Alcohol Abuse during Pregnancy
Eric, Mirela, Vuckovic, Nada, Leppée, Marcel, Culig, Josip, Krivokuca, Dragan, Alcoholism
Maternal use of alcohol drinks during pregnancy is associated with a risk of congenital malformations, functional disorders or immunosuppression. Maternal use of alcohol drinks leads to fetal alcohol syndrome.1,2
The majority of chronic alcoholics suspect there might be association between their longstanding alcohol intake and their children's failure to develop well. However, the feeling of guilt and psychic instability caused by alcohol make them refuse admitting their alcohol dependence. These patients may decide to admit their alcohol dependence only upon successful elimination of the guilty feeling and reassurance that it will help their children.3,4
The prevalence of alcohol induced lesions is hard to assess; according to French statistical reports, it is estimated to 1:21 2 pregnancies, showing a three times greater possibility of the prevalence of the Down syndrome.4
The aim of the study was to assess the prevalence of maternal alcohol use and the rate of congenital malformations in neonates exposed in utero to this xenobiotic.
SUBJECTS AND METHODS
The part of the study performed at the Genetic Counseling Unit, Institute for Children and Adolescents, University Department of Gynecology and Obstetrics, and the Department of Pathology and Histology, Clinical Center in Novi Sad, Serbia, included pregnant women who came to the Genetic Counseling Unit because of risky pregnancies and pregnant women hospitalized at the University Department of Gynecology and Obstetrics for delivery or abortion (part 1).
The other part of the study was performed in four maternity hospitals in Zagreb, Croatia: at the Department of Gynecology and Obstetrics, Zagreb University Hospital Center; Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital; Department of Gynecology and Obstetrics, Merkur University Hospital; and the Department of Gynecology and Obstetrics, Sveti Duh General Hospital (part 2).
The study included 6099 pregnant women from Novi Sad and 893 pregnant women from Zagreb. Informed consent of their participation in the study was obtained from all study subjects.
Data were collected from the following sources:
1) Questionnaire for pregnant women, filled in by a physician, containing two types of data: hospital records and information obtained by the interview;
2) Thorough physical examination of the neonate, performed by a neonatologist according to standard protocol; and
3) Thorough pathologic examination of the fetus, performed by a pathologist according to standard protocols.
Vital data on the newborns, maternal data on previous deliveries, as well as the medication taken between hospital admission and delivery were collected from hospital records. The other part of the questionnaire contained data on the mother's age, level of education, use of contraception, ultrasound (US) studies during pregnancy, x-rays during pregnancy, and use of drugs, alcohol, nicotine and opioid substances during pregnancy. Only pregnant women using alcohol during pregnancy were included in the final analysis, i.e. 21 women (7 women from Novi Sad and 14 women from Zagreb). After the delivery or abortion, the newborns and fetuses were thoroughly examined and monitored for the occurrence of minor or major malformations.
The use of alcohol drinks and the existence of congenital malformations in newborns and fetuses exposed in utero to this xenobiotic were monitored according to gestational trimesters.
Data analysis showed the use of alcohol during pregnancy in 21 (0.3%) of the 6992 investigated women. Malformations were found in 2 (9.5%) fetuses.
Unlimited daily use of alcohol drinks in pregnancy was recorded in 3 (14.3%) cases, whereas another 4 (19.0%) women reported occasional use of small amounts of alcohol drinks until becoming aware of pregnancy, and occasional alcohol intake at meals during pregnancy was recorded in 14 (66. …