Quality of Intimate Relationships, Paternal Drinking Habits,

and Acculturation as Predictors of

Maternal Drinking in Pregnancy

Ludmila Bakhireva, MD, PhD, MPH

College of Pharmacy and

Department of Family and Community Medicine

Collaborative Initiative on FASD (NIH/NIAAA): 2007-2012Collaboration b/w 16 research & clinical institutions in 6 different countries.

U01 project:

Spectrum of and Nutritional Risk Factors for FASD in Russia and Ukraine (P.I. Christina Chambers)

Objectives of the Current Analysis:

1. Determine the influence of the partner’s alcohol consumption behavior on maternal drinking in pregnancy.

2. Determine if problems in intimate relationships are associated with risky maternal drinking in pregnancy.

Collaborators: CD Chambers, A. Kristjanson, S. Wilsnac

Influence of Partner's Drinking Habits on Maternal Alcohol Use in Pregnancy

Partner’s drinking habitsMaternal Drinking in Pregnancy

p-value

Abstainers (N=80)

Some exposure in early

pregnancy (n=43)

Continuous

drinkers(N=43)

% % %Frequency of paternal drinking <.0001 < 3 times/week 97.5 72.1 74.4 ≥ 3 times/week 2.5 27.9 25.6Binge drinking <.0001 No 100 69.8 58.1 Yes (≥ 5 drinks/occasion) 0 30.2 41.9Heavy drinking* <.0001 No 97.5 55.8 48.8 Yes 2.5 44.2 51.2Paternal TWEAK score: <.0001 < 2 87.0 39.5 16.3 ≥ 2 (hazardous drinking) 13.0 60.5 83.7

* Heavy drinking: frequent (≥ 3 times/week) or binge (≥ 5 drinks/occasion) drinker

Summary: Pregnant women alcohol consumption behavior is closely related to their partner’s alcohol consumption habits.

Sample: 166 pregnant women in Ukraine

Couple Relationship & Maternal Drinking Habits During Pregnancy

3.91 3.74 3.354.01 3.84 3.541

2

3

4

5

Abstainers (N=80)

Some exposure, quit in pregnancy

(N=43)

Continuous drinkers (N=43)

Sati

sfac

tio

n w

ith

Rel

atio

nsh

ip

Maternal Drinking in Pregnancy

Satisfaction with Relationship (mean score)

Unadjusted p<0.001

Adjusted p=0.001

Women were asked to report how happy they are with their relationship on the 1-5 scale with 1: extremely unhappy; 5: extremely happy.

* Adjusted for: maternal age, gravidity, pregnancy planning, SES

Couple Relationship & Maternal Drinking Habits During Pregnancy

3.95 3.70 3.403.91 3.74 3.561

2

3

4

5

Abstainers (N=80)

Some exposure, quit in

pregnancy (N=43)

Continuous drinkers (N=43)A

bilit

y to

Dis

cuss

Pro

blem

s wit

h Pa

rtne

r (M

ean)

Drinking Exposure

Ability to Discuss Problems (mean score)

Unadjusted p<0.001

Adjusted p=0.032

Women were asked to report how easy it is for them to talk about their feelings or problems with the partner on the 1-5 scale with 1: very difficult; 5: very easy

* Adjusted for: maternal age, gravidity, pregnancy planning, SES

Couple Relationship & Maternal Drinking Habits During Pregnancy

3.37 3.05 2.793.20 2.99 2.831

2

3

4

5

Abstainers (N=80)

Some exposure, quit in

pregnancy (N=43)

Continuous drinkers (N=43)

Pro

ble

m R

eso

luti

on

wit

h P

artn

er

(Mea

n)

Drinking Exposure

Problem Resolution (mean score)

Unadjusted p=0.003

Adjusted p=0.111

Women were asked to report how often they quarrel with the partner with 5: “we almost always solve disagreements w/o quarreling”; 1: “we do not only quarrel, we also have physical fights”.

* Adjusted for: maternal age, gravidity, pregnancy planning, SES

The SMART Study at UNM (Safety of Medications and Perception of Teratogenicity)

Southeast Heights Clinic

7525 Zuni SE

South Broadway Clinic 1500 Walter SE

West Mesa Clinic 6900 Gonzales SW

Northwest Valley Clinic 1231 Candelaria NW

UNM Hospital (Triage, Fetal Monitoring Center, General)

• Prospective clinic-based multi-center study

• Pregnant women recruited from UNM & satellite prenatal care clinics (N=200)

• Interviews in English & Spanish

• High proportion of Hispanic (78%), uninsured (42%), foreign-born (55%) pregnant women

• Alcohol consumption a month around LMP was ascertained (including “binge” episodes)

Collaborators:

L. Bakhireva (P.I.) W. Rayburn. MD S. Phelan, MD A. Rowland, Ph.D. B. Young, MPH P. Sarangarm P. Jaiswal Clinic providers

The SMART Study: ResultsHispanic women:

• 17.4% - binge drinking (≥4drinks/occasion) a month around their LMP

Risk of binge drinking in periconceptional period:

• Elevated among Latinas born in the US (OR=3.2; 95% CI: 1.2; 8.9)

• Elevated among Latinas who primarily speak English at home (OR=3.6; 95% CI: 1.3; 10.5)

• No independent association with education, insurance, smoking status, gravidity, parity, pregnancy planning

Summary:

• Acculturation is a risk factor of risky drinking around conception & early pregnancy among Latinas in New Mexico