Prenatal alcohol consumption: exploring prevalence and the impact of an educational intervention

Abstract

Background Alcohol is a well-known teratogen and its consumption during pregnancy is a growing public health concern across the globe. Prevalence rates of prenatal alcohol use remain high, despite international guidelines recommending abstinence. This has significant consequences as it is a direct cause of foetal alcohol spectrum disorder, which is known to have widespread adverse effects on the individual, their families and wider society. Ascertaining the true extent of prenatal alcohol use remains a major challenge however as obtaining this information can be challenging. Objectives The purpose of the systematic review was to assess the international prevalence of prenatal alcohol exposure as obtained using meconium biomarkers in general maternity populations. The purpose of the empirical study was to explore the prevalence of prenatal alcohol use by self-report of women in the UK, and the impact of an educational intervention on attitudes and knowledge towards drinking during pregnancy. Methodology The systematic review was completed on studies reporting the prevalence of prenatal alcohol exposure as determined by meconium biomarker testing, and their methodological quality was appraised. A national anonymous online study was conducted for the empirical study. This comprised of an educational intervention and questionnaire measures assessing prevalence of self-report prenatal alcohol use, attitudes and knowledge. Results Findings from the systematic review demonstrated that prevalence rates of prenatal alcohol exposure assessed using meconium biomarkers varied from 2.4% to 44%. Studies were found to be of moderate quality, although varied greatly with respect to their sociodemographic and methodological characteristics. Findings from the empirical study demonstrated high rates of binge drinking prior to pregnancy (82%), which decreased significantly following recognition of pregnancy (0.2%). The educational intervention was found to have a significant impact on attitudes and knowledge (z = -9.67, p < .001 r = 0.29). Conclusion Results of the systematic review support the utility of meconium as a promising objective tool for the detection of prenatal alcohol exposure but recommends use with caution and adherence to stringent methodological protocols. Further research is warranted on its utility in clinical practice. Results of the empirical study support the use of educational interventions in improving women’s knowledge of risks and increasing negative attitudes towards prenatal alcohol use. Recommendations for implementation of such interventions at community and clinical levels to reduce prenatal alcohol use and subsequent risks of foetal alcohol spectrum disorder are made.