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Alcohol Consume For Previa PDF
Alcohol Consume For Previa PDF
DOI 10.1007/s10995-010-0615-6
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Introduction
Maternal alcohol use during pregnancy is a leading preventable cause of fetal malformations, neurodevelopmental
abnormalities and perinatal mortality [13]. One of the
pathways by which alcohol is postulated to exert its
inhibitory effects on fetal development is via impaired
placentation [4]. The two important placental pathologies
include placenta previa and placental abruption, both of
which are precursors of perinatal mortality and morbidity.
Placental abruption accounts for up to a third of all perinatal deaths [5, 6], mostly due to its detrimental effects
on length of gestation and fetal growth [7, 8]. Similarly,
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Statistical Analysis
Chi-square test was used to assess differences in sociodemographic characteristics and maternal pregnancy
complications between the two groups (Drinking/Nondrinking). We used logistic regression models to generate
adjusted odd ratios and their 95 percent confidence intervals. The covariates in our models were selected a priori
based on previously published literature and biologic
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Results
A total of 1,304,557 singleton births were available for
analysis. We excluded pregnancies before 20 weeks or
beyond 44 weeks of gestation (69,424 or 5.3 percent) and
records for which prenatal drinking (6,897), gestational age
(6,559), birth weight (216) values were missing (total =
13,823 or 1.1 percent). The final dataset comprised a total of
1,221,310 singleton records, consisting of drinking (15,911
or 1.3 percent) and non-drinking gravidas (1,205,399 or 98.7
percent; the referent group).
Overall, the prevalence of prenatal drinking was 1.3%.
Figure 1 illustrates trend of the prevalence of prenatal
drinking during pregnancy in the study population over
the course of the study while (Table 1) shows frequency
comparison between drinking and non-drinking mothers
with respect to selected socio-demographic characteristics.
Overall, alcohol consumption among pregnant women
declined considerably from 16.8% in 1989 to 2.2% in 2005.
Those gravidas who did not abstain during pregnancy were
more likely to be older, black, multiparous and to have
smoked during pregnancy. Drinking mothers were also less
likely to be married, to have received adequate prenatal care
and to have attained high school education than their nondrinking counterparts.
Table 2 displays the prevalence of common medical and
obstetric complications among mothers in the study. The
overall prevalence of pregnancy complication was 10.9%
(N = 133,652) distributed as follows: drinkers (N = 1,444
or 9.1%) and non-drinkers (132,208 or 11.0%) [P \ 0.01].
Of the obstetric complications, anemia, placenta previa and
placental abruption were more likely among drinkers while
pre-eclampsia, eclampsia, insulin dependent diabetes, other
forms of diabetes and chronic hypertension were more
common among mothers who were non-drinkers during
pregnancy.
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Table 1 Comparison of
selected socio-demographic
characteristics by prenatal
drinking status, Missouri,
19892005
Non-drinker
(N = 1,205,399)%
Drinker
(N = 15,911)%
P-value
9.83
18.47
\0.0001
58.80
68.66
\0.0001
Black
14.99
21.24
\0.0001
White
82.58
77.54
80.49
78.05
\0.0001
19.42
52.44
\0.0001
67.84
59.54
\0.0001
50.94
39.40
\0.0001
Maternal age
C35 years
Parity
Multiparous
Race
Education
C12 years
Smoking
Yes
Married
Yes
Adequate prenatal care
Yes
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Table 2 Prevalence of
common medical/obstetric
complications among mothers
by prenatal drinking status,
Missouri, 19892005
Non-drinker
(N = 1,205,399) n (%)
Drinker
(N = 15,911) n (%)
P-value
17,420(1.45)
252(1.58)
\0.0029
49(0.31)
\0.0001
27,363(2.27)
258(1.62)
\0.0001
11,421(0.95)
119(0.75)
\0.0003
55,600(4.61)
473(2.97)
\0.0001
1,194(0.10)
10(0.06)
\0.0029
9,152(0.76)
197(1.24)
\0.0001
4,496(0.37)
86(0.54)
\0.0006
Anemia
Yes
Insulin-dependent diabetes
Yes
8,862(0.74)
Discussion
The objective of this study was to describe the association
between alcohol consumption and risk of placental abruption and/or placenta previa in a large population-based
cohort of singleton deliveries (n = 1,221,310). Our principal finding was that mothers who consumed alcohol
during pregnancy were at elevated risk of experiencing
placental abruption, but not placenta previa. This finding is
consistent with previous reports that alcohol intake during
pregnancy increases the risk of placental abruption
[1113]. On the other hand, our result is at variance with a
cohort study from Canada, in which no significant association was observed between placental abruption and
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Table 3 Adjusted odd ratio for the association between prenatal alcohol ingestion and placenta previa and placental abruption
Placenta previa (N = 4,582)
Number of cases Adj. OR (95% CI)
Number of cases Adj. OR (95% CI) Number of cases Adj. OR (95% CI)
Non-drinker
N = 4,496
Referent
N = 9,152
Referent
N = 13,439
Referent
Drinker
N = 86
1.19 (0.951.47)
N = 197
1.33 (1.161.54)
N = 279
1.29 (1.141.45)
1.11 (0.871.43)
N = 144
1.28 (1.081.51)
N = 205
1.22 (1.061.41)
1.37 (0.762.49)
N = 19
1.09 (0.691.72)
N = 29
1.15 (0.801.67)
1.58 (0.872.86)
N = 34
1.98 (1.402.80)
N = 45
1.89 (1.402.56)
Adj. OR = adjusted odds ratio. Non-drinker: number of drinks per week = 0; drinker: number of drinks per week [ 0. Adjusted estimates were
generated after controlling for the effects of maternal age, parity, race, smoking, education, marital status, adequacy of prenatal care, gender of
the infant and year of birth
a
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