1Title

2 Prevalence and factors associated with alcohol consumption in pregnant women attending
3 antenatal service at GJPMCH in July-September 2021.

4Background

5 The Lancet Global Health, Svetlana Popova and colleagues (2018) report unacceptably
6 high global prevalence rates of alcohol use in pregnancy (9·8%) and fetal alcohol
7 syndrome (FAS) (14·6 cases per 10000 population) and estimate that each year 119,000
8 children are born with FAS. Studies conducted amongst women accessing antenatal care
9 in a range of countries indicate different levels of reported alcohol use during pregnancy:
10 in the UK, 25%; in Sweden 12%2; and in Korea 16.4%. In Nepal a study found out that
11 substantial women drank alcohol during pregnancy while in India they estimated 5.8%
12 pregnant women in general population consumes alcohol.
13 The national drinking (current alcohol user) prevalence was 30.6% (9,507) where 12.5%
14 were women of reproductive age group in a study population of 31,066 according to
15 Wangdi and Jamtsho (2019). The use of alcohol is widely accepted and practiced in
16 Bhutan especially in postnatal mothers who consume homemade alcohol believing that it
17 results in increased milk flow. A decade ago Udon (2011) stated the prevalence of
18 alcohol use in pregnant women in JDWNRH which was alarming.

19 In the studies done so far, the factors associated with alcohol consumption during
20 pregnancy were commonly low educational status, socioeconomic factors, depression,
21 poor social support, partner alcohol use and easily available local brewed alcohol which
22 varied in different countries.

23 World health organization recommends that there is no safe amount and type of
24 alcohol drinking during pregnancy however its use during pregnancy is high despite the
25 well-established evidence of adverse pregnancy outcome. Alcohol is also a public health
26 issue since it is a potent teratogenic agent. Alcohol concentration is the same in a
27 pregnant woman as in the fetus, causing the amniotic fluid to remain impregnated with
28 unmodified alcohol (ethanol) and acetaldehyde. Alcohol can cross the placental barrier
29 and harm the fetus since the fetus has a slower metabolism and detoxification
30 mechanisms than that of an adult. In 1973, a specific phenotype was identified and
31 defined in children born to female alcoholics, called "fetal alcohol syndrome” (FAS).
32 This is a preventable irreversible condition characterized by typical craniofacial
33 anomalies, intra and extra uterine growth restriction, central nervous system dysfunction
34 (including neurological abnormalities, behavioral changes, neuropsychomotor
35 developmental delay and intellectual disability).

36 The public health burden related to maternal and fetal mortality and morbidity
37 resulting from alcohol consumption during pregnancy is huge in the long run. At regional
38 and national level, alcohol use prevalence data is useful indicator for maternal and child
39 health. Although assessing the prenatal alcohol exposure is one of the most preventable
40 birth defects, in GJPMCH there is no formal screening done to assess the alcohol use in
41 pregnant women. Studies are dearth to inform programmes and policy makers for
42 preventive measures. More effective prevention strategies targeting alcohol use during
43 pregnancy and surveillance of FAS are urgently needed. More effective prevention
44 strategies targeting alcohol use during pregnancy and surveillance of FAS are urgently
45 needed. Efforts should be made to obtain countries’ own prevalence data on alcohol use
46 during pregnancy and FAS, which will provide a basis for public health policy, health-
47 care planning, and resource allocation for FAS prevention initiatives. The purpose of the
48 study is to assess the prevalence and associated factors of alcohol consumption in
49 pregnant women availing antenatal services in GJPMCH.
50Research question

51 What is the prevalence and factors associated for alcohol consumption in pregnant
52 women vailing antenatal service in GJPMCH?

53Aim

54 The aim of the study is to investigate the prevalence and factors associated with alcohol
55 consumption in GJPMCH.

56Objectives

57 1. To assess the prevalence of alcohol consumption in pregnant women

58 2. To identify the factors associated with alcohol consumption in pregnant women.
59Hypothesis

60 Pregnant mothers with different characteristics consumes alcohol.

61Alternate hypothesis

62 There is no alcohol use in pregnant mothers.