Alcohol consumption before, during, and after unwanted pregnancy

意外怀孕之前、期间和之后的饮酒量

• 批准号: 8734303
• 负责人: Sarah C.M. Roberts
• 金额: $ 14.43万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-15 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8734303
• 关键词: Affect; Aftercare; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Anxiety; Breast Feeding; Caring; Characteristics; Child; Clinic; Consumption; Data; Data Analyses; Data Set; Dependence; Development; Drug abuse; Education; Equation; Ethnic Origin; Failure; Feeling; Fetal Alcohol Exposure; Fetal Alcohol Syndrome; Fetal alcohol effects; First Pregnancy Trimester; Future; General Population; Health; Healthcare; Heavy Drinking; Income; Intervention; Interview; Literature; Longitudinal Studies; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Modeling; Outcome; Parenting behavior; Pattern; Policies; Population; Positioning Attribute; Postpartum Period; Pregnancy; Pregnant Women; Race; Reproductive Health; Research; Research Personnel; Risk Factors; Role; Sampling; Severities; Sex Characteristics; Site; Staging; Stress; Termination of pregnancy; United States; Unwanted pregnancy; Violence; Woman; Women' s Group; Women' s Health; alcohol consumption during pregnancy; alcohol intervention; base; binge drinking; comparison group; design; drinking; effective intervention; evidence base; fetal; follow-up; high risk; indexing; innovation; modifiable risk; partner violence; prevent; prospective; public health relevance; reduced alcohol use; sex; unintended pregnancy

DESCRIPTION (provided by applicant): The primary purpose of this project is to describe trajectories of alcohol consumption before, during, and after pregnancy among women with unwanted pregnancies, and assess how the pregnancy is resolved (having the child versus termination) influences these trajectories. In this study, unwanted refers to pregnancies women sought to terminate. These alcohol trajectories can affect fetal and women's health in both the short and long term. In the short term, for women who carry unwanted pregnancies to term, failure to stop alcohol consumption during pregnancy can cause a range of fetal alcohol effects including, but not limited to, Fetal Alcohol Syndrome, and alcohol consumption after pregnancy can impair the ability to breastfeed safely. In the long term, continuation or resumption of binge or heavy drinking after pregnancy has implications for women's health and health of future pregnancies. While some research examines these alcohol trajectories among women in general, the research focuses mainly on demographic and alcohol pattern influences on changes and does not focus on women with unintended pregnancies (of which pregnancies women sought to terminate are a subset). This lack of research is surprising given that half of pregnancies are unintended and the possibility that women with unintended pregnancies may drink more or be less likely to stop drinking during pregnancy than other women. This developmental study will use data from the innovative Turn away Study dataset. The Turn away Study is a prospective, longitudinal study of women with unwanted pregnancies who sought, but did not necessarily receive elective pregnancy terminations at 30 sites across the U.S. Preliminary analyses suggest women in the sample binge drink at rates notably higher than other women. This secondary analysis study will use Structural Equation Modeling to analyze changes in alcohol consumption from baseline through two-year follow-up interviews, including whether trajectories differ by whether the woman terminates or carries the pregnancy to term. In addition, this study will extend previous research on changes in alcohol consumption over the course of pregnancy and parenting transitions by identifying modifiable risk factors (e.g. feelings about pregnancy, partner violence, stress, depression/anxiety) associated with failure to stop or reduce alcohol consumption. Findings will contribute to our scientific understanding of how having a child from an unwanted pregnancy and pregnancy termination affects alcohol consumption. Further, findings from this developmental study will be used to inform interventions to prevent and limit alcohol-exposed pregnancies and alcohol-impaired parenting among women with unwanted pregnancies. Specifically, findings will inform adaptation of alcohol interventions by 1) identifying modifiable risk factors for failure to stop/reduce alcohol consumption after pregnancy recognition and failure to maintain pregnancy-related reductions in consumption and 2) exploring the possibility of reaching this high risk population to deliver the intervention in a range of health care settings either before pregnancy or in the postpartum or interconception periods.

描述（由申请人提供）：该项目的主要目的是描述在怀孕不良怀孕之前，期间和怀孕后饮酒的轨迹，并评估如何解决怀孕（孩子与终止）如何影响这些轨迹。在这项研究中，不必要的是妇女试图终止的怀孕。这些酒精轨迹在短期和长期内都会影响胎儿和妇女的健康。在短期内，对于那些怀孕期间怀孕的妇女，怀孕期间未能停止饮酒会导致一系列胎儿酒精效应，包括但不限于胎儿酒精综合症和怀孕后的酒精消耗可能会损害安全母乳喂养的能力。从长远来看，怀孕后的暴饮暴食或大量饮酒的延续或恢复对未来怀孕的妇女健康和健康有影响。尽管一些研究研究了女性的这些酒精轨迹，但该研究主要集中于人口统计学和酒精模式对变化的影响，并且不关注意外怀孕的妇女（其中妇女试图终止的怀孕是一个子集）。缺乏研究令人惊讶，因为一半的怀孕是意想不到的，并且在怀孕期间，怀孕期间的妇女可能比其他女性饮酒更多或更容易停止饮酒的可能性。这项发展研究将使用创新的转向研究数据集中的数据。转折研究是对寻求怀孕的妇女的一项前瞻性，纵向的研究，但在美国的30个地点进行了选举妊娠终止，这表明样本暴饮暴食中的妇女以比其他女性高得多。这项二级分析研究将使用结构方程模型来分析从基线到两年随访访谈的酒精消耗变化，包括轨迹是否因终止还是将怀孕的孕妇终止。此外，这项研究将通过识别可修改的危险因素（例如感觉）来扩展对怀孕和育儿过渡过程中酒精消耗变化的先前研究 关于怀孕，伴侣暴力，压力，抑郁/焦虑），与未能停止或减少饮酒有关。调查结果将有助于我们科学地理解生育不必要的怀孕和妊娠终止如何影响饮酒。此外，这项发展研究的发现将用于告知干预措施，以预防和限制患有不必要怀孕的妇女的饮酒妊娠和受酒精损害的育儿。具体而言，调查结果将通过1）确定可修改的风险因素，以适应酒精的干预措施，以便在怀孕识别后无法停止/减少酒精消耗，并且无法维持与妊娠相关的消费量的减少； 2）探索在怀孕前或康复期或互联网或互联网或互联网或互联网或互联网范围内，探索这一高风险人群的可能性。

项目成果

Alcohol use before and during unwanted pregnancy.

• DOI: 10.1111/acer.12544
• 发表时间: 2014-11
• 期刊: Alcoholism, clinical and experimental research
• 作者: Roberts SC;Wilsnack SC;Foster DG;Delucchi KL
• 通讯作者: Delucchi KL

Moderators and mediators of the relationship between receiving versus being denied a pregnancy termination and subsequent binge drinking.

• DOI: 10.1016/j.drugalcdep.2015.11.033
• 发表时间: 2016-02-01
• 期刊: Drug and alcohol dependence
• 影响因子: 4.2
• 作者: Roberts SC;Subbaraman MS;Delucchi KL;Wilsnack SC;Foster DG
• 通讯作者: Foster DG

Receiving Versus Being Denied a Pregnancy Termination and Subsequent Alcohol Use: A Longitudinal Study.

接受与被拒绝终止妊娠以及随后的饮酒：一项纵向研究。

• DOI: 10.1093/alcalc/agv021
• 发表时间: 2015
• 期刊: Alcohol and alcoholism (Oxford, Oxfordshire)
• 作者: Roberts,SarahCM;Delucchi,Kevin;Wilsnack,SharonC;Foster,DianaGreene
• 通讯作者: Foster,DianaGreene

Which women are missed by primary health-care based interventions for alcohol and drug use?

• DOI: 10.1016/j.addbeh.2015.12.015
• 发表时间: 2016-04
• 期刊: Addictive behaviors
• 影响因子: 4.4
• 作者: Roberts SC;Ralph LJ;Wilsnack SC;Foster DG
• 通讯作者: Foster DG