Low-income pregnant Latinas drink despite universal alcohol-warning messages

November 14, 2005

Although numerous public-information campaigns have addressed the dangers of drinking during pregnancy, language and cultural differences may present a barrier for some to understanding those risks. A study in the November issue of Alcoholism: Clinical & Experimental Research looks at alcohol consumption among low-income pregnant Latinas during the "periconceptional" period (three months before recognition of the pregnancy). Results indicate that, contrary to stereotypical beliefs, this group is just as much at risk for early-pregnancy drinking and related effects as other racial/ethnic groups in the U.S.

"Traditionally held cultural values that discourage women from drinking alcohol may change when women, such as Latinas, emigrate to the U.S.," said Christina D. Chambers, assistant professor of pediatrics and family and preventive medicine at the University of California, San Diego and corresponding author for the study. "Furthermore, due to cultural, educational, or language barriers, low-income Latinas may be less likely to admit to alcohol use and/or have less accurate awareness of the risks of drinking during pregnancy."

"For the first time, we have a systematic analysis of drinking behavior in Latina women," said Mary J. O'Connor, a professor in the department of psychiatry and biobehavioral sciences at the University of California, Los Angeles as well as director of the Fetal Alcohol Spectrum Disorders Clinic at the Semel Institute for Neuroscience and Human Behavior. "The typical myth in the past is that Latina women don't drink, but in fact, this is a population that is at risk, and we need to provide this population with the supports that they need to decrease their drinking during pregnancy."

Chambers said the dangers of early-pregnancy drinking are not always obvious. "Some babies born to mothers who drink alcohol heavily during pregnancy have a pattern of birth defects known as Fetal Alcohol Syndrome (FAS), which includes some differences in appearance of the child's face, poor growth, and long-term learning and behavior problems," added Chambers. "Many more children, whose mothers may drink smaller amounts of alcohol during pregnancy, are affected perhaps to a lesser extent by a wider spectrum of alcohol-related effects known as Fetal Alcohol Spectrum Disorders (FASD). FAS may be more recognized, but FASD is actually more widespread."

As part of a larger study of intervention strategies, researchers conducted cross-sectional in-home interviews with 100 pregnant low-income Latinas who were receiving services from the Special Supplemental Nutrition Program for Women, Infants, and Children in San Diego County, California.

"We found that 43 percent of pregnant Latinas in our sample reported some alcohol consumption in the three months before recognizing they were pregnant," said Chambers, "and that 20 percent of the pregnant Latinas reported at least one binge episode of four or more standard drinks during that same time period. These figures are similar to many other race/ethnic groups in the U.S."

The study also found that women who reported drinking were very aware of universal alcohol-warning messages and, in fact, had a higher level of general knowledge about associated problems than did the non-drinkers in the group.

"Latinas who spoke English, were more acculturated, were younger, more educated, had ever been tobacco users, and had been pregnant fewer times were more likely to report drinking in the time surrounding early pregnancy," said Chambers. "In fact, Latinas who were more knowledgeable about FAS and remembered seeing warning signs/messages about alcohol use in pregnancy were also more likely to report drinking in the three months before recognizing they were pregnant."

Chambers added that these findings suggest that universal education is not sufficiently effective in eliminating periconceptional alcohol consumption among these women. "Future studies might examine the most cost-effective and efficient methods of identifying risky drinkers among Latinas of reproductive age, and also test interventions tailored to Latinas who currently drink and who have the potential to become pregnant."

O'Connor concurs, and also adds that "we need to discuss the fact that rates of drinking have increased among pregnant women in general. We as researchers need to go beyond asking 'did they drink, or did they not drink?' and look at demographic and social/emotional variables as predictors. For example, we've looked at the effects of caregivers' advice to women to stop drinking on whether they actually stopped drinking, and what we found is that if the women are depressed, it doesn't matter what the doctor says. It's important to treat the depression first. Furthermore, caregivers need to talk to all woman of child-bearing age about the Surgeon General's message, that there is no safe limit ... including the adolescent who goes for their first OB-GYN appointment, a person who might be hospitalized in a psychiatric unit for depression, and college students."

O'Connor added that the time has also come for more research into legal and ethical issues related to addiction among pregnant women. "This is an area that people tend to shy away from because it's highly emotional and potentially volatile, yet it's important because so much of everything now is just opinion. I think it's important for researchers to demonstrate that women have better outcomes in a supportive, therapeutic treatment situation as opposed to jail, or having to wear a patch, or having to be sterilized ... but I think that this would be a very hard research project to do."
Alcoholism: Clinical & Experimental Research (ACER) is the official journal of the Research Society on Alcoholism and the International Society for Biomedical Research on Alcoholism. Co-authors of the ACER paper, "Alcohol Consumption Among Low-Income Pregnant Latinas," were: Suzanne Hughes, Susan B. Meltzer, Dennis Wahlgren, Nada Kassem, and Melbourne F. Hovell of the Center for Behavioral Edpidemiology and Community Health at San Diego State University; Sarah Larson of the San Diego State University Foundation; and Edward P. Riley of the Department of Psychology at San Diego State University. The study was funded by the Association of Schools of Public Health, Centers for Disease Control and Prevention, and the Agency for Toxic Substances and Disease Registry.

Alcoholism: Clinical & Experimental Research

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