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Quality of Intimate Relationships, Paternal Drinking Habits, and Acculturation as Predictors of Maternal Drinking in Pregnancy. Ludmila Bakhireva, MD, PhD, MPH College of Pharmacy and Department of Family and Community Medicine. Collaborative Initiative on FASD (NIH/NIAAA): 2007-2012 - PowerPoint PPT Presentation
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Quality of Intimate Relationships, Paternal Drinking Habits,
and Acculturation as Predictors of
Maternal Drinking in Pregnancy
Ludmila Bakhireva, MD, PhD, MPH
College of Pharmacy andDepartment of Family and Community Medicine
Collaborative Initiative on FASD (NIH/NIAAA): 2007-2012Collaboration b/w 16 research & clinical institutions in 6 different countries.
U01 project: Spectrum of and Nutritional Risk Factors for FASD
in Russia and Ukraine (P.I. Christina Chambers)
Objectives of the Current Analysis:
1. Determine the influence of the partner’s alcohol consumption behavior on maternal drinking in pregnancy.
2. Determine if problems in intimate relationships are associated with risky maternal drinking in pregnancy.
Collaborators: CD Chambers, A. Kristjanson, S. Wilsnac
Influence of Partner's Drinking Habits on Maternal Alcohol Use in Pregnancy
Partner’s drinking habitsMaternal Drinking in Pregnancy
p-value
Abstainers (N=80)
Some exposure in early
pregnancy (n=43)
Continuous
drinkers(N=43)
% % %Frequency of paternal drinking <.0001 < 3 times/week 97.5 72.1 74.4 ≥ 3 times/week 2.5 27.9 25.6Binge drinking <.0001 No 100 69.8 58.1 Yes (≥ 5 drinks/occasion) 0 30.2 41.9Heavy drinking* <.0001 No 97.5 55.8 48.8 Yes 2.5 44.2 51.2Paternal TWEAK score: <.0001 < 2 87.0 39.5 16.3 ≥ 2 (hazardous drinking) 13.0 60.5 83.7
* Heavy drinking: frequent (≥ 3 times/week) or binge (≥ 5 drinks/occasion) drinker
Summary: Pregnant women alcohol consumption behavior is closely related to their partner’s alcohol consumption habits.
Sample: 166 pregnant women in Ukraine
Couple Relationship & Maternal Drinking Habits During Pregnancy
3.91 3.74 3.354.01 3.84 3.541
2
3
4
5
Abstainers (N=80)
Some exposure, quit in pregnancy
(N=43)
Continuous drinkers (N=43)
Satis
facti
on w
ith R
elati
onsh
ip
Maternal Drinking in Pregnancy
Satisfaction with Relationship (mean score)
Unadjusted p<0.001Adjusted p=0.001
Women were asked to report how happy they are with their relationship on the 1-5 scale with 1: extremely unhappy; 5: extremely happy.
* Adjusted for: maternal age, gravidity, pregnancy planning, SES
Couple Relationship & Maternal Drinking Habits During Pregnancy
3.95 3.70 3.403.91 3.74 3.561
2
3
4
5
Abstainers (N=80)
Some exposure, quit in
pregnancy (N=43)
Continuous drinkers (N=43)Ab
ility
to D
iscu
ss P
robl
ems w
ith
Part
ner (
Mea
n)
Drinking Exposure
Ability to Discuss Problems (mean score)
Unadjusted p<0.001Adjusted p=0.032
Women were asked to report how easy it is for them to talk about their feelings or problems with the partner on the 1-5 scale with 1: very difficult; 5: very easy
* Adjusted for: maternal age, gravidity, pregnancy planning, SES
Couple Relationship & Maternal Drinking Habits During Pregnancy
3.37 3.05 2.793.20 2.99 2.831
2
3
4
5
Abstainers (N=80)
Some exposure, quit in
pregnancy (N=43)
Continuous drinkers (N=43)
Prob
lem
Res
oluti
on w
ith P
artn
er
(Mea
n)
Drinking Exposure
Problem Resolution (mean score)
Unadjusted p=0.003Adjusted p=0.111
Women were asked to report how often they quarrel with the partner with 5: “we almost always solve disagreements w/o quarreling”; 1: “we do not only quarrel, we also have physical fights”.
* Adjusted for: maternal age, gravidity, pregnancy planning, SES
The SMART Study at UNM (Safety of Medications and Perception of Teratogenicity)
Southeast Heights Clinic
7525 Zuni SE
South Broadway Clinic 1500 Walter SE
West Mesa Clinic 6900 Gonzales SW
Northwest Valley Clinic 1231 Candelaria NW
UNM Hospital (Triage, Fetal Monitoring Center, General)
• Prospective clinic-based multi-center study
• Pregnant women recruited from UNM & satellite prenatal care clinics (N=200)
• Interviews in English & Spanish
• High proportion of Hispanic (78%), uninsured (42%), foreign-born (55%) pregnant women
• Alcohol consumption a month around LMP was ascertained (including “binge” episodes)
Collaborators:
L. Bakhireva (P.I.) W. Rayburn. MD S. Phelan, MD A. Rowland, Ph.D. B. Young, MPH P. Sarangarm P. Jaiswal Clinic providers
The SMART Study: ResultsHispanic women:
• 17.4% - binge drinking (≥4drinks/occasion) a month around their LMPRisk of binge drinking in periconceptional period:
• Elevated among Latinas born in the US (OR=3.2; 95% CI: 1.2; 8.9)
• Elevated among Latinas who primarily speak English at home (OR=3.6; 95% CI: 1.3; 10.5)
• No independent association with education, insurance, smoking status, gravidity, parity, pregnancy planning
Summary:• Acculturation is a risk factor of risky drinking around conception &
early pregnancy among Latinas in New Mexico