indiana university bloomington d.t. dibaba mph, s. horbal mph, m. a. sayegh phd, mph indiana...
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INDIANA UNIVERSITY BLOOMINGTONINDIANA UNIVERSITY BLOOMINGTON
D.T. Dibaba MPH, S. Horbal MPH, M. A. Sayegh PhD, MPH
Indiana University School of Public Health- Bloomington Department of Epidemiology and Biostatistics
Bloomington, IN USA
The association between maternal alcohol intake during pregnancy and the risk of intrauterine growth restriction, low birth weight, preterm birth and small for gestational age: A Meta-analysis
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The prevalence of alcohol use during pregnancy in the USA is about 12.5%, in 2011. (CDC, 2012).
Maternal alcohol use during pregnancy is one of the major risk factors related with adverse birth outcomes.
Introduction
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Conditions related to preterm birth and low birth weight are the second leading cause of infant death (after birth defects). Mathews T.J. & MacDorman M.F. (2008)
In 2012, 1 of every 9 infant was born premature. CDC (2014)
Introduction
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Inconsistent epidemiological research findings Chen J.H. (2012), Kesmodel U. et al( 2000), McCarthy F.P. et al
(2013), Pfinder M. et al (2013), Patra et al (2011
No other recent meta-analysis on the association between drinking of different levels and the risk of IUGR, LBW, preterm birth or SGA separately
New studies have been conducted since previous meta-analyses
Background
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Investigate the association of alcohol intake by category (moderate, and heavy intake) during pregnancy with risk of IUGR, LBW, preterm birth and SGA birth by doing meta-analyses of original studies
Objective
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Drinking Abstinent: no alcoholic drink during pregnancy
Light drinking: <1 drink/day or <5 drinks/week
Moderate drinking : 1 drink/day or 5-7 drinks/week
Heavy drinking: ≥3 drinks/day or >7 drinks/week
Methods: Measures
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Outcomes
LBW: birth weight<2500g
SGA: birth weight <10th percentile of babies with the same gestational age
IUGR: birth weight<10th percentile for birth weight and <2.5th percentile for abdominal circumference
Preterm: birth<37th weeks of gestation
Methods: Measures
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Searched online original studies indexed in PubMed, ScienceDirect, and Google Scholar
Used key words and medical subject headings
Retrieved additional articles through hand search of reference lists in relevant articles
Methods:Literature Search
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Used Fixed and random effects meta-analysis models in
STATA to pool OR and 95%CIs.Used I2 to assess heterogeneityUsed Egger’s test and funnel plot to assess
publication bias
Methods:Analysis
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A total of 208,519 mother-infant dyads including:
89,763 participants from 7 cohort studies
9,262 from 5 case-control studies, and
109,494 participants from 8 cross-sectional studies
Results
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In the cohort studies, compared to abstainers, heavy alcohol intake during pregnancy is directly associated with increased risk of preterm birth.
Results
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In cohort studies, heavy alcohol intake is not significantly associated with the following outcomes:
IUGR, OR = 1.14 (0.48, 2.70)
LBW, OR = 1.51 (0.67, 3.39)
SGA, OR = 0.95 (0.59, 1.53)
Results
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Heavy alcohol intake is directly associated with the risk of LBW in cross-sectional studies.
Results
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ResultsIn case-control studies, moderate alcohol intake is inversely associated with risk of SGA.
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In case-control studies, moderate alcohol intake is inversely associated with risk of preterm birth. OR = 0.80 (0.66, 0.97)
In cross-sectional studies, moderate alcohol intake showed borderline inverse association with risk of low birth weight and preterm birth.
LBW, OR = 0.87 (0.75, 1.02)
Preterm birth, OR = 0.89 (0.78, 1.02)
Results
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Heavy alcohol intake during pregnancy is directly associated with risk of LBW and preterm birth.
While analyses showed an association between moderate alcohol intake and lowered risk of preterm birth and SGA, these results do not indicate that pregnant women should consume alcohol in any quantity, but only indicate associations that need to be investigated further.
Future studies are needed to understand the effect of moderate and light alcohol intake during pregnancy and adverse birth outcomes.
Conclusion
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Thank you! Questions? Email: [email protected]
The End!