PRENATAL EXPOSURE TO ALCOHOL
AND PRENATAL DIET AMONG INUIT
      WOMEN OF NUNAVIK



         Sarah Fraser
Plan
• What are the prenatal alcohol consumption patterns
  in Nunavik?

• What is the impact on infant development?

• Nu...
Nunavik
• 14 remote and isolated communities on two
  coasts, Hudson and Ungava

• 11 000 inhabitants

• 90% inuit
Research project
• Recrutement started in 1995
• 248 women participated to prenatal interviews
• 185 mothers and infants w...
Results: Sample Characteristics
Characteristics                     N      %      Mean S.D.    Range
Maternal Age (Years) ...
Patterns of prenatal exposure
• 90% smoked during pregnancy with an average of 10
  cigarettes per day
• 36% consumed mari...
Prenatal alcohol exposure and development
• In epidemiological research we see an association
  between alcohol and develo...
Results: the effects of binge drinking on infant
                        development

Outcome                             ...
Nutrition and prenatal alcohol consumption

• Research suggests that the FAS/ FASD is not an equal
  opportunity birth def...
Nutrition in Nunavik
• Traditional foods are rich in various nutients and
  especially in polyunsaturated fatty acids: art...
Research question
Does a high level of polyunsaturated fatty aicds in umbilical
  cord phospholipids protect against the e...
Nutrition in Nunavik
Prenatal diet                      Mean          Min - Max
                                   S.D.
Co...
Prenatal alcohol and PUFAs on infant development

                     Predictors                N     Beta (p)
Birth weig...
Limitations of this study

• Infant blood is available for 50% of the sample with significant
  differences between infant...
Conclusion and final thoughts
• The results suggest an impact of binge drinking on prenatal
  growth and postnatal vision
...
Nakurmik Marialuk
Patterns of prenatal exposure among pregnant
women of Nunavik
  Prenatal exposure            N     %       Mean S.D.     R...
Upcoming SlideShare
Loading in...5
×

Prenatal Exposure to Alcohol and Prenatal Diet Among Inuit Women of Nunavik

1,218

Published on

Sarah Fraser
Nasivik
Canadian Institutes of Health Research

NAHO 2009 National Conference

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
1,218
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
9
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

Prenatal Exposure to Alcohol and Prenatal Diet Among Inuit Women of Nunavik

  1. 1. PRENATAL EXPOSURE TO ALCOHOL AND PRENATAL DIET AMONG INUIT WOMEN OF NUNAVIK Sarah Fraser
  2. 2. Plan • What are the prenatal alcohol consumption patterns in Nunavik? • What is the impact on infant development? • Nutrition and prenatal alcohol exposure: how are these associated? • Diet in Nunavik • Conclusions
  3. 3. Nunavik • 14 remote and isolated communities on two coasts, Hudson and Ungava • 11 000 inhabitants • 90% inuit
  4. 4. Research project • Recrutement started in 1995 • 248 women participated to prenatal interviews • 185 mothers and infants were followed-up at 6 months and 178 at 11 mois. Information gathered: • Maternal Interviews (demographic information, alcohol, nicotine and drug use, psychological distress…) • Maternal blood and umbilical cord blood • Infant weight, birth and head-circumference at birth • Visual acuity at 6 months
  5. 5. Results: Sample Characteristics Characteristics N % Mean S.D. Range Maternal Age (Years) 215 25.1 ± 5.9 15.0 – 41.0 Maternal Education (years) 215 8.0 ± 1.7 5.0 – 14.3 Maternal SES 215 17.5 ±11.4 5.0 – 55.0 Number of live births 215 2.1 ± 1.8 0.0 - 9.0 Maternal weight before delivery 215 70.6 ±12.4 50.0 - 123.9 (kg) Gestational hypertension (% yes) 201 7.5 Antibiotics during pregnancy (5 yes) 207 60.4 Sex of infant (% male) 215 57.0 Gestational age at birth (wks) 213 38.7 ± 1.8 32.0 - 42.0
  6. 6. Patterns of prenatal exposure • 90% smoked during pregnancy with an average of 10 cigarettes per day • 36% consumed marijuana at least once • 60% of women consumed alcohol at least once during pregnancy, with an average of 6 drinking days • 38% binged at least once during pregnancy • The quantity of alcohol consumed and pattern of consumption was not associated with socio-economic status or maternal age • Feeling down/blue, lonely, hopeless about the futur, bored, and crying easily are associated with higher quantity of alcohol consumed during pregnancy
  7. 7. Prenatal alcohol exposure and development • In epidemiological research we see an association between alcohol and development in samples where alcohol consumption is ≥ 2 drinks/day • Effects include reduced growth, cognitive development (memory, attention, language, math), visual development, and difficult behaviours. • Animal research suggests that exposure to high doses per occasion (≥ 5 drinks) is more harmful to the fœtus than more frequent exposure to small doses
  8. 8. Results: the effects of binge drinking on infant development Outcome N Std β (P) R2 Birth weight1,2,3,4,5,6 196 -.129 (.01) .571 Head Circumference at birth1,2,4,5,6 184 -.154 (.01) .396 Birth length 1,2,4,6 185 -.042 (.48) .389 Visual Acuity 6 months 1,6,7 181 -.244 (.00) .094 Mean looking duration, Fagan 6 months 8,9 174 -.049 (.51) .068 Mean looking duration, Fagan 12 months10,11 169 .062 (.41) .065 Controlling for 1 gestational age, 2 number of live births, 3 maternal weight before delivery, 4 gestational hypertension (Yes/No), 5 maternal socio-economic status, 6 infants sex, 7 average number of cigarettes smoked during pregnancy, 8 Maternal score on the Raven, 9 number of traditional meals consumed per week during pregnancy, 10 number of years of schooling completed by mother 11 lead (pb) concentrations in maternal blood 12 birth weight 13 Score on HOME interview
  9. 9. Nutrition and prenatal alcohol consumption • Research suggests that the FAS/ FASD is not an equal opportunity birth defect • The incidence of FAS and FASD is much greater in aboriginal and African American communities: lower SES, nutrition • Experimental research on animals suggests that certain nutrients can reduce the effects of prenatal alcohol on exposed pups (vitamin C and E, polyunsaturated fatty acids, folic acid, choline)
  10. 10. Nutrition in Nunavik • Traditional foods are rich in various nutients and especially in polyunsaturated fatty acids: artic char (690mg de DHA par 100g), salmon (612mg DHA par 100g), beluga fat (4974mg DHA par 100g), seal fat (12285mg par 100g). • Important changes in diet have taken place in the past decades with a decrease in consumption in foods rich in PUFAs and an increase in foods rich in fats.
  11. 11. Research question Does a high level of polyunsaturated fatty aicds in umbilical cord phospholipids protect against the effects of alcohol consumption during pregnancy on prenatal growth and visual acuity at 6 months?
  12. 12. Nutrition in Nunavik Prenatal diet Mean Min - Max S.D. Country Food per week 4.9 ± 5.4 0 - 44.0 Fish meals per week 3.4 ± 4.0 0 - 28.0 Beluga meals throughout pregnancy 24 ± 39.0 0 - 231.0 Whale meals throughout pregnancy 0.8 ± 5.2 0 - 52.0 Seal meals throughout pregnancy 0.8 ± 1.8 0 - 21.7 PUFA DHA in umbilical cord 3.6 ± 1.1 .1 – 1.1 DHA/AA in umbilical cord .4 ± .2 .5 – 7.2
  13. 13. Prenatal alcohol and PUFAs on infant development Predictors N Beta (p) Birth weight Step 1: Maternal weight 103 .44 (.00) Binge drinking -.14 (.11) DHA/AA .17 (.05) Step 2: Binge* DHA/AA -.28 (.30) Head circumference Step 1: Maternal weight 102 .46 (.00) Sex of baby .15 (.09) Binge drinking - .11 (.21) DHA/AA .07 (.44) Step 2: Binge* DHA/AA -.22 (.42) Visual Acuity Step 1: Smoking3 95 .29 (.01) Binge drinking -.33 (.00) DHA/AA .08 (.42) Step 2: Binge* DHA/AA -.21 (.48)
  14. 14. Limitations of this study • Infant blood is available for 50% of the sample with significant differences between infants for whom samples are available and missing cases • Low statistical power because of small sample size • PUFA Blood levels represent maternal intake during weeks preceding labour. Considering seasonal variations in diet this may not be a valid measure of PUFA intake through-out pregnancy
  15. 15. Conclusion and final thoughts • The results suggest an impact of binge drinking on prenatal growth and postnatal vision • Binge drinking is associated with psychological well-being (sadness, boredom) • Our results concerning the impact of polyunsaturated fatty acids suggest no protection against prenatal alcohol exposure • Studies suggest an association between eating traditional foods, fatty acid levels and psychological well-being
  16. 16. Nakurmik Marialuk
  17. 17. Patterns of prenatal exposure among pregnant women of Nunavik Prenatal exposure N % Mean S.D. Range Consumed alcohol during 215 60.6% pregnancy (% yes) Ounces of absolute alcohol 130 0.08 ± 0.2 0.0 – 1.6 per day Number of drinking days 130 6.0 ± 14.9 0.0 – 136.0 Binge drinking during 215 38.1% pregnancy (% yes) Frequency of binging 82 3.4 ± 9.6 0.0 – 71.0 Smoked during pregnancy 213 90.1 (% yes) Number of cigarettes 194 10.5 ± 5.4 0.3 – 25.0 smoked/day Marijuana during pregnancy 215 36.3 (% yes)
  1. A particular slide catching your eye?

    Clipping is a handy way to collect important slides you want to go back to later.

×