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Multiple Tools Are Needed for the Detection of Prenatal Alcohol Exposure: Findings From a Community Antenatal Setting
Background Although the toxic effects of prenatal alcohol exposure (PAE) on children are well established, there is emerging evidence about the dynamics and associated demographics of drinking patterns across pregnancy, with risky drinking more likely to take place in the period before pregnancy awa...
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| Published in: | Alcoholism, clinical and experimental research clinical and experimental research, 2020-04, Vol.44 (4), p.1001-1011 |
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| container_end_page | 1011 |
| container_issue | 4 |
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| container_title | Alcoholism, clinical and experimental research |
| container_volume | 44 |
| creator | Stevens, Suzanne Anstice, Nicola Cooper, Aimee Goodman, Lucy Rogers, Jennifer Wouldes, Trecia A. |
| description | Background
Although the toxic effects of prenatal alcohol exposure (PAE) on children are well established, there is emerging evidence about the dynamics and associated demographics of drinking patterns across pregnancy, with risky drinking more likely to take place in the period before pregnancy awareness. This study investigated the use of complementary measurement tools in the understanding of alcohol use across pregnancy and reports on the rates and patterns of alcohol use in a community antenatal setting.
Methods
Data on alcohol consumption before and after awareness of pregnancy were collected via multiple measurement tools: anonymous lifestyle questionnaire, TWEAK (Tolerance, Worried, Eye‐opener, Amnesia, K/Cut down) screener questionnaire, and Substance Use Inventory interviews across multiple pregnancy timepoints. Additionally, phosphatidylethanol (PEth), a direct biomarker of alcohol metabolism, collected from newborns’ dried blood spot cards, was analyzed.
Results
The TWEAK screener was more likely to identify risky drinking behavior than the lifestyle questionnaire. When pregnancy was unplanned, women were more likely to find out they are pregnant significantly later (p |
| doi_str_mv | 10.1111/acer.14309 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2390770237</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2390770237</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3579-7c5a581d362ae4379def609c202d6afa039bf236f01a8eb1971b583101b277d53</originalsourceid><addsrcrecordid>eNp9kD1PwzAQQC0EoqWw8AOQJTaklLOdxAlbVFpAKh-CMkdOcqFBSVxsR9B_T0oLI7fc8u6d9Ag5ZTBm_VyqHM2Y-QLiPTJkgQAPuJT7ZAjMD7wQIBqQI2vfAcCPwvCQDARnPmcyGJLuvqtdtaqRLrSuLU0M0gfEAgtaakPdEuk1OsxdpVuqS_pksFVO1TSpc73UNZ1-rbTtDF7RWdUWVftm6czohio60U3TtZVb06R1u6sXdK5njslBqWqLJ7s9Iq-z6WJy680fb-4mydzLRSBjT-aBCiJWiJAr9IWMCyxDiHMOvAhVqUDEWclFWAJTEWYsliwLIsGAZX2AIhAjcr71roz-6NC69F13pu1fplzEICVwIXvqYkvlRltrsExXpmqUWacM0k3hdFM4_Sncw2c7ZZc1WPyhv0l7gG2Bz6rG9T-qNJlMn7fSb91DhW4</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2390770237</pqid></control><display><type>article</type><title>Multiple Tools Are Needed for the Detection of Prenatal Alcohol Exposure: Findings From a Community Antenatal Setting</title><source>Wiley-Blackwell Read & Publish Collection</source><creator>Stevens, Suzanne ; Anstice, Nicola ; Cooper, Aimee ; Goodman, Lucy ; Rogers, Jennifer ; Wouldes, Trecia A.</creator><creatorcontrib>Stevens, Suzanne ; Anstice, Nicola ; Cooper, Aimee ; Goodman, Lucy ; Rogers, Jennifer ; Wouldes, Trecia A.</creatorcontrib><description>Background
Although the toxic effects of prenatal alcohol exposure (PAE) on children are well established, there is emerging evidence about the dynamics and associated demographics of drinking patterns across pregnancy, with risky drinking more likely to take place in the period before pregnancy awareness. This study investigated the use of complementary measurement tools in the understanding of alcohol use across pregnancy and reports on the rates and patterns of alcohol use in a community antenatal setting.
Methods
Data on alcohol consumption before and after awareness of pregnancy were collected via multiple measurement tools: anonymous lifestyle questionnaire, TWEAK (Tolerance, Worried, Eye‐opener, Amnesia, K/Cut down) screener questionnaire, and Substance Use Inventory interviews across multiple pregnancy timepoints. Additionally, phosphatidylethanol (PEth), a direct biomarker of alcohol metabolism, collected from newborns’ dried blood spot cards, was analyzed.
Results
The TWEAK screener was more likely to identify risky drinking behavior than the lifestyle questionnaire. When pregnancy was unplanned, women were more likely to find out they are pregnant significantly later (p < 0.001) and consume alcohol at moderate–heavy levels (p = 0.03), prolonging the risk to the fetus. There was an association between maternal self‐reported alcohol use on the lifestyle questionnaire and Substance Use Inventory interviews, but no association between maternal reports of alcohol use and PEth results (p = 0.72). Women self‐reported moderate–heavy alcohol use in early pregnancy only and a positive PEth screen indicated PAE in late pregnancy, suggesting that these methods may identify different groups of women.
Conclusions
Multiple measurement tools and methods are needed to identify PAE at different points across pregnancy. Prospective sensitive interviewing is better suited to detecting PAE in early pregnancy, but not later when social desirability bias is stronger, and the use of an objective biomarker, such a PEth, may be useful for identifying the risk of PAE in late pregnancy.
The findings highlight the time before pregnancy awareness as a high‐risk period for maternal drinking. Multiple methodologies are needed to identify prenatal alcohol exposure at different points across pregnancy. Sensitive interviewing is better suited to detecting PAE in early pregnancy, but not later when social desirability bias is stronger. An objective biomarker, such a PEth, may be useful for identifying risk of PAE in late pregnancy, but caution should be applied when interpreting for clinical or forensic purposes.</description><identifier>ISSN: 0145-6008</identifier><identifier>EISSN: 1530-0277</identifier><identifier>DOI: 10.1111/acer.14309</identifier><identifier>PMID: 32142175</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Alcohol use ; Alcoholism ; Amnesia ; Biomarker ; Biomarkers ; Demography ; Drinking behavior ; Drug tolerance ; Drug use ; Fetuses ; Interviews ; Lifestyles ; Measurement Tools ; Neonates ; Pregnancy ; Prenatal Alcohol Exposure ; Prenatal experience ; Questionnaires ; Social desirability ; Substance use</subject><ispartof>Alcoholism, clinical and experimental research, 2020-04, Vol.44 (4), p.1001-1011</ispartof><rights>2020 by the Research Society on Alcoholism</rights><rights>2020 by the Research Society on Alcoholism.</rights><rights>2020 Research Society on Alcoholism</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3579-7c5a581d362ae4379def609c202d6afa039bf236f01a8eb1971b583101b277d53</citedby><cites>FETCH-LOGICAL-c3579-7c5a581d362ae4379def609c202d6afa039bf236f01a8eb1971b583101b277d53</cites><orcidid>0000-0001-7532-1253</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32142175$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Stevens, Suzanne</creatorcontrib><creatorcontrib>Anstice, Nicola</creatorcontrib><creatorcontrib>Cooper, Aimee</creatorcontrib><creatorcontrib>Goodman, Lucy</creatorcontrib><creatorcontrib>Rogers, Jennifer</creatorcontrib><creatorcontrib>Wouldes, Trecia A.</creatorcontrib><title>Multiple Tools Are Needed for the Detection of Prenatal Alcohol Exposure: Findings From a Community Antenatal Setting</title><title>Alcoholism, clinical and experimental research</title><addtitle>Alcohol Clin Exp Res</addtitle><description>Background
Although the toxic effects of prenatal alcohol exposure (PAE) on children are well established, there is emerging evidence about the dynamics and associated demographics of drinking patterns across pregnancy, with risky drinking more likely to take place in the period before pregnancy awareness. This study investigated the use of complementary measurement tools in the understanding of alcohol use across pregnancy and reports on the rates and patterns of alcohol use in a community antenatal setting.
Methods
Data on alcohol consumption before and after awareness of pregnancy were collected via multiple measurement tools: anonymous lifestyle questionnaire, TWEAK (Tolerance, Worried, Eye‐opener, Amnesia, K/Cut down) screener questionnaire, and Substance Use Inventory interviews across multiple pregnancy timepoints. Additionally, phosphatidylethanol (PEth), a direct biomarker of alcohol metabolism, collected from newborns’ dried blood spot cards, was analyzed.
Results
The TWEAK screener was more likely to identify risky drinking behavior than the lifestyle questionnaire. When pregnancy was unplanned, women were more likely to find out they are pregnant significantly later (p < 0.001) and consume alcohol at moderate–heavy levels (p = 0.03), prolonging the risk to the fetus. There was an association between maternal self‐reported alcohol use on the lifestyle questionnaire and Substance Use Inventory interviews, but no association between maternal reports of alcohol use and PEth results (p = 0.72). Women self‐reported moderate–heavy alcohol use in early pregnancy only and a positive PEth screen indicated PAE in late pregnancy, suggesting that these methods may identify different groups of women.
Conclusions
Multiple measurement tools and methods are needed to identify PAE at different points across pregnancy. Prospective sensitive interviewing is better suited to detecting PAE in early pregnancy, but not later when social desirability bias is stronger, and the use of an objective biomarker, such a PEth, may be useful for identifying the risk of PAE in late pregnancy.
The findings highlight the time before pregnancy awareness as a high‐risk period for maternal drinking. Multiple methodologies are needed to identify prenatal alcohol exposure at different points across pregnancy. Sensitive interviewing is better suited to detecting PAE in early pregnancy, but not later when social desirability bias is stronger. An objective biomarker, such a PEth, may be useful for identifying risk of PAE in late pregnancy, but caution should be applied when interpreting for clinical or forensic purposes.</description><subject>Alcohol use</subject><subject>Alcoholism</subject><subject>Amnesia</subject><subject>Biomarker</subject><subject>Biomarkers</subject><subject>Demography</subject><subject>Drinking behavior</subject><subject>Drug tolerance</subject><subject>Drug use</subject><subject>Fetuses</subject><subject>Interviews</subject><subject>Lifestyles</subject><subject>Measurement Tools</subject><subject>Neonates</subject><subject>Pregnancy</subject><subject>Prenatal Alcohol Exposure</subject><subject>Prenatal experience</subject><subject>Questionnaires</subject><subject>Social desirability</subject><subject>Substance use</subject><issn>0145-6008</issn><issn>1530-0277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kD1PwzAQQC0EoqWw8AOQJTaklLOdxAlbVFpAKh-CMkdOcqFBSVxsR9B_T0oLI7fc8u6d9Ag5ZTBm_VyqHM2Y-QLiPTJkgQAPuJT7ZAjMD7wQIBqQI2vfAcCPwvCQDARnPmcyGJLuvqtdtaqRLrSuLU0M0gfEAgtaakPdEuk1OsxdpVuqS_pksFVO1TSpc73UNZ1-rbTtDF7RWdUWVftm6czohio60U3TtZVb06R1u6sXdK5njslBqWqLJ7s9Iq-z6WJy680fb-4mydzLRSBjT-aBCiJWiJAr9IWMCyxDiHMOvAhVqUDEWclFWAJTEWYsliwLIsGAZX2AIhAjcr71roz-6NC69F13pu1fplzEICVwIXvqYkvlRltrsExXpmqUWacM0k3hdFM4_Sncw2c7ZZc1WPyhv0l7gG2Bz6rG9T-qNJlMn7fSb91DhW4</recordid><startdate>202004</startdate><enddate>202004</enddate><creator>Stevens, Suzanne</creator><creator>Anstice, Nicola</creator><creator>Cooper, Aimee</creator><creator>Goodman, Lucy</creator><creator>Rogers, Jennifer</creator><creator>Wouldes, Trecia A.</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K7.</scope><scope>K9.</scope><orcidid>https://orcid.org/0000-0001-7532-1253</orcidid></search><sort><creationdate>202004</creationdate><title>Multiple Tools Are Needed for the Detection of Prenatal Alcohol Exposure: Findings From a Community Antenatal Setting</title><author>Stevens, Suzanne ; Anstice, Nicola ; Cooper, Aimee ; Goodman, Lucy ; Rogers, Jennifer ; Wouldes, Trecia A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3579-7c5a581d362ae4379def609c202d6afa039bf236f01a8eb1971b583101b277d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Alcohol use</topic><topic>Alcoholism</topic><topic>Amnesia</topic><topic>Biomarker</topic><topic>Biomarkers</topic><topic>Demography</topic><topic>Drinking behavior</topic><topic>Drug tolerance</topic><topic>Drug use</topic><topic>Fetuses</topic><topic>Interviews</topic><topic>Lifestyles</topic><topic>Measurement Tools</topic><topic>Neonates</topic><topic>Pregnancy</topic><topic>Prenatal Alcohol Exposure</topic><topic>Prenatal experience</topic><topic>Questionnaires</topic><topic>Social desirability</topic><topic>Substance use</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Stevens, Suzanne</creatorcontrib><creatorcontrib>Anstice, Nicola</creatorcontrib><creatorcontrib>Cooper, Aimee</creatorcontrib><creatorcontrib>Goodman, Lucy</creatorcontrib><creatorcontrib>Rogers, Jennifer</creatorcontrib><creatorcontrib>Wouldes, Trecia A.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><jtitle>Alcoholism, clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Stevens, Suzanne</au><au>Anstice, Nicola</au><au>Cooper, Aimee</au><au>Goodman, Lucy</au><au>Rogers, Jennifer</au><au>Wouldes, Trecia A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Multiple Tools Are Needed for the Detection of Prenatal Alcohol Exposure: Findings From a Community Antenatal Setting</atitle><jtitle>Alcoholism, clinical and experimental research</jtitle><addtitle>Alcohol Clin Exp Res</addtitle><date>2020-04</date><risdate>2020</risdate><volume>44</volume><issue>4</issue><spage>1001</spage><epage>1011</epage><pages>1001-1011</pages><issn>0145-6008</issn><eissn>1530-0277</eissn><abstract>Background
Although the toxic effects of prenatal alcohol exposure (PAE) on children are well established, there is emerging evidence about the dynamics and associated demographics of drinking patterns across pregnancy, with risky drinking more likely to take place in the period before pregnancy awareness. This study investigated the use of complementary measurement tools in the understanding of alcohol use across pregnancy and reports on the rates and patterns of alcohol use in a community antenatal setting.
Methods
Data on alcohol consumption before and after awareness of pregnancy were collected via multiple measurement tools: anonymous lifestyle questionnaire, TWEAK (Tolerance, Worried, Eye‐opener, Amnesia, K/Cut down) screener questionnaire, and Substance Use Inventory interviews across multiple pregnancy timepoints. Additionally, phosphatidylethanol (PEth), a direct biomarker of alcohol metabolism, collected from newborns’ dried blood spot cards, was analyzed.
Results
The TWEAK screener was more likely to identify risky drinking behavior than the lifestyle questionnaire. When pregnancy was unplanned, women were more likely to find out they are pregnant significantly later (p < 0.001) and consume alcohol at moderate–heavy levels (p = 0.03), prolonging the risk to the fetus. There was an association between maternal self‐reported alcohol use on the lifestyle questionnaire and Substance Use Inventory interviews, but no association between maternal reports of alcohol use and PEth results (p = 0.72). Women self‐reported moderate–heavy alcohol use in early pregnancy only and a positive PEth screen indicated PAE in late pregnancy, suggesting that these methods may identify different groups of women.
Conclusions
Multiple measurement tools and methods are needed to identify PAE at different points across pregnancy. Prospective sensitive interviewing is better suited to detecting PAE in early pregnancy, but not later when social desirability bias is stronger, and the use of an objective biomarker, such a PEth, may be useful for identifying the risk of PAE in late pregnancy.
The findings highlight the time before pregnancy awareness as a high‐risk period for maternal drinking. Multiple methodologies are needed to identify prenatal alcohol exposure at different points across pregnancy. Sensitive interviewing is better suited to detecting PAE in early pregnancy, but not later when social desirability bias is stronger. An objective biomarker, such a PEth, may be useful for identifying risk of PAE in late pregnancy, but caution should be applied when interpreting for clinical or forensic purposes.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32142175</pmid><doi>10.1111/acer.14309</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0001-7532-1253</orcidid></addata></record> |
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| ispartof | Alcoholism, clinical and experimental research, 2020-04, Vol.44 (4), p.1001-1011 |
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| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Alcohol use Alcoholism Amnesia Biomarker Biomarkers Demography Drinking behavior Drug tolerance Drug use Fetuses Interviews Lifestyles Measurement Tools Neonates Pregnancy Prenatal Alcohol Exposure Prenatal experience Questionnaires Social desirability Substance use |
| title | Multiple Tools Are Needed for the Detection of Prenatal Alcohol Exposure: Findings From a Community Antenatal Setting |
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