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: 8512511
• 负责人: Sarah C.M. Roberts
• 金额: $ 17.47万
• 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 2015-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8512511
• 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酒精消费的轨迹之前，期间和怀孕后意外怀孕的妇女，并评估如何解决怀孕（有孩子与终止）影响这些轨迹。在这项研究中，意外怀孕是指妇女试图终止的怀孕。这些酒精轨迹可以在短期和长期内影响胎儿和妇女的健康。在短期内，对于怀孕的妇女来说，怀孕期间未能停止饮酒可能会导致一系列胎儿酒精影响，包括但不限于胎儿酒精综合征，怀孕后饮酒可能会损害安全母乳喂养的能力。从长远来看，怀孕后继续或恢复狂欢或酗酒对妇女的健康和未来怀孕的健康都有影响。虽然一些研究调查了一般妇女的这些酒精轨迹，但研究主要集中在人口和酒精模式对变化的影响上，而不是集中在意外怀孕的妇女身上（其中试图终止妊娠的妇女是一个子集）。这种缺乏研究的情况令人惊讶，因为一半的怀孕是意外的，而且意外怀孕的妇女可能比其他妇女在怀孕期间饮酒更多或更不可能停止饮酒。这项发展研究将使用来自创新的转身研究数据集的数据。拒绝研究是一项前瞻性的纵向研究，针对的是在美国30个地点寻求但不一定接受选择性终止妊娠的意外怀孕妇女。初步分析表明，样本中的妇女酗酒率明显高于其他妇女。这项二次分析研究将使用结构方程模型来分析酒精消费量从基线到两年随访访谈的变化，包括女性终止妊娠或妊娠至足月的轨迹是否不同。此外，这项研究将通过确定可改变的风险因素（如情感），扩展先前关于怀孕和育儿过渡期间饮酒量变化的研究。 怀孕、伴侣暴力、压力、抑郁/焦虑）与未能停止或减少饮酒有关。研究结果将有助于我们科学地理解意外怀孕和终止妊娠如何影响酒精消费。此外，这项发展研究的结果将用于为干预措施提供信息，以预防和限制意外怀孕妇女中的酒精暴露怀孕和酒精受损的育儿。具体而言，研究结果将通过以下方式为酒精干预措施的适应提供信息：1）确定怀孕识别后未能停止/减少酒精消费以及未能保持与怀孕相关的消费减少的可改变风险因素; 2）探索在怀孕前或产后或怀孕期间在一系列医疗保健环境中提供干预措施的可能性。