TY - JOUR T1 - Prevalence, predictors and perinatal outcomes of peri-conceptional alcohol exposure--retrospective cohort study in an urban obstetric population in Ireland JF - BMC Pregnancy Childbirth Y1 - 2011 A1 - Mullally, Aoife A1 - Cleary, B A1 - Barry, Joe A1 - Fahey, T A1 - Murphy, Deirdre J KW - Adult KW - Age Factors KW - Alcohol Drinking KW - Cohort Studies KW - Female KW - Fertilization KW - Fetal Alcohol Syndrome KW - Humans KW - Ireland KW - Pregnancy KW - Premature Birth KW - Retrospective Studies KW - Risk Factors KW - Self Report KW - Socioeconomic Factors KW - Substance-Related Disorders KW - Urban Population AB - BACKGROUND: Evidence-based advice on alcohol consumption is required for pregnant women and women planning a pregnancy. Our aim was to investigate the prevalence, predictors and perinatal outcomes associated with peri-conceptional alcohol consumption. METHODS: A cohort study of 61,241 women who booked for antenatal care and delivered in a large urban maternity hospital between 2000 and 2007. Self-reported alcohol consumption at the booking visit was categorised as low (0-5 units per week), moderate (6-20 units per week) and high (>20 units per week). RESULTS: Of the 81% of women who reported alcohol consumption during the peri-conceptional period, 71% reported low intake, 9.9% moderate intake and 0.2% high intake. Factors associated with moderate alcohol consumption included being in employment OR 4.47 (95% CI 4.17 to 4.80), Irish nationality OR 16.5 (95% CI 14.9 to 18.3), private health care OR 5.83 (95% CI 5.38 to 6.31) and smoking OR 1.86 (95% CI 1.73 to 2.01). Factors associated with high consumption included maternal age less than 25 years OR 2.70 (95% CI 1.86 to 3.91) and illicit drug use OR 6.46 (95% CI 3.32 to 12.60). High consumption was associated with very preterm birth (<32 weeks gestation) even after controlling for socio-demographic factors, adjusted OR 3.15 (95% CI 1.26-7.88). Only three cases of Fetal Alcohol Syndrome were recorded (0.05 per 1000 total births), one each in the low, moderate and high consumption groups. CONCLUSIONS: Public Health campaigns need to emphasise the importance of peri-conceptional health and pre-pregnancy planning. Fetal Alcohol Syndrome is likely to be under-reported despite the high prevalence of alcohol consumption in this population. VL - 11 UR - http://www.biomedcentral.com/1471-2393/11/27 ER - TY - JOUR T1 - Prevalence and predictors of periconceptional folic acid uptake--prospective cohort study in an Irish urban obstetric population JF - Hum Reprod Y1 - 2010 A1 - McGuire, M A1 - Cleary, B A1 - Sahm, L A1 - Murphy, Deirdre J KW - Adult KW - Cohort Studies KW - Female KW - Folic Acid KW - Humans KW - Ireland KW - Neural Tube Defects KW - Pregnancy KW - Prevalence KW - Socioeconomic Factors KW - Urban Health KW - Urban Population AB - BACKGROUND: Neural tube defects (NTDs) are severe abnormalities of the central nervous system that occur as a result of abnormal development in the third and fourth weeks of gestation. Studies have shown that periconceptional folic acid (FA) can reduce both the incidence and recurrence of NTDs. METHODS: A cohort study was carried out using the electronic hospital booking records of women delivering in a large Dublin maternity hospital between 2000 and 2007. Logistic regression analyses were performed to measure the associations between maternal factors and optimal FA use. RESULTS: Of the 61,252 women in the cohort, 85% reported taking FA at some point during the periconceptional period; however, only 28% took FA as recommended. Factors associated with taking the recommended amount of FA included nulliparity [adjusted OR: 1.35 (95% CI: 1.28-1.43)], early booking (<12 weeks) [OR: 1.24 (95% CI: 1.17-1.31)], increasing maternal age (e.g. 30-34 years) [OR: 1.39 (95% CI: 1.30-1.48)], private health care [OR: 4.32 (95% CI: 4.1-4.6)] and fertility treatment [OR: 2.88 (95% CI: 2.44-3.40)]. Factors associated with taking less than recommended or no FA included unplanned pregnancy [OR: 0.08 (0.07-0.08)], lower socio-economic status (e.g. unemployed) [OR: 0.63 (95% CI: 0.55-0.71)], non-Irish nationality [OR: 0.82 (0.74-0.90)] and smokers [OR: 0.51 (95% CI: 0.47-0.55)]. CONCLUSIONS: Social, demographic and economic factors have an important influence on the FA uptake. Vulnerable groups who report limited uptake of FA need to be specifically targeted in future Public Health campaigns and further consideration needs to be given to the debate on food fortification in countries where this is currently not available. VL - 25 UR - http://www.ncbi.nlm.nih.gov/pubmed/19910320 IS - 2 ER -