Consumption of alcohol and binge drinking among pregnant women in Addis Ababa, Ethiopia: Prevalence and determinant factors

Maternal information-seeking on pregnancy-induced hypertension and associated factors among pregnant women, in low resource country, A cross-sectional study design

Pregnancy-induced hypertension is the most prevalent medical problem associated with pregnancy. It has been reported to affect 6-10% of all pregnant women worldwide. Mothers' failure to seek information related to PIH increases the risk of death from the complication of pregnancy-induced hypertension. This study aimed to assess PIH information-seeking behaviour and its associated factors among pregnant women in rural Sekela Woreda. A community-based cross-sectional study was conducted from May 15 to June 15, 2022. An interviewer-administered structured questionnaire was used to collect the data. The sample size was 635. A cluster sampling technique was used to select the sampled kebeles. The study population included rural pregnant women. This study included pregnant women who were permanent residents of the study area, whereas this study excluded pregnant women who were admitted only for delivery services and temporary residents who visited the study area. The mean age of the participants was 31.8 ± 6.09 years, with minimum and maximum ages of 20 and 45 years, respectively. We conducted descriptive analysis, bivariable analysis, and multivariable analysis to identify determinants of PIH information seeking. The proportion of pregnancy-induced hypertension (PIH) information seeking among pregnant women was 214 (35.4%) out of 604. Pregnant mothers aged 35 years and above (AOR =0.67, 95% CI =0.46, 0.97), family resistance (AOR = 0.45, 95% CI =0.29, 0.69), health care satisfaction (AOR =1.7, 95% CI =1.1, 2.5), and perceived severity of pregnancy-induced hypertension (PIH) (AOR =1.6, 95% CI =1.1, 2.4) were significantly associated with pregnancy-induced hypertension information seeking. According to our findings Information seeking related to pregnancy-induced hypertension is low. Aged mothers, family resistance, mothers' satisfaction with health care services, and perceived severity of PIH were found to be associated with pregnancy-induced hypertension information seeking. Expanding health education programs for pregnant women and providing awareness and training about PIH to participants and their husbands is the most effective way to reduce the prevalence of PIH complications.

Effect of prenatal alcohol consumption on maternal anemia among pregnant women in Gondar town, Northwest Ethiopia: a retrospective cohort study

BACKGROUND

Alcohol consumption during pregnancy can lead to multiple health, social and behavioral problems for both the mother and the offspring. Anemia is one of the major public health concerns and causes of morbidity and mortality among pregnant women with poor maternal and fetal outcomes in developing countries. This study aimed to identify the link between prenatal alcohol consumption and anemia among pregnant women in Gondar town, Northwest Ethiopia.

METHODS

A facility-based retrospective cohort study was conducted among 1669 pregnant women who were booked in for antenatal care in Gondar town. We used a two-stage random sampling technique to recruit and include study participants in the cohort. Data were collected using an interviewer-administered questionnaire. Multivariable analysis was performed to examine the association between reported prenatal alcohol exposure (non-hazardous and hazardous) and anemia in pregnancy using log-binomial regression modeling. The burden of anemia in pregnancy was reported using the adjusted risk ratio (ARR) and population-attributable risk.

RESULTS

The prevalence of anemia during pregnancy was 14.86% (95% CI 13.23 to 16.65%). Hazardous alcohol consumption during pregnancy was significantly associated with anemia in pregnancy (ARR=2.24; 95% CI 1.60, 3.15). The adjusted population-attributable risk of anemia in pregnancy related to hazardous alcohol consumption during pregnancy was 7.68%.

CONCLUSIONS

This study revealed that anemia during pregnancy continues to be a public health concern. Regardless of timing, there is a clear association between prenatal alcohol consumption and anemia during pregnancy that suggests a need for targeted prenatal alcohol use screening, and ongoing intervention for alcoholic pregnant women.

Magnitude and risk factors of khat, alcohol and cigarettes use among pregnant women in Africa: a systematic review and meta-analysis

BACKGROUND

The use of khat, alcohol, and cigarettes during pregnancy is a serious public health problem associated with harmful outcomes for the fetus and the mother's health. Studies that investigated khat, alcohol, and cigarettes usage during pregnancy yielded varied and contradictory results. This study used a systematic review and meta-analysis to estimate the pooled prevalence and associated factors of khat, alcohol, and cigarettes use among pregnant women in Africa.

METHODS

A review of eligible studies was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. This review has been registered in PROSPERO with protocol ID CRD42021289074. Literature published in English from January 1, 2002 to November 30, 2021 was retrieved from PubMed, Google Scholar, Cochrane, HINARI, African Journal Online, and Science Direct databases. The quality of included articles was assessed using the Joanna Briggs Institute's (JBI) critical appraisal checklist. The I2 statistic and Cochran's Q test were used to assess the presence of heterogeneity between studies. To assess publication bias, a funnel plot and Egger's regression test were utilized. The random effect model was used to estimate the summary prevalence and the corresponding 95% confidence interval (CI) of risk factors for khat, alcohol, and cigarettes use.

RESULTS

Out of the 1509 studies identified, 71 met the inclusion criteria. The pooled prevalence of khat chewing, alcohol drinking, active smoking, and secondhand smoke exposure during pregnancy was 18.93%, 22.20%, 11.85%, and 43.45%, respectively. The subgroup analysis by UN sub-region showed the highest pooled prevalence of alcohol use during pregnancy in Middle Africa (25.69%) and the lowest in Northern Africa (1.10%). Several factors were identified as risk factors for alcohol use, including low educational level, younger age women, pre-pregnancy alcohol use, unplanned pregnancy, history of abortion, poor social support, mental distress, poor knowledge on alcohol risks, and partner alcohol use.

CONCLUSION

This review indicated that the pooled magnitude of khat, alcohol and cigarette use during pregnancy was higher in Africa. Substance use screening and brief interventions (SBI) should be routinely delivered in antenatal care settings to reduce pregnant women's substance use.

Prevalence of hazardous alcohol consumption and associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia: a multicentred cross-sectional study

BACKGROUND

Alcohol is a major public health problem in pregnant women due to its harmful effects on pregnancy and adverse birth outcomes. Therefore, assessing the prevalence and the factors associated with hazardous alcohol consumption among HIV-positive women is important for early identification and intervention and implementation of rehabilitation centres in healthcare settings in order to prevent maternal adverse birth outcomes.

OBJECTIVE

The aim of this study was to assess the prevalence of hazardous alcohol consumption and the associated factors among HIV-positive pregnant women attending public hospitals in Northwest Ethiopia.

DESIGN AND STUDY SETTING

A facility-based, cross-sectional study was conducted among 401 HIV-positive pregnant women attending public hospitals in Northwest Ethiopia from 7 February to 7 April 2021.

PARTICIPANTS

From a total calculated sample size of 423, 401 HIV-positive pregnant women who had a follow-up with selected hospitals' prevention of mother-to-child transmission (PMTCT) clinics completed the interview (17 participants refused to provide information and 5 terminated the interview in the middle of it due to serious illness).

MAIN OUTCOME MEASURES

The main outcome measure of this study was hazardous alcohol consumption assessed using the Fast Alcohol Screening Test. Bivariate and multivariable binary logistic regressions were used to identify factors associated with hazardous alcohol consumption. Statistically significant associations were set at p<0.05.

RESULTS

The overall prevalence of hazardous alcohol consumption among HIV-positive pregnant was found to be 7.7% (95% CI 5.2, 10.5). After adjusting for possible confounders, history of mental illness (adjusted OR (AOR)=3.10; 95% CI 1.19, 8.05), having comorbid psychological distress (AOR=4.39; 95% CI 1.57, 12.30), non-disclosure of HIV status to partner (AOR=3.28; 95% CI 1.21, 8.84) and poor medication adherence (AOR=2.82; 95% CI 1.20, 6.62) were significantly associated with hazardous alcohol use.

CONCLUSIONS AND RECOMMENDATIONS

The overall prevalence of hazardous alcohol consumption among HIV-positive pregnant women was high, especially among pregnant women who had a history of mental illness. Poor medication adherence, non-disclosure of HIV status to partner and having comorbid psychological distress are the main factors associated with hazardous alcohol consumption. Early detection and appropriate interventions to prevent hazardous alcohol consumption should be promoted at PMTCT clinics.

The epidemiology of khat (catha edulis) chewing and alcohol consumption among pregnant women in Ethiopia: A systematic review and meta-analysis

The use of khat (Catha edulis) and alcohol during pregnancy is a serious public health problem that has been associated with a number of harmful outcomes for both the fetus and the mother's health. There has been no systematic review with meta-analysis to determine risk factors associated with khat and alcohol use among pregnant women in Ethiopia. Therefore, we aimed to determine the pooled prevalence and risk factors of khat and alcohol use during pregnancy in Ethiopia. This review has been registered in PROSPERO with protocol ID: CRD42023395115. Studies identified from PubMed, Google Scholar, the WHO African Index Medicus, the Cochrane Library, African Journal Online, and Science Direct. Articles published from January 1, 2000 to February 10, 2023 were included. We searched for articles that included any combination of the following key terms: "khat", "qat", "alcohol", "ethanol", "prevalence", "factors", "pregnant" and "Ethiopia". Two reviewers worked independently to screen studies and extract data. A funnel plot and Egger's regression test were used to test publication bias. A forest plot was used to present the pooled prevalence and odds ratio with a 95% confidence interval (CI) using the random effect model. I2 metrics were used to assess heterogeneity. The meta-analysis was carried out with Stata 14.0 software. Nine hundred sixty-two records were retrieved from different sources, and 23 studies were included in the final analysis. The pooled prevalence of khat use and alcohol drinking during pregnancy was 26.6% (95% CI 17.8, 35.5) and 31.65% (95% CI: 21.8, 41.5), respectively. Partner khat use (OR 5.9 [95% CI (2.4, 14.5)]) was associated factor for khat use during pregnancy. Low educational level (OR 2.54 [95% CI (1.8, 3.5)]), pre-pregnancy alcohol use (OR 3.5 [95% CI (2.6, 4.7)]), unplanned pregnancy (OR 2.7 [95% CI (1.8, 4.0)]), history of abortion (OR 2.3 [95% CI (1.4, 3.7)]), poor social support (OR 3.3 [95% CI (2.0, 5.3)]), and mental distress (OR 2.6 [95% CI (2.0, 3.3)]) were associated factors for alcohol drinking during pregnancy. This review indicated that the magnitude of khat and alcohol use during pregnancy in Ethiopia was high. Targeted interventions for groups of pregnant women at high risk of khat and alcohol use are urgently needed. Community-based health education interventions and point-of-sale warnings are essential to reduce the burden. Future studies should consider the influence of community-level factors on khat and alcohol use during pregnancy.

Prevalence of alcohol use during pregnancy, Brazil, 2011-2012

This is a national cross-sectional, hospital-based study, which interviewed 23,894 postpartum women in 2011-2012 aiming to estimate the prevalence of alcohol use during pregnancy and identifying more vulnerable groups. Alcohol use during pregnancy was identified using the TWEAK scale, and women with a score of ≥ 2 were classified as having a "presumable diagnosis of inadequate alcohol use". The national prevalence of alcohol use and the prevalence in subgroups were calculated according to maternal characteristics, with respective 95% confidence intervals (95%CI). Coexistence of smoking, inadequate prenatal consultations, and alcohol use during pregnancy were graphically identified. The prevalence of alcohol use was 14% (95%CI: 13.3-14.7), with 10% (95%CI: 9.3-10.6) of women presenting presumable diagnosis of inadequate alcohol us during pregnancy. Higher prevalence of alcohol use and presumable diagnosis of inadequate alcohol us was observed in black women, aged 12-19 years, with lower educational level, from a lower economic class, without a partner, without paid work, with more than three previous births, who did not want to get pregnant, with inadequate prenatal care, with previous delivery in public services, and who reported smoking during pregnancy. Among the interviewees, 1.2% presented all three risk factors for negative perinatal outcomes at the same time: smoking, alcohol use, and inadequate prenatal care. The results showed a high prevalence of alcohol use during pregnancy and presumable diagnosis of inadequate alcohol us, especially among women with worse social conditions. These data are relevant for the formulation of public policies to prevent alcohol use and provide support services to help this population stop alcohol use during pregnancy.

Neurotoxicology of alcohol: a bibliometric and science mapping analysis

Alcohol consumption is common in many societies and has increased considerably, resulting in many socioeconomic and public health problems. In this sense, studies have been carried out in order to understand the mechanisms involved in alcohol consumption and related harmful effects. This study aimed to identify and map the knowledge and to perform bibliometric analysis of the neurotoxicology of alcohol based on the 100 most cited articles. A search was carried out in the Web of Science Core Collection database and information was extracted regarding the journal, authors, keywords, year of publication, number of citations, country and continent of the corresponding author. For each selected manuscript, the study design, alcohol exposure model, dose, period of exposure, and effect on the central nervous system and research hotspots were mapped. The journal with the highest number of publications was Alcoholism: Clinical and Experimental Research (n = 11 papers), the author who contributed the most was Crews FT (n = 8 papers), the studies had a total of 288 keywords and 75% of the publications were from the United States of America. The experimental studies evaluated the effects of prenatal and postnatal exposure and were conducted in rats and mice using doses ranging from 2.5 to 14 g/kg/day, with administration by subcutaneous, intraperitoneal, intragastric, or inhalation route or with free access through drinking bottles. Among the studies mapped, the oldest one (1989) aimed to understand the systemic damage and mechanisms of action involved, while the most recent focused on understanding the receptors and mechanisms involved in addiction, as well as genetic factors. Our results show the panorama of the most widespread scientific production in the scientific community on the neurotoxicology of ethanol, a high prevalence was observed in studies that addressed fetal alcohol syndrome and/or the effects of ethanol on neurodevelopment.

Aerobic Physical Training Attenuates Oxidative Stress in the Spinal Cord of Adult Rats Induced by Binge-like Ethanol Intake

Binge drinking is the most frequent consumption pattern among young adults and remarkably changes the central nervous system; thus, research on strategies to protect it is relevant. This study aimed to investigate the detrimental effects of binge-like EtOH intake on the spinal cord of male rats and the potential neuroprotective effects provided by moderate-intensity aerobic physical training. Male Wistar rats were distributed into the 'control group', 'training group', 'EtOH group', and 'training + EtOH'. The physical training protocol consisted of daily 30-min exercise on a treadmill for 5 consecutive days followed by 2 days off during 4 weeks. After the fifth day of each week, distilled water ('control group' and 'training group') or 3 g/kg of EtOH diluted at 20% w/v ('EtOH group' and 'training + EtOH group') was administered for 3 consecutive days through intragastric gavage to simulate compulsive consumption. Spinal cord samples were collected for oxidative biochemistry and morphometric analyses. The binge-like EtOH intake induced oxidative and tissue damage by decreasing reduced glutathione (GSH) levels, increasing lipid peroxidation (LPO), and reducing motor neurons (MN) density in the cervical segment. Even under EtOH exposure, physical training maintained GSH levels, reduced LPO, and prevented MN reduction at the cervical segment. Physical training is a non-pharmacological strategy to neuroprotect the spinal cord against oxidative damage induced by binge-like EtOH intake.

Assessment of Malnutrition among Children Presenting in a Nutrition Center in Gimbichu, Ethiopia

Nowadays, Ethiopia has several problems affecting children below 5 years of age, resulting in low life expectancies. Our group carried out a study to calculate the presence of malnutrition as wasting, stunting underweight, and BMI-for-age in children presenting in a nutrition center in a rural Ethiopian village in the Oromia region according to WHO guidelines. Our results demonstrated that they had moderate chronic malnutrition or stunting from 1 to 2 years of age, affecting their life, their parents, their community/household, and their country. In our viewpoint, the solution for this situation will require a global focus on several levels, including individual, family, community, and country, the last being with the help of new health policies focused on short-, medium-, and long-term strategies with multi- and interdisciplinary approaches.

Assessment of alcohol utilization during pregnancy and its associated factors among reproductive women in Mecha Woreda of North Western Ethiopia

Background

Pregnancy is a time when women are making many changes, including the patterns of alcohol consumption. Alcohol consumption during pregnancy encourages the risks of mothers and unborn child. Alcohol use during pregnancy can result in prematurity, brain damage, growth restriction, developmental delay and social, emotional and behavioral deficits, particularly in developing countries.

Methods

A community based cross-sectional study was employed. Structured questionnaires were used to assess the prevalence of alcohol utilization, and socio-demographic as well as economic characteristics of women who have pregnancy experience. Both bivariate and multivariate logistic regression models were employed. Descriptive and inferential statistical analyses were used.

Results

The study results showed that the prevalence of alcohol use and response rate was high. Factors like age group of women from 35–49 years (AOR = 0.221; 95%CI = 0.057–0.856), illiterate women(AOR = 2.697;95% CI = 1.207–6.026), currently pregnant (AOR = 0.139;95%CI = 0.057 0.343), women currently use alcohol (AOR = 0.021; 95% CI = 0.009 0.049), alcohol use pre-pregnancy (AOR = 0.016; 95% CI = 0.006–0.042), women drinking alcohol with husband during pregnancy (AOR = 0.228; 95% CI = 0.085–0.614), the risk of alcohol consumption during pregnancy is low(AOR = 0.262;95%CI = 0.074–0.925), risk alcohol consumption during pregnancy is medium (AOR = 0.296;95% CI = 0.103–0.849),utilization of alcohol during pregnancy is valuable (AOR = 0.104; 95%CI = .0.013–0.833) were statistically associated with alcohol use during pregnancy.

Conclusion

The result inferred that there is a high level of alcohol use throughout pregnancy. Due to the differences in the culture and communal means of drinking alcohol, the frequency of alcohol consumption during pregnancy varies among different regional studies and countries.

Responding to the Unique Complexities of Fetal Alcohol Spectrum Disorder

Fetal alcohol spectrum disorder (FASD) is a multifaceted disability, characterized not only by brain- and body-based challenges, but also high rates of environmental adversity, lifelong difficulties with daily living, and distinct sociocultural considerations. FASD is one of the most common neurodevelopmental disabilities in the Western world and associated with significant social and economic costs. It is important to understand the complexities of FASD and the ways in which FASD requires unique consideration in research, practice, and policy. In this article, we discuss our perspectives on factors that distinguish FASD from other disabilities in terms of complexity, co-occurrence, and magnitude. We provide an overview of select literature related to FASD as a socially rooted disability with intergenerational impacts and multiple layers of stigma. These social issues are intertwined with notable experiences of adversity across the lifespan and high rates of co-occurring health concerns for individuals with FASD, all of which present unique challenges for individuals, caregivers, families, service providers, and policy makers. Understanding these factors is the first step in developing and implementing specialized initiatives in support of positive outcomes for individuals with FASD and their families. Future directions are proposed for advancing research, practice, and policy, and responding to the unique complexities of FASD.

The Prevalence of Alcohol Consumption Among Pregnant Women in Ethiopia: A Systematic Review and Meta-Analysis

BACKGROUND

Evidence indicates that a significant proportion of women drink alcohol during pregnancy. Studies have also suggested that prenatal alcohol consumption was associated with a wide range of adverse outcomes. To the best of our knowledge, this is the first systematic review and meta-analysis aimed to systematically summarize the available evidence on the epidemiology of alcohol consumption among pregnant women in Ethiopia and suggest evidence based recommendations for future clinical practice.

METHODS

This systematic review and meta-analysis was followed the PRISMA guidelines. PubMed, SCOPUS and EMBASE databases were searched to identify relevant articles that assessed alcohol consumption among pregnant women in Ethiopia. The Comprehensive Meta-Analysis software version 3.0 was used to conduct a meta-analysis using the random-effect model. Cochran's Q- and I²-tests were used to assess the heterogeneity of the included studies.

RESULTS

A total of 6361 pregnant women from fifteen primary studies were included in the final analysis. The pooled prevalence estimate of alcohol consumption among pregnant women in Ethiopia was found to be 14.1%. The pooled prevalence of alcohol consumption among pregnant women in Ethiopia was reported to be lower in the studies that used the standardized alcohol consumption assessment tools (9.4%) when compared to the studies that did not use standardized tools (17%). The pooled prevalence of alcohol consumption among pregnant women ranged between 12.8% and 15.5% in leave-one-out sensitivity analysis.

CONCLUSION

A considerable number of women in Ethiopia consume alcohol during pregnancy. Therefore, early identification and intervention strategies are highly recommended.