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Alcohol Use, Injuries, and Prenatal Visits During Three Successive Pregnancies Among American Indian Women on the Northern Plains Who have Children with Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome

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Abstract

Introduction The purpose of the study was to compare three sequential pregnancies of American Indian women who have children with FAS or children with incomplete FAS with women who did not have children with FAS. Methods Two retrospective case-control studies were conducted of Northern Plains American Indian children with fetal alcohol syndrome (FAS) (Study 1) or incomplete FAS (Study 2) in 1981–1993. Three successive pregnancies ending in live births of 43 case mothers who had children with FAS, and 35 case mothers who had children with incomplete FAS were compared to the pregnancies of 86 and 70 control mothers who did not have children with FAS, respectively, in the two studies. Prenatal records were abstracted for the index child (child with FAS or incomplete FAS) and siblings born just before and just after the index child, and comparable prenatal records for the controls. Results Compared to the controls, significantly more case mothers used alcohol before and after all three pregnancies and during pregnancy with the before sibling and the index child. Mothers who had children with FAS reduced their alcohol use during the pregnancy following the birth of the index child. All Study 1 case mothers (100%) and 60% of Study 2 case mothers used alcohol during the pregnancy with the index child compared to 20 and 9% of respective control mothers. More study 1 case mothers experienced unintentional injuries (OR 9.50) and intentional injuries during the index pregnancy (OR 9.33) than the control mothers. Most case mothers began prenatal care in the second trimester. Conclusions Alcohol use was documented before, during and after each of the three pregnancies. Women of child-bearing age should be screened for alcohol use whenever they present for medical services. Mothers who had a child with FAS decreased their alcohol consumption with the next pregnancy, a finding that supports the importance of prenatal screening throughout pregnancy. Women who receive medical care for injuries should be screened for alcohol use and referred for appropriate treatment. Protective custody, case management and treatment services need to be readily available for women who use alcohol.

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References

  1. Sokol, R. J., Martier, S., & Ager, J. (1989). The T-ACE questions: Practical prenatal detection of risk drinking. American Journal of Obstetrics and Gynecology, 160, 863–868.

    PubMed  CAS  Google Scholar 

  2. Duimstra, C., Johnson, D., Kutsch, C., Wang, B., Zentner, M., Kellerman, S., & Welty, T.(1993). A fetal alcohol syndrome surveillance pilot project in American Indian communities in the Northern Plains. Public Health Reports, 108, 225–229.

    PubMed  CAS  Google Scholar 

  3. Abel, E. L. (1998). Fetal alcohol abuse syndrome. New York: Plenum Press.

    Google Scholar 

  4. Streissguth, A. (1997). Fetal alcohol syndrome. Baltimore: Paul H Brookes Publishing Co.

    Google Scholar 

  5. Abel, E. L. (1990). Fetal alcohol syndrome. Oradell, NJ: Medical Economics Books.

    Google Scholar 

  6. Aase, J. A. (1994). Clinical recognition of FAS. Alcohol Health and Research World, 18, 5–9.

    Google Scholar 

  7. Hoyme, H. E., May, P. A., Kalberg, W. O., Kodituwakku, P., Gossage, P., Trujilo, P. M., Buckley, D. G., Miller, J. H., Aragon, A. S., Khaole, N., Viljioen, D. L., Jones, K. L., & Robinson, L. K. (2005). A practical clinical approach to diagnosis of fetal alcohol spectrum disorders: Clarification of the 1996 Institute of Medicine criteria. Ped, 115, 39–47.

    Article  Google Scholar 

  8. Jones, K. L., & Smith, D. W. (1973). Recognition of the fetal alcohol syndrome in early infancy. Lancet, 2, 999–1001. doi:10.1016/S0140-6736(73) 91092-1.

    Article  PubMed  CAS  Google Scholar 

  9. Adnams, C. M., Sorour, P., Kalberg, W. O., Kodituwakku, P., Perold, M. D., Kotze, A., et al. (2007). Language and literacy outcomes from a pilot intervention study for children with fetal alcohol spectrum disorders in South Africa. Alcohol, 41, 403–414. doi:10.1016/j.alcohol.2007.07.005.

    Article  PubMed  Google Scholar 

  10. Buxton, B. (2005). Damaged angels. New York: Carroll & Graf Publishers.

    Google Scholar 

  11. May, P. A., Brooke, L., Gossage, J. P., Croxford, J., Adnams, C., Jones, K. L., Robibnson, L., & Viljioen, D. (2000). Epidemiology of fetal alcohol syndrome in a South African community in the Western Cape Province. American Journal of Public Health, 90, 1905–1912.

    PubMed  CAS  Google Scholar 

  12. May, P. A., Gossage, J. P., Brooke, L. E., Snell, C. L., Marais, A.-S., Hendricks, L., Croxford, J. A., & Viljoen, D. (2005). Maternal risk factors for fetal alcohol syndrome in the Western Cape Province of South Africa: A population-based study. American Journal of Public Health, 95, 1190–1199. doi:10.2105/AJPH.2003.037093.

    Article  PubMed  Google Scholar 

  13. May, P. A., Gossage, J. P., Marais, A.-S., Adnams, C. M., Hoyme, H. E., Jones, K. L., Robinson, L. K., Khaole, N., Snell, C.L., Kalberg, W.O., Hendricks, L., Brooke, L., Stellavato, C., & Viljoen, D. L. (2007). The epidemiology of fetal alcohol syndrome and parital FAS in a South African community. Drug and Alcohol Dependence, 88, 259–271. doi:10.1016/j.drugalcdep. 2006.11.007.

    Article  PubMed  Google Scholar 

  14. Institute of Medicine. (1996). Fetal Alcohol Syndrome. In K. Stratton, C. Howe, & F. Battaglia (Eds.). Washington, DC: National Academy Press.

  15. Kvigne, V. L., Bad Heart Bull, L., Welty, T., Leonardson, G. L., & Lacina, L. (1998). Relationship of prenatal alcohol use with maternal and prenatal factors in American Indian women. Social Biology, 45, 214–222.

    PubMed  CAS  Google Scholar 

  16. Kvigne, V. L., Leonardson, G. L., Borzelleca, J., Brock, E., Neff-Smith, M., & Welty, T. (2003). Characteristics of mothers who have children with fetal alcohol syndrome and some characteristics of fetal alcohol syndrome. Journal of the American Board of Family Practice, 16, 296–303.

    Article  PubMed  Google Scholar 

  17. Day, N. L., Cottreau, C. M., & Richardson, G. A. (1993). The epidemiology of alcohol, marijuana, and cocaine use among women of childbearing age and pregnant women. Clinical Obstetrics and Gynecology, 36, 232–245. doi:10.1097/00003081-199306000-00005.

    Article  PubMed  CAS  Google Scholar 

  18. Kvigne, V. L., Leonardson, G. L., Neff-Smith, M., Brock, E., Borzelleca, J., & Welty, T. (2004). Characteristics of children who have full or incomplete fetal alcohol syndrome. Journal of Ped, 145, 635–640. doi:10.1016/j.jpeds.2004.07.015.

    Article  Google Scholar 

  19. Centers for Disease Control. (1995). Sociodemographic and behavioral characteristics associated with alcohol consumption during pregnancy—United States. Morbidity and Mortality Weekly Report, 44, 261–264.

    Google Scholar 

  20. Linking multiple data sources in fetal alcohol syndrome surveillance—Alaska. (1994). Morbidity and Mortality Weekly Report, 42, 312–314.

    Google Scholar 

  21. SAS Institute Inc. (1988). SAS/STAT User’s Guide. Release 6.03 edition. Cary, NC: SAS Institute Inc.

  22. Centers for Disease Control. (1994). Epi Info Version 6. Atlanta, GA: Centers for Disease Control and Prevention.

    Google Scholar 

  23. Beckman, L. J. (1994). Treatment needs of women with alcohol problems. Alcohol Health and Research World, 18, 206–211.

    Google Scholar 

  24. Maier, S. E., Wei-Jung, A. C., & West, J. R. (1996). The effects of timing and duration of alcohol exposure on development of the fetal brain. In E. L. Abel (Ed.), Fetal alcohol syndrome. New York: CRC Press.

    Google Scholar 

  25. Maier, S. E., & West, J. R. (2001). Drinking patterns and alcohol-related birth defects. Alcohol Research and Health, 25, 168–74.

    PubMed  CAS  Google Scholar 

  26. Iyasu, S., Randall, L. L., Welty, T. K., Hsia, J., Kinney, H. C., Mandell, F., McClain, M., Randall, B., Habbe, D., Wilson, H., & Willinger, M. (2002). Risk factors for sudden infant death syndrome among Northern Plains Indians. JAMA, 288, 2717–2723. doi:10.1001/jama.288.21.2717.

    Article  PubMed  Google Scholar 

  27. Welty, T. K., Lee, E. T., Yeh, J., Cowan, L. D., Go, O., Fabsitz, R. R., Le, N., Oopik, A. J., Robbins, D. C., & Howard, B. V. (1995). Cardiovascular disease risk factors among American Indians. American Journal of Epidemiology, 142, 269–287.

    PubMed  CAS  Google Scholar 

  28. May, P. A, McCloskey, J., & Gossage, J. P. (2002). Fetal alcohol syndrome among American Indians: epidemiology, issues and research review. In P. D. Mail, S. Heurtin-Roberts, S. E. Martin, & J. Howard (Eds.). Alcohol use among American Indians and Alaska natives. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.

    Google Scholar 

  29. Kvigne, V. L., Leonardson, G. L., & Welty, T. K. (2006). Characteristics of fathers who have children with fetal alcohol syndrome or incomplete fetal alcohol syndrome. S D Med, 59, 337–340.

    PubMed  Google Scholar 

  30. Kvigne, V. L., Leonardson, G. L., Borzelleca, J., & Welty, T. K (2008). Characteristics of grandmothers who have grandchildren with fetal alcohol syndrome or incomplete fetal alcohol syndrome. Matern Child Health. doi:10.1007/s10995-007-0308-y.

  31. Golden, J. (2005). Message in a bottle. Cambridge, MA: Harvard University Press.

    Google Scholar 

  32. Brook, D., Zhang, C., Rosenberg, G., & Brook, J. (2006). Maternal cigarette smoking during pregnancy and child agressive behavior. American Journal on Addictions, 15, 450–456. doi:10.1080/10550490600998559.

    Article  PubMed  Google Scholar 

  33. Nilsson, P., Hofvendahl, S., Hofvendahl, E., Brandt, L., & Ekbom, A. (2006). Smoking in pregnancy in relation to gender and adult mortality risk in offspring: The Helsingborg birth cohort study. Scandinavian Journal of Public Health, 34, 660–664. doi:10.1080/14034940600607509.

    Article  PubMed  Google Scholar 

  34. Al Mamun, A., O’Callaghan, F., Alati, R., O’Callaghan, M., Najman, J., Williams, G., & Bor, W. (2006). Does maternal smoking during pregnancy predict the smoking patterns of young adult offspring? A birth cohort study. Tobacco Control, 15, 452–457. doi:10.1136/tc.2006.016790.

    Article  PubMed  Google Scholar 

  35. Pernanen, K. (1991). Alcohol in human violence. New York: Guilford Press.

    Google Scholar 

  36. Zahnd, E., Klein, D., Crim, D., Holtby, S., & Bachman, R. (2002). Alcohol-related violence among American Indians. In P. D. Mail, S. Heurtin-Roberts, S. E. Martin, & J. Howard (Eds.), Alcohol use among American Indians and Alaska natives. Bethesda, MD: National Institute on Alcohol Abuse and Alcoholism.

    Google Scholar 

  37. Silverman, J., Decker, M., Reed, E., & Raj, A. (2006). Intimate partner violence victimization prior to and during pregnancy among women residing in 26 U.S. states: associations with maternal and neonatal health. American Journal of Obstetrics and Gynecology, 195, 140–148. doi:10.1016/j.ajog.2005.12.052.

    Article  PubMed  Google Scholar 

  38. Ernst, C. C., Grant, T. M., Streissguth, A. P., & Sampson, P. D. (1999). Intervention with high-rish alcohol and drug-abusing mothers: II. Three-year findings from the Seattle model of paraprofessional advocacy. Journal of Community Psychology, 27, 19–38. doi: 10.1002/(SICI) 1520-6629(199901) 27:1<19::AID-JCOP2>3.0.CO;2-K

    Article  Google Scholar 

  39. Grant, T. M., Ernst, C. C., Pagalilauan, G., & Streissguth, A. (2003). Postprogram follow-up effects of paraprofessional intervention with high-risk women who abused alcohol and drugs during pregnancy. Journal of Community Psychology, 31, 211–222. doi:10.1002/jcop. 10048.

    Article  Google Scholar 

  40. May, P. A., Miller, J. H., Goodhart, K., Maestas, O. R., Buckley, D., Trujilo, P. M., & Gossage, J. P. (2008). Enhanced case management to prevent fetal alcohol spectrum disorders in Northern Plains communities. Maternal and Child Health Journal. doi:10.1007/s10995-007-0304-2.

  41. Handmaker, N. S., & Wilbourne, P. (2001). Motivational interventions in prenatal clinics. Alcohol Research and Health, 25, 210–229.

    Google Scholar 

  42. Herzig, K., Danley, D., Jackson, R., Petersen, R., Chamberlain, L., & Gerbert, B. (2006). Seizing the 9-month moment: Addressing behavior risks in prenatal patients. Patient Education and Counseling, 61, 228–235. doi:10.1016/j.pec.2005.04.001.

    Article  PubMed  Google Scholar 

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Acknowledgments

The authors acknowledge the work of the abstractors: Angel Wilson FNP, Mary Ewing FNP, George Coy MPH, Barbara Frost MD, Betty Reppert PA-C MPH, Margaret A. Brown RN BS, Richard Williams MD MPH, Patricia Reams MD MPH, Victoria Gutmaker RN BS, Dana Sleicher MA MPH, Patricia Maddox MSN MPH, Joan Kub PhD, Juliette Raymond MD MPH, Barbara E. Parker RN MPH, Nancy Glass MSN MPH, Luis Callejas MD MPH, Beth Phillips MSN MPH, Elizabeth Jordan RN MSN, Nancy Deckert RN, Deborah K. Kuehn RN/CNP MSN, L. Russell Canfield MD, and Katherine Canfield MD. We also acknowledge the work of the people who completed data entry: Andrew Desruisseau MD, John M. Marion, Laurie Pope, and Loralei Lacina MD. Michele Strachan MD, Don Blackman PhD, Eva Marie Smith MD, R. Louise Floyd DSN, Diane R. Burkom, and the late Christopher Krogh MD made valuable contributions to the project. Roger Rochat MD, and Myra Tucker provided editorial input. The Indian Health Service and Centers for Disease Control and Prevention supported this study through a memorandum of agreement. The opinions expressed in this paper are those of the authors and do not necessarily reflect the views of the IHS.

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Authors and Affiliations

  1. Aberdeen Area Indian Health Service, 2013 W 15th St #1, Sioux Falls, SD, 57104, USA

    Valborg L. Kvigne

  2. Mountain Plains Research, 55 Rodeo Trail, Dillon, MT, 59725, USA

    Gary R. Leonardson

  3. Virginia Commonwealth University, Box 980034, MCV Station, Richmond, VA, 23298, USA

    Joseph Borzelleca & Ellen Brock

  4. Global Consultants, P.O. Box 462, Gordonville, VA, 22942, USA

    Martha Neff-Smith

  5. 939 Flynn Lane, McCall, ID, 83638, USA

    Thomas K. Welty

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  1. Valborg L. Kvigne
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Correspondence to Valborg L. Kvigne.

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Kvigne, V.L., Leonardson, G.R., Borzelleca, J. et al. Alcohol Use, Injuries, and Prenatal Visits During Three Successive Pregnancies Among American Indian Women on the Northern Plains Who have Children with Fetal Alcohol Syndrome or Incomplete Fetal Alcohol Syndrome. Matern Child Health J 12 (Suppl 1), 37–45 (2008). https://doi.org/10.1007/s10995-008-0367-8

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