Just Released! WHO Guidelines: Substance Use and Pregnancy
World Health Organization
These evidence-based, consensus guidelines have been developed to enable professionals to assist pregnant women who use alcohol or drugs or with substance use disorders to achieve healthy outcomes. Until now, there were no global guidelines providing evidence-based recommendations for identifying and managing substance use and substance use disorders in pregnancy. To read the article click here.
Garden of the Mind
Why no one can say exactly how much is safe to drink while pregnant.
By Rebecca Schwarzlose, from Brains, Pregnancy, Science, January 2014
Early Pregnancy Alcohol Linked to Heightened Premature and Small Baby Risk
In the UK the Department of Health recommends that pregnant women and those trying to conceive should not drink alcohol at all and no more than 1-2 units a week. [See below for translation to U.S. standard drinks.*] Middle class women were most likely to drink more than this, the study found. The researchers base their findings on responses to food frequency questionnaires by 1264 women at low risk of birth complications in Leeds. All the women were part of the Caffeine and Reproductive Health (CARE) study, looking into links between diet and birth outcomes.
The mums to be were asked how often they drank alcohol, and what type it was, at four time points: in the four weeks before conception; and in each of the subsequent three months (trimesters) throughout the pregnancy. Alcohol consumption was significantly higher before conception and in the first three months of pregnancy than in the subsequent two trimesters, averaging 11, 4, and just under two units a week, respectively. Over half (53%) of the women drank more than the recommended maximum two weekly units during the first trimester. And almost four out of 10 said they drank more than 10 units a week in the period leading up to conception. Those who drank more than two units a week were morelikely to be older, educated to degree level, of white ethnicity, and more likely to live in affluent areas. Some 13% of the babies born were underweight, and 4.4% were smaller than would be expected; a similar proportion (4.3%) were born prematurely. Drinking during the first three months of pregnancy was most strongly linked to these outcomes. Women who drank more than the recommended two weekly units were twice as likely to give birth to an unexpectedly small or premature baby than women who abstained completely. But even women who didn't exceed the maximum recommended alcohol intake during this period were still at increased risk of a premature birth, even after taking account ofother influential factors.
Drinking during the period leading up to conception was also linked to a higher risk of restricted fetal growth,indicating that this may also be a critical period, suggest the authors. "Our results highlight the need for endorsing the abstinence-only message,and further illuminate how timing of exposure is important in the association of alcohol with birth outcomes, with the first trimester being the most vulnerable period," they write.
* This is equivalent to about ½ to 1 US standard drink.
US standard drink = 12 oz. beer, 5 oz. wine, or 1.5 oz. distilled spirits.
1 British unit is 8 grams of pure alcohol.
1 US standard drink is 14 grams of pure alcohol.
Online calculator: http://www.cleavebooks.co.uk/scol/ccalcoh1.htm
An article by Diane King and Becky Porter of CDC’s Arctic FASD Regional Training Center from the Anchorage Daily News about alcohol use, FASDs, alcohol screening and brief intervention (SBI) and the RTC’s efforts in implementing alcohol SBI in public health centers in Alaska as well as new funding from SAMHSA for training efforts. Read at:
Changing High-Risk AlcOhol Use and Increasing Contraception Effectiveness Study (CHOICES)
The CHOICES intervention is now included in SAMHSA’s National Registry of Evidence-based Programs and Practices (NREPP). A link to the NREPP registry description of CHOICES is included on our website at http://www.cdc.gov/ncbddd/fasd/research-preventing.html along with a CHOICES one-pager and a link to download or order the CHOICES curriculum. The direct link to the NREPP description of CHOICES is found here and the full PDF is attached. Being included in NREPP is a promising strategy for making the intervention more accessible to others.
National Center on Birth Defects and Developmental Disabilities (NCBDDD) has published two new studies on alcohol use during pregnancy published recently.
- The journal Alcoholism: Clinical and Experimental Research has published “The association of mild, moderate, and binge prenatal alcohol exposure and child neuropsychological outcomes: A meta-analysis.”Rread the abstract of the study here and a summary of key findings here.
- The journal American Journal of Health Education has published “Women's knowledge, views, and experiences regarding alcohol use and pregnancy: Opportunities to improve health messages.” Read the article’s abstract here and summary of key findings here.
FAS ANNIVERSARY. 2013 marks the 40th anniversary of when Drs. Kenneth Lyons Jones and David Smith discovered Fetal Alcohol Syndrome (FAS). In the following video, Dr. Jones delivers a powerful message about drinking alcohol during pregnancy. Plus, expert resources are available on MotherToBaby.org. To view the video click here.
New Centers for Disease Control & Prevention (CDC) Report: Excessive Alcohol Use Very Expensive for States, DC
We are pleased to announce the release of a new article entitled the “State Costs of Excessive Alcohol Consumption, 2006.” The article, which is available free to the public, is being posted online today by the American Journal of Preventive Medicine, and will be published in the journal’s October 2013 online issue.
The authors report that excessive alcohol use cost states and D.C. a median of $2.9 billion in 2006 (the most recent data available), ranging from $420 million in North Dakota to $32 billion in California. This means the median cost per state for each alcoholic drink consumed was about $1.91.
Binge drinking, which is defined as consuming five or more drinks on an occasion for men or four or more drinks on an occasion for women, was responsible for more than 70 percent of excessive alcohol use related costs in all states and D.C. The District of Columbia had the highest per-person cost ($1,662), while Utah had the highest cost per drink ($2.74). Furthermore, about $2 of every $5 in state costs were paid by government.
Economic cost estimates for states and D.C. were based on a previous CDC study that found that excessive drinking cost the United States $223.5 billion in 2006. Costs were assessed across 26 cost categories and included losses in workplace productivity, health care expenses, criminal justice, and motor vehicle crash expenses. However, the study did not include a number of other costs, such as those due to pain and suffering, and is therefore likely to be an underestimate.
We encourage you to find out how much excessive drinking cost your state or district, and help us spread the word by:
- Customizing and releasing the press release below for your state,*
- Customizing and posting some of the suggested Facebook or Twitter text below to your account*, and
- Raising awareness about the high cost of excessive drinking where you live.
Please visit our web site – www.cdc.gov/alcohol – for more information on excessive alcohol use, and the alcohol section of the Community Guideweb site for more information on evidence-based strategies to prevent excessive alcohol use.
Thank you for your continued interest and efforts in the prevention of excessive alcohol consumption.
Preparing a Healthy Path:
The Impacts of FAS/ARND on Tribal Justice Systems
A Training Curriculum for Tribal Justice Systems Personnel
In 2001, the Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Fetal Alcohol Syndrome Prevention Team awarded the National Indian Justice Center (NIJC) a cooperative agreement. Pursuant to that cooperative agreement, NIJC developed a fetal alcohol syndrome (FAS) awareness curriculum which promotes a tribal multi-disciplinary team approach for responding to persons with FAS and alcohol related neuro-developmental disorder (ARND) who are involved in the tribal justice system as defendants, witnesses and/or victims. The goals of this curriculum are to increase awareness of FAS/ARND among tribal justice system personnel and to reduce the secondary disabilities associated with FAS/ARND specifically those that result in increased criminal behavior among or victimization of persons with FAS/ARND.
To learn more about FAS/ARND, go to About FAS.
This curriculum is available through NIJC at a cost of $40 including, printing, handouts and standard shipping via U.S. mail. For more information about the curriculum content, go to About the FAS Curriculum. To order the curriculum, go to NIJC's Publication List.
A New Resource to Help Pediatricians Identify and Manage Children with Fetal Alcohol Spectrum Disorders (FASDs)
The American Academy of Pediatrics (AAP), with support through a cooperative agreement with the Centers for Disease Control and Prevention’s (CDC) National Center on Birth Defects and Developmental Disabilities (NCBDDD) has developed a comprehensive, web-based FASD toolkit (www.aap.org/fasd) that helps to raise awareness, promote surveillance and screening, and ensure that all affected children receive appropriate and timely interventions