Author: Nyanda McBride
Source: Australian Nursing Midwifery Journal. 22.10 (May 2015):
Alcohol exposure during pregnancy, which results in Fetal Alcohol Syndrome (FAS), is the leading cause of environmental birth defects and intellectual disability in the western world. FAS is characterised by irreversible, primary structural brain damage, leading to secondary deficits in growth and neurological development resulting in a range of life long intellectual and behavioural disabilities.
In Australia, the estimated prevalence rate of FAS Is 0.06 per 1,000 live births (under 15 years) and an Indigenous rate of 8.11 per 1,000 (Elliott et al. 2008). These rates are relatively low due to the underdeveloped diagnosis of FAS in Australia.
However, Australia has a high level of alcohol exposed pregnancies with approximately 50% of Australian women consuming alcohol during pregnancy (AIHW 2010) and around 21 % of pregnant women drinking to high risk levels (McBride et al 2012).
Australian per capita alcohol consumption is high by world standards (WHO 2011) and therefore alcohol use during pregnancy is often supported by complex social and cultural circumstances. Social determinants research spotlights reasons for alcohol use during pregnancy: recent maternal drug use (Accornero et al. 2002), high life stress (Lewis et al. 2011), custodial changes, current drug use in the home, and exposure to violence (Delaney-Black et al 2000), all increase use. Several of these factors have a level of partner involvement suggesting that decisions about alcohol use during pregnancy are not solely made by women, but occur within the context of the home and the broader social environment.
Research from human studies also indicates that paternal alcohol consumption in the preconception period plays a role in fertility, and in fetal and child health. Alcohol use during sperm development can impact on the viability and health of sperm (Muthusami Chinnaswamy 2005); male consumption during preconception is associated with early pregnancy loss (Tine Brink et al. 2004); and not achieving a live birth (Klonoff-Cohen et al. 2003). Paternal alcohol consumption can result in offspring with low birth weight (Little Sing 1987), and reduced cognitive ability (Hegedus et al 1984). Several studies report that heavy alcohol consumption by the father during pre-conception results in an increased level of internalising and externalising behaviours in young children (McBride Johnson 2015).
Research also reports that male partners can have an important impact on maternal alcohol consumption during pregnancy through social facilitation (Abel 2004). Australian data Indicate that women are most likely to drink in their own home or at the home of a friend; that over 75% of women who drink during pregnancy usually drink with their partner, with nearly 40% of these women reporting that their partner usually initiates a drinking occasion (McBride, Carruthers Hutchinson 2012).
Recent studies report that most men (75-80%) want male-oriented pre-conception information (Frey et al. 2012); and that male involvement in preconception health increases female partners compliance on behaviours that could impact on fetal health (Czeizel et al. 2013). Involving and informing prospective fathers about male preconception health is likely to be an important prevention strategy for FAS.
Abel E. 2004. Paternal contribution to fetal alcohol syndrome. Addiction Biology. 9:127-33.
Accornero V, Morrow C, Bandstra E, Johnson A, Anthony J. 2002. Behavioral outcome of preschoolers exposed prenatally to cocaine: role of maternal behavioural health. Journal of Pediatric Psychology. 27(3):259-69.
Australian Institute of Health and Welfare 2010. National Drug Strategy Household Survey report. Drug statistics series no. 25 (cat. no. PHE 145). Canberra: AIHW; 2011.
Czeizel A et al. 2013. The participation of prospective fathers In preconception care. Clinical medicine insights. Reproductive Health. 7:1.
Delaney-Black V, Covington CY, Templin T, Ager J, Nordstrom-Klee B, Martier S, et al. 2000. Teacher-assessed behaviour of children prenatally exposed to cocaine. Pediatrics. 106(4)782-91.
Elliott E, Payne J, Morris A, Haan E, Bower C 2008. Fetal alcohol syndrome: a prospective national surveillance study. Archives of Disease in Childhood 93:732-7.
Frey K et al 2012. Preconception healthcare: what do men know and believe? Journal of Men’s Health. 9(1):25-35.
Hegedus A, Alterman A, Tarter R 1984. Learning achievements in sons of alcoholics. Alcoholism: Clinical and Experimental Research. 8:330-3.
Klonoff-Cohen H, lam-Kruglick P, Gonzalez C 2003. Effects of maternal and paternal alcohol consumption on the success rates of in vitro fertilization and gamete intrafallopian transfer. Fertility 8 Sterility. 79(2):330-9.
Lewis PT, Shipman VC, May PA 2011. Socioeconomic status, psychological distress, and other maternal risk factors for fetal alcohol spectrum disorders among American Indians of the northern plains. American Indian and Alaska Native Mental Health Research. 17(2): 1-21.
Little R, Sing C 1987. Father’s drinking and infant birth weight: reporting of an association. Teratology. 36:59-65.
McBride N, Johnson S. Paternal role in alcohol exposed pregnancies and FASD. Finding from a systematic literature review. 6th International Conference on FASD, Vancouver, Canada 3-7 March 2015.
McBride N, Carruthers S, Hutchinson D 2012. Reducing Alcohol Use During Pregnancy: Listening to women who drink as a prevention starting point. A formative Intervention research study. Global Health Promotion. 19(2): 102-14.
Muthusami K, Chinnaswamy P 2005. Effects of chronic alcoholism on male fertility hormones and seman quality. Fertility and Sterility. 84(4):919-24.
Tine Brink H et al. 2004. Consumption at the time of conception and spontaneous abortion. American Journal of Epidekiology. 160(7):661-7.
World Health Organization (WHO) 2011. Global health report on alcohol. Geneva, Switzerland: WHO Press
Nyanda McBride is a Senior Research Fellow and Program Leader at the National Drug Research Institute, Curtin University, WA
Source Citation (MLA 7th Edition)
McBride, Nyanda. “Paternal involvement in alcohol exposure during pre-conception and pregnancy.” Australian Nursing Midwifery Journal May 2015: 51. General OneFile. Web. 27 May 2015.