High prevalence of prenatal alcohol exposure detected by breathalyzer in the Republic of the Congo, Africa.

OBJECTIVE: Assess the prevalence of prenatal alcohol exposure in the Republic of the Congo by measuring breath alcohol concentration (BrAC) levels using a breathalyzer device. METHODS: Pregnant women were assessed for alcohol use with a breathalyzer reading during two prenatal visits and during labor and delivery. RESULTS: Among 662 pregnant women consented and screened with a breathalyzer, 192 (29.0%) had a positive BrAC during 1st trimester. During the second assessment, approximately 69% (132) of the 192 pregnant women had a second positive BrAC. A third assessment during labor and delivery identified 60 women (31%) with a third positive BrAC. About 19% (36) of the 192 pregnant women had positive BrACs at all three times. Among women who were positive on the first and second assessments, 30% had a BrAC that was above 0.07, which is almost equivalent of binge drinking (four or more standard drinks in about 2 h). The mean BrAC reading decreased as the pregnancy progressed. CONCLUSIONS: The results of this study utilizing a unique exposure detection methodology suggest that the use of BrAC may be a useful objective option to detect and quantify alcohol consumption during pregnancy. The prevalence of alcohol use identified during pregnancy in the Republic of the Congo was increased over 20% when compared to maternal reports from a previous study. Nearly one of every five women identified at the first prenatal visit continued drinking throughout pregnancy. Urgent measures are needed to reduce alcohol consumption among this population of pregnant women.

Prenatal alcohol exposure in the Republic of the Congo: prevalence and screening strategies.

OBJECTIVE: To determine prevalence of prenatal alcohol use in Brazzaville, Congo and to evaluate a prenatal screening tool for use in this population. METHODS: A prospective population screening program of 3099 women at 10 prenatal care clinics in Brazzaville, Congo using the 1-Question screen. To validate the 1-Question screen in this population we screened 764 of these women again using the T-ACE as a gold standard for comparison study. The study outcomes were as follows: prevalence of self-reported prenatal alcohol use in Brazzaville using the 1-Question screen, estimation of number of drinking days, drinks per drinking day, most drinks on any one occasion. We also estimated the epidemiologic performance criteria for the 1-Question screen. RESULTS: The 3099 women screened were classified as follows: no risk 77% (n=2,384); at risk 3.7% (n=115); and as high risk 19.3% (n=600). Of the women reporting drinking during pregnancy, 87.4% reported drinking 4 or more drinks on any occasion. The agreement for detection of alcohol use during pregnancy by the 1-Question Screen and a positive T-ACE score was 94.7%. CONCLUSIONS: 23.3% of women attending prenatal care in Brazzaville reported alcohol use during pregnancy and 83% of them continued to drink after recognition of pregnancy. Prenatal alcohol exposure should be the focus of efforts to improve identification of alcohol use prior to and during pregnancy to improve maternal and child health. Birth Defects Research (Part A) 97:489-496, 2013. © 2013 Wiley Periodicals, Inc.