Many pregnant women still consume alcohol despite prenatal checks: U of M study

A study of Manitoba women who gave birth to children with fetal alcohol spectrum disorder says current levels of prenatal care don't go far enough.

The study, by the University of Manitoba, found more than 40 per cent of those women received inadequate or no prenatal care.

Meanwhile, almost 60 per cent did receive adequate prenatal care, yet still consumed enough alcohol to affect the fetus.

"This indicates a need for additional research to better understand the role of physicians in reducing alcohol use during pregnancy," states a news release from the university about the study, which examined the health data of 700 Manitoba births over a 28-year period, from 1984 to 2012.

"Our research suggests that screening and intervention programs in prenatal care settings may be missing an extremely high-risk population for alcohol use during pregnancy," said the study's lead author Deepa Singal, a postdoctoral fellow at the Manitoba Centre for Health Policy at the U of M's Max Rady College of Medicine.

"If pregnant women who have issues with alcohol use or dependence don't venture into a doctor's office, or do so rarely, they are not being reached by programs or supports offered there."

The study found that mothers of children with FASD have higher rates of social complexities, including poverty, single parenthood and mental health disorders. It's likely that these complexities pose barriers to accessing prenatal care, Singal said.

Pregnant women who consume alcohol may be reluctant to seek health care because they may fear stigma, judgment and losing their children to child welfare services, she said.

​FASD is a neurodevelopmental disorder that can occur when a baby is exposed to alcohol in the womb. It can have lifelong effects that include physical, mental, behavioural and learning disabilities.

The researchers conducted the study by analyzing anonymous health information stored in a data repository at the Manitoba Centre for Health Policy.

They used FASD diagnoses in children to identify the 700 mothers, then traced their contacts with the health-care system both before and after the birth, comparing them with a group of 2,100 other mothers whose children did not have FASD.

Forty-one per cent of mothers in the FASD group received inadequate or no prenatal care, compared with 15 per cent of mothers in the comparison group.

"Our findings show that these women are not receiving an important health-care service that is critical to monitoring their health and that of their baby, and could help to reduce their alcohol consumption during pregnancy," said Singal.

"Outreach efforts to make contact with at-risk women should be incorporated into FASD prevention strategies. More broadly, we need programs across sectors to address the social determinants of health — factors such as poverty, low educational attainment, unemployment, stress and addiction — in order to increase the rate of prenatal care among vulnerable women who consume alcohol."

The researchers recommend doctors routinely screen for alcohol use in pregnancy, make referrals to treatment and support programs, and link patients to community resources.