalence of beer consumption among hazardous drinkers in our pregnant patient population. METHODS: This prospective clinic-based cohort study involved women who were surveyed during their first prenatal visit. Hazardous drinking was identified on alcohol surveys as frequent or binge drinking habits with related consequences. Participants completed initial and postpartum interviews about the quantity, frequency, and type (beer, wine, liquor, and/or combinations) of alcoholic beverages consumed before and after pregnancy recognition. RESULTS: Of the total 4,494 patients who completed the survey, 203 (4.52%) met criteria for hazardous drinking, met study eligibility criteria, and completed the interviews. Beer was consumed most often (n = 151, 74.4%) and in greater quantities than wine (P < .05) or liquor (P < .01). Beer continued to be consumed by 52.3% women after pregnancy recognition. Although abstinence for prolonged periods was common during pregnancy, beer was consumed more than wine and liquor per drinking episode (2.7 versus 0.9 drinking units per drinking day; P = .002) indicating a binging pattern. Very few switched to drinking either a light beer (n = 6) or a nonalcoholic beer (n = 1). CONCLUSION: Beer is the most consumed among women with hazardous drinking habits before and after pregnancy awareness. Focusing on binge beer drinking is worthwhile during routine prenatal questioning. LEVEL OF EVIDENCE: II-2.