Frequency of alcohol effects in fetus and pattern of alcohol consumption by pregnant women at a public maternity hospital in São Paulo city, Brazil

Authors

  • Maria dos Anjos Mesquita Hospital e Maternidade Cruz Azul
  • Conceição Aparecida de Mattos Segre Instituto de Assistência ao Servidor Público Estadual

DOI:

https://doi.org/10.7322/jhgd.19903

Keywords:

newborn, pregnant women, alcohol, fetal alcohol syndrome, alcohol-related disorders

Abstract

OBJETIVE: to evaluate the frequency of alcohol effects in fetus and the pattern of alcohol consumption by pregnant women of a public maternity hospital in the city of São Paulo, Brazil. METHOD: one thousand sixty four live newborns were evaluated and their mothers interviewed by direct questions and by T-ACE questionnaire. The weekly intake of alcohol by pregnant women was quantified in the previous three months and during the gestation, and the physical characteristics of newborns compared with the consumption pattern. The Mann-Whitney test, Chi-square test and Spearman rank correlation coefficient were used. The significant level of 5% was adopted. RESULTS: in 76 children (38.69/1000 live births) the fetal alcohol spectrum disorders was identified. Three children (1.52/1000 live births) presented fetal alcohol syndrome. In the previous three months of pregnancy, 43.90% pregnant women consumed alcohol weekly. During the gestation the numbers decreased to 21.20% in first trimester, 17.50% in the second and 17.10% in the third and 33.29% of pregnant women reported drinking alcohol at some time during pregnancy. The T-ACE questionnaire was positive in 31.11% pregnant women and negative in 68.84%. The amount of alcohol consumption during the first six months of gestation was related to lower the weight, head circumference and length of newborns. These measures did not present significant differences between pregnant women T-ACE positive and negative. CONCLUSION: seventy six newborns with fetal alcohol spectrum disorders were found. The frequency of alcohol use by pregnant women was high and suggests the routine follow-up of the alcohol consume during pregnancy.

References

Bertrand J, Floyd RL, Weber MK. Guidelines for identifying and referring persons with fetal alcohol syndrome. MMWR Recomm Rep. 2005;54(RR-11):1-12.

Hoyme HE, May PA, Kalberg WO, Kodituwakku P, Gossage JP, Trujillo PM, et al. A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: clarification of the 1996 Institute of Medicine criteria. Pediatrics.2005;115(1):39-47.

Fetal alcohol syndrome: guidelines fore ferral and diagnosis. National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Department of Health and Human Services in coordination with National Task Force on Fetal Alcohol Syndrome and Fetal Alcohol Effect [Internet]. 2004 Jul [cited 2008Mar 8]. Available from:http://www.cdc.gov/ncbddd/fas/documents/FAS_guidelines_accessible.pdf.

Chudley AE, Conry J, Cook JL, LoockC, Rosales T, LeBlanc N. Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ. 2005;172(5Suppl):1S-21S.

Prenatal exposure to alcohol. Alcohol Res Health. 2000;24(1):32-41.

What is fetal alcohol syndrome? National Organization on Fetal Alcohol Syndrome [Internet]. 2003 [cited 2003Jun 15]. Available from: http://www.nofas.org/main/what_is_FAS.htm.

May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome: a summary. National Institute on AlcoholAbuse and Alcoholism (NIAAA)[Internet]. 2001 [cited 2003 Jul 18].Available from:http://www.niaaa.nih.gov/publications/marh25-3/159-167.htm.

Floyd RL, O‘Connor MJ, Sokol RJ, Bertrand J, Cordero JF. Recognition and prevention of fetal alcohol syndrome. Obstet Gynecol. 2005;106(5 Pt 1):1059-64.

Thackray H, Tifft C. Fetal alcohol syndrome. Pediatr Rev. 2001; 22(2):47-55.

Jones MW, Bass WT. Fetal alcohol syndrome. Neonatal Nets. 2003;22(3):63-70.

Jacobs EA, Copperman SM, Joffe A, Kulig J, McDonald CA, Rogers PD et al. Fetal alcohol syndrome and alcohol-related neurodevelopmental disorders. Pediatrics. 2000;106(2):358-61.

U.S. Surgeon General Advisory on alcohol use in pregnancy. Washington, DC:US Department of Health and Human Services [Internet]. 2005 Feb[cited 2008 Apr 2]. Available from: http://www.surgeongeneral.gov/pressreleases/sg02222005.html.

Moraes CL, Reichenheim ME. Rastreamento de uso de álcool por gestantes de serviços públicos de saúde do Rio de Janeiro. Rev Saúde Pública. 2007;41(5):695-703.

Peadon E, O‘Leary C, Bower C, ElliottE. Impacts of alcohol use in pregnancy –the role of the GP. Aust Family Physician. 2007;36(11):935-39.

Maier SE, West JR. Drinking patterns and alcohol-related birth defects National Institute on Alcohol Abuse an Alcoholism (NIAAA) [Internet]. 2001[cited 2003 Jul 25]. Available from: http://www.niaaa.nhl.gov/publications/arh25-3/168-174.htm.

Usher R, McLean F. Intrauterine growth of live-born Caucasian infants at sealevel: standards obtained from me assortments in 7 dimensions of infants born between 25 and 44 weeks of gestation. J Pediatr.1969;74(6):901-10.

Sokol RJ, Martier SS, Ager JW. The T-ACE questions: practical prenatal detection of risk drinking. Am J Obstet Gynecol.1989;160(4):863-8.

Stoler JM, Holmes LB. Recognition of facial features of fetal alcohol syndrome in the newborn. Am J Med Genet.2004;127(1):21-7.

Warren KR, Calhoun FJ, May PA,Viljoen DL, Li TK, Tanaka H et al. Fetal alcohol syndrome: an international perspective. Alcohol Clin Exp Res. 2001; 25(5 Suppl ISBRA):202S-6S.

Laranjeira R, Pinsky I, Zaleski. Caetano R. I Levantamento Nacional sobre os Padrões de Consumo de Álcool na População Brasileira. SENAD [Internet]. 2007 [acesso em 2 de abril de 2008]. Disponível em: http://www.senad.gov.br/relatorio_padroes_consumo_alcool.pdf.

Passini Junior R. Alcohol consumption during pregnancy. Rev Bras Ginecol Obstet. 2005; 27(7):373-75.

May PA, Gossage P, Brooke LE, Hons BA, Snell CL, Marais AS et al. Maternal risk factors for fetal alcohol syndrome in the Western Cape Province of South Africa: a population-based study. Am J Public Health. 2005;95(7):1190-9.

Ethen MK, Ramadhari TA, Sheuerle AE, Canfield MA, Wyszynski DF, Druschel, et al. Alcohol consumption by women before and during pregnancy [Internet].2008 [cited 2008 Aug 12]. Availablefrom:www.springerlink.com.w10155.dotlib.com.br/content/qu5t630620726743/fultext.pdf.

Olegard R, Sabel KG, Aronsson M, Sandin B, Johansson PR, Carlsson C et al. Effects on the child of alcohol abuse during pregnancy. Retrospective and prospective studies. Acta Paediatr Scand Suppl. 1979; 68:112-21.

Freire TM, Machado JC, Melo EV, Melo DG. Efeitos do consumo de bebida alcoólica sobre o feto. Rev Bras Ginecol Obstet. 2005;27(7):376-81.

Atenção pré-natal. Manual puerpério [Internet]. 2006. [acesso em 20 de junho de 2008]. Disponível em: http://www.saude.gov.br

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Published

2009-04-01

Issue

Vol. 19 No. 1 (2009)

Section

Original Research

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