Discuss about the Consumption Of Alcohol During Pregnancy.
Numerous studies have established the dangers of alcohol consumption during pregnancies. Whereas all the past studies agree that high alcohol consumption in pregnancy acts teratogenically, many controversies remain unresolved concerning the notion of ‘safe levels’ and ‘moderate’ levels of use in expectant women. As all scholars have agreed that high alcohol consumption is dangerous, this study will concentrate on the remaining doubts of moderate alcohol consumption and perhaps clear the misconception and controversies held by the previous studies. These effects of moderate drinking are expected to fall on the same nature of the observed risks of higher consumption. Some of these are the fetal alcohol syndrome (FAS) in moderate drinking (Moreno, 2017). Among these are the intrauterine growth restriction/restriction (IUGR), central nervous system (CNS) dysfunction and craniofacial features. Even though these effects are conditions are less severe than FAS, they can still affect the child. Firstly, this paper will consider the global research on the level of alcohol use among expectant women.
The study of (Popova, et al., 2017) is the leading study in terms of the estimation of reflecting the global status regarding the use of alcohol by expectant women. This meta-analysis depicted Russia, UK, Denmark, Belarus, and Ireland as the leading countries with the uppermost estimates of prevalence alcohol use among expectant women. Also, this study showed that the countries with the lowest prevalence were Qatar, Saudi Arabia, UAE, Kuwait, and Oman. The research also estimated the global prevalence of the consumption of any amount alcohol in the general population as 9·8%.
In Africa, another study by ( Popova, et al., 2016) had earlier presented a look at the prevalence of alcohol use in pregnancy in Africa. This research showed that the three countries that were leading with the highest estimate Uganda, Rwanda, and Burundi. On the other hand, the countries that had the lowest estimates in the prevalence of estimates of prevalence of alcohol use among expectant women were Guinea, Seychelles, and Algeria.
In the United States, the study of ( Flak, et al., 2014) presents that many a great number of women in the childbearing age highly consume alcohol during pregnancy. According to ( Flak, et al., 2014), the great number makes even the smallest outcomes of the prenatal alcohol use to have detrimental repercussions. The report by (Centers for Disease Control and Prevention[CDC], 2012) demonstrating the status at US regarding the use of alcohol among pregnant women also reflects the estimates of the rest of the world. According to this report, 51.5 percent of non-expectant were taking alcohol, and about 7.6 of the expectant women do take alcohol. The report further states that binge drinking counts to an estimate of 15 percent in non-pregnant women and 1.4 percent for expectant. Among expectant women, this report estimates a prevalence of 14.3 percent for women age 35–44 years, 10 percent for college graduates, and 9.6% among employed women.
In Canada, the study of (Lange , et al., 2015) states that one in every ten expectant women take alcohol while expectant. In addition to this, the report by (Taylor, 2016) stated that 10 percent of women who gave birth between 2006-2007 confirmed that they consumed alcohol while pregnant. In Australia, the report by (National Health and Medical Research Council , 2009) provides that there are higher rates of alcohol use among pregnant women with the 2007 reporting survey found that 47 percent for national pregnant women, and 59 percent for Western Australian pregnant women.
Despite various warning from government institutions and other agencies on the risk of alcohol consumption, most women do not take these warnings seriously. The report by (CDC, 2016) warned women within the gap of reproductive age that they should entirely cease from taking alcohol. In particular, the study says they should avoid it either when trying to conceive and after conceiving.
According to (Charness, et al., 2016)the effects of alcohol on the developing pregnancy depends on three factors. These factors are the level of alcohol consumed, the period between the next drinks, and the stage of the development of the embryo. However, despite some other studies stating that there is a safe level, there are still other studies and experiments that provide that there is no such a safe level amount of alcohol during pregnancy (Coons, et al., 2017). These studies confirm that there no moderate amounts that do not have increased dangers of spontaneous abortions.
Among other effects, craniofacial malformations are the hallmark features that come with prenatal alcohol exposure (Roussotte, et al., 2011). Examples of these are smooth philtrum, shortened palpebral fissures, and thinned vermillion border (Petrelli, et al., 2018). Another effect is the growth retardation and along with it, central CNS abnormalities (Petkovic & Barisic, 2013), All these effects form the triad of symptoms of FAS (Skogerbo, et al., 2013). However, there is still a need to recognize that FAS is a general term holding the severe effects of fetal alcohol exposure. With this, many children and youths with behavioral and cognitive deficits are suspected to have had a prenatal alcohol exposure and do not necessarily need to have facial dysmorphia to pass FAS diagnostic standards. Other than FAS, other Fetal alcohol-related pathologies are neurodevelopmental disorders caused by alcohol, and they occur at rate of higher exposure (Charness, et al., 2016). In addition, there also other Anomalies that affect other body organs as discussed below;
There are a number of studies that have brought evidence that the use of alcohol by expectant women may cause Clefts oral clefts on the developing pregnancy. One of these studies is the study of (DeRoo, et al., 2008) In this study, the authors were examining weather maternal alcohol exposure has any link oral clefts. The authors undertook a study on infants born between 1996and 2001 in Norway. In overall, 377 babies had cleft lip (CL) but they had on had no with cleft palate (CP). 196 of the babies had CP only, and 763 were controls. The mothers of the babies reported having consumed alcohol in the first-trimester. Comparing with abstainers, mothers who reported binge-drinking had higher chances of getting a baby with CL with or without a CP. The conclusion of this study was that binge-levels of alcohol on pregnant mothers can cause infant clefts.
Another evidence connecting the use of alcohol by expectant women and oral creft was revealed in (DeRoo, et al., 2016). The authors in this study used individual participant to collect data from six population-based case-controled studies. The analysis included more than 4600 infants with CL only, CL with CP, or CP only. Unaffected children were more than 10,000 who were placed in controls. The authors studied the levels of alcohol taken in the first two trimesters, the average taken in one incident, and the highest level taken in one incident. While comparing with non-drinkers, the authors found that the mothers of who took from five and above drinks per sitting had higher chances of having a baby with CL only. Non-binge mothers had no cases of CL.
There are also studies that have stated that alcohol use during pregnancy can cause higher risks of cardiac problems. One of the studies that have shown that even moderate levels of alcohol are dangerous to a pregnancy is the study of (Yang, et al., 2015). This study had 20 studies, and it was testing the association between congenital heart defects (CHDs) and prenatal alcohol exposure, ventricular septal defects (VSDs), or atrial septal defects (ASDs). The study confirmed a relationship drinking in pregnancy and CTDs, and d-Transposition of the Great Arteries (dTGA). In addition, heavy and binge in pregnancy had a strong connection to the overall CHDs. There was also a modest relationship between drinking and CTDs.
NTDs is a condition that occurs when neural tubes fail to close at the time of early gestation (Chen, 2008). Various studies have depicted alcohol as one of the known teratogens that can induce NTDs (Makelarski, et al., 2013). The study of (Grewal, et al., 2008)examined whether there is an association between NTDs, peri-conceptional period, orofacial clefts, and conotruncal heart problems in offspring and maternal alcohol and smoking habits. The researchers collected data from fetuses and infants born between July 199 to June 2003. This study had 1,355 cases, 337 NTDs, 701 had orofacial clefts, and 323 conotruncal heart problems. The results showed that smoking of <5 cigarettes in a day had risks of NTDs while cigarettes higher than five in a day were associated with conotruncal heart problems. On the part of alcohol, alcohol taken for less than one day per week had a link to higher chances of NTDs. This study is one of those that demonstrated that even low levels of alcohol could be dangerous.
Alcohol consumption by pregnant women may also lead to increased risks of atopic dermatitis (AD) in early infancy (Carson, et al., 2012). Also, this problem is seen to increase if both parents are suffering from an allergic disease. In (Shaheen, et al., 2014), the authors aimed to explore on the connection between mothers’ consumption while expectant and AD. After the analysis, the researchers found that there was evidence suggesting the relationship between mothers’ alcohol intake in pregnancy and increased risk of AD.
Most studies consider alcohol intake as the most probable cause of Attention Deficit Hyperactivity Disorder (ADHD), without counting on smoking as the other cause (Montag, 2016). Evidence of the correlation between ADHD and alcohol and was presented in (Brown, et al., 2010). In this analysis, the authors examined child developmental and behavioral feature. The data of 9-months data point in Early Childhood Longitudinal Studies was examined. The researchers found that there was an indication of a relationship between the quantities of alcohol used by the mothers while she was pregnant and the sensory regulation, motor, and mental development.
According to (Taylor, 2016), Although governments and other health institutions have enlightened people about the uncertainties of taking alcohol while pregnant, there is a great number of people who are ignoring all these warnings. The work of (Taylor, 2016) continues to advocate for total abstinence by stating that even drinking sometimes before conceiving can still have detrimental effects. Besides, this work continues to state that about 50% of the pregnancies happen while unplanned. In this notion, it means that most of the women who consume alcohol have higher chances of getting pregnant unknowingly, and while still drinking. , meaning women may consume alcohol before knowing they.
Despite some studies stating that there are safe quantities of drinking, there is a lot of evidence refuting this claim. For instance, the study of (Mamluk, et al., 2017) In this extensive systematic literature review, the researchers intended to find out whether low levels of alcohol consumption had any effects on a pregnancy. The authors performed a random-effects meta-analysis and used a narrative summary where applicable. The two main finds were that there were few proposed investigations to particularly address questions of the impacts of small quantities of alcohol use by expectant mothers and its adverse or beneficial effects on the infant. On the same, there were few researchers looking to investigate the consequences of light alcohol usage on the pregnancy. Secondly, these researchers found that there was a scarcity of evidence explaining the safe limit or any detrimental effect of light alcohol usage. In overall, the researchers found evidence that drinking about ≤32 g per week while pregnant had rare effects. On the other hand, there were some facts showing that small quantities of alcoholic drinks in expectant mothers had an association with pre-mature births and gestational ages (SGA). In conclusion, the authors advised for total abstinence while pregnant.
Additionally, (Sundelin-Wahlsten, et al., 2016), evaluated the effects of maternal alcohol usage and investigated the possible consequences of alcohol on the growing newborns. The study aimed to assess the physical complexities and other consequences of the neuropsychological development throughout the upbringing the newborn. Also, the study wanted to look at the general childhood development and the genetic construct. It also looked at the mothers’ experiences while pregnant, at birth, and the baby’s health. The study also looked at the behavioral and developmental data of the baby from delivery up to the age of 1.5 years.
The researchers collected data from 291 Swedish women. These mothers were then placed into 4 different groups according to the data scores. On analysis, there was no variation in group gestational length. However, the children of those mothers who took alcohol during the pregnancy were shorter than those of the mothers who did not. Those women who had a higher level of consumption also smoke and had unplanned pregnancies. Also, their children manifested behavioral problems. The women who had higher levels of alcohol usage in pregnancy than they had previously had higher chances of getting unplanned pregnancies or undertake an abortion. This study concluded that that low levels and moderate levels of alcohol consumption while pregnant had a negative impact on the child’s behavior and development.
Similarly, the study of (Andersen, et al., 2012) also has a compelling evidence that drinking alcohol during the pregnancy can bring detrimental effects. In this analysis, the researchers intended to evaluate the dangers of fetal death or spontaneous abortion as claimed by previous studies that had warned that maternal alcohol use could lead to a fetal death or stillbirth. The researchers carried out their cohort study within the scope of the earlier study by the Danish National Birth Cohort (DNBC). In this study, (Andersen, et al., 2012) collected data from 92 719 participants. All these participants had enrolled to the DNBC to provide information regarding their lifestyle during their pregnancy. In particular, they were offering data regarding their different trimesters of pregnancy.
The authors collected information such as average weekly alcohol consumption during the pregnancy, the rate of smoking, amount of coffee drunk, occupational state and reproductive records. Pregnancy outcomes such as stillbirth, spontaneous abortion, live birth and other pregnancy issues were recorded. Additional information was the gestational age at the end of pregnancy. All this data was then analyzed. The results showed that 50% had stopped taking alcohol during the pregnancy while only 2.2% recorded >4 drinks in a week. Women who reported the fetal death in the first trimester 1.66%, and 2.82% for those who took 2–3½ drinks in a week. For those who took >4 were 1.57% and 1.73% spontaneous death in the pregnancy from 13-16 weeks.
These results demonstrated that even a low quantities consumed within the time of pregnancy could pose a substantial risk of spontaneous abortion. The results also show that alcohol-related risk increase risks of miscarriage diminished as one progressed to the 16th week of pregnancy. The risks of miscarriage were higher in the first trimester where someone was taking a higher dose. There was no correlation between levels of drinking and following spontaneous abortion or stillbirth.
The study of ( Flak, et al., 2014) is also another example of meta-analysis reviews that suggest that there cannot be harmless quantities regarding alcohol use while in pregnant. This analysis study indicated that even moderate prenatal alcohol intake with levels as low as less than daily in drinking can still affect the child behaviors. The main objective of ( Flak, et al., 2014) was to evaluate most of the literature work regarding the correlation between mild levels, moderate, and the extreme levels of binge at the time of pregnancy. The meta-analysis also had the focus of evaluating the effects of drinking on the child neurodevelopment. In total, this study identified 1,593 articles. Out of these, 34 articles presented information gathered from different investigations that matched their inclusion standards. The information required for the focus population, evaluation instruments, covariates, outcomes, alcohol susceptibility quantification, and results were retrieved. The outcomes that these researchers were looking for were information like academic performance, language skills, behavior, attention, cognition, memory, and visual/motor development.
According to 8 studies, these researchers were able to find a significant detrimental correlation in 10,000 children who were aged six months to 14 years. The detrimental effects of these children resulted from binge levels of prenatal alcohol susceptibility and their thinking. In three studies, 11,900 children between nine months and five years detrimental correlation between small quantities alcohol susceptibility and their performance. There were also small observations of the definite relationship between light and ordinary levels of alcohol susceptibility and child’s thinking capacity, but this relationship was not that significant. This study concluded that there are damaging consequences of binge-level of exposure on the child’s thinking. Susceptibility to small quantities less than everyday intake can also be detrimental to a child’s performance. These results leave no other choice except abstinence from drinking while pregnant.
Similarly, the work of (Jensen, et al., 2015) refutes the idea that alcohol intake during pregnancy can have no detrimental effects. In this study, the authors noted that alcohol indeed affects a child grapho-motor skill among others. The authors investigated the consequences of motherly alcohol intake and higher quantities when pregnant on kid’s Draw-A-Person (DAP) records. In particular, this study was examining the potential influences of small to medium quantities of alcohol consumed while pregnant and the consequences of binge-level of alcohol on the kid’s grapho-motor abilities assessed by the DAP. The study involved 1533 children who were 5-year of age from DNBC. The regression reviews exhibited an adverse effect from nine and above drinks in a week. Also, the DAP mean counts (6.26) decreased as seen in the completely adjusted model..
The results showed there were adverse consequences in kids where mothers were taking alcohol whose quantities were from nine and above in a week. Also, the results reflected binge episodes in early pregnancy. Children whose mothers consumed moderate levels and binged levels scored on average of 6 points lower than those children whose mother abstained from the consumption during the pregnancy. These results suggested that alcohol susceptibility to pregnancies either in moderate or binge levels can affect children’s thinking capacity.
These studies are among other numerous studies that demonstrate that there is nothing like sage levels of alcohol when it comes to matters of drinking during pregnancy. The findings of these study are also consistent with other studies that have followed them, or those have been done before. For instance, (Kesmodel, et al., 2010) had earlier investigated the impact of drinking while pregnant on neurodevelopment.
Conclusion
This paper aimed to present a clear outlook on the status of alcoholism and pregnancies. There has been a great debate among scholars with some stating that there little or moderate levels of alcohol could have no effects on a pregnancy. On the other hand, there are also other researchers who are in this position and continue to advise those in pregnancies or planning to conceive to stay away from alcoholic drinks. This paper also joins the realm of other scholars who are against drinking while pregnant. This paper reasons that it is better to abstain from drinking because there would be no chances of effects that come with alcohol. Besides, as human bodies react differently, what could be moderate or low level for one person could be a higher level to another person. With this, abstaining from drinking remains the only safe choice instead of taking chances.
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