Maternal Alcohol Use and Nutrition During Pregnancy: Diet and Anthropometry

• Published in: Alcoholism, clinical and experimental research Vol. 41; no. 12; pp. 2114 - 2127
• Main Authors: Carter, R. Colin, Senekal, Marjanne, Dodge, Neil C., Bechard, Lori J., Meintjes, Ernesta M., Molteno, Christopher D., Duggan, Christopher P., Jacobson, Joseph L., Jacobson, Sandra W.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.12.2017
• Subjects: Adult; Alcohol Consumption During Pregnancy; Alcohol Drinking - adverse effects; Alcohol use; Alcoholic beverages; Alcohols; Animal models; Anthropometry; Ascorbic acid; Body fat; Body Height - drug effects; Body mass; Body measurements; Body Weight - drug effects; Body weight gain; Case-Control Studies; Choline; Diet; Dietary intake; Drinking behavior; Drug abuse; Energy measurement; Ethanol; Exposure; Female; Fetal Alcohol Spectrum Disorders; Fetal alcohol syndrome; Folic acid; Humans; Iron; Longitudinal Studies; Methamphetamine; Methamphetamine - adverse effects; Micronutrients; Nutrient deficiency; Nutrients; Nutrition; Nutritional status; Phosphorus; Pregnancy; Prenatal experience; Prospective Studies; Public health; Skin; Skinfold Thickness; Smoking; Smoking - adverse effects; Vitamin B12; Vitamin C; Vitamin D; Vitamins; Weight reduction; Young Adult; Alcohol Consumption During Pregnancy; Diet; Nutrition; Anthropometry; Fetal Alcohol Spectrum Disorders
• ISSN: 0145-6008; 1530-0277
• DOI: 10.1111/acer.13504

Background Despite known risks of prenatal nutritional deficiencies and studies documenting increased prevalence of poor dietary intake among nonpregnant alcohol abusers, the nutritional status of heavy drinking pregnant women remains largely unstudied. Animal models have found interactions between prenatal ethanol exposure and micronutrients, such as choline, folate, B12, and iron, and human studies have reported that lower maternal weight and body mass confer increased fetal alcohol‐related risk. Methods One hundred and twenty‐three heavy drinking Cape Coloured pregnant women and 83 abstaining controls were recruited at their first antenatal clinic visit. At 3 prenatal study visits, each gravida was interviewed about alcohol, smoking, and drug use and weight, height, and arm skinfolds were measured. Dietary intakes of energy, protein, fat, and major micronutrients were assessed from three 24‐hour recall interviews. Results The majority of women gained less than the recommended 0.42 kg/wk during pregnancy. Whereas methamphetamine use was associated with smaller biceps skinfolds, an indicator of body fat, alcohol consumption was not related to any anthropometric indicator. Alcohol was related to higher intake of phosphorus, choline, and vitamins B12 and D. Alcohol, cigarette, and methamphetamine use were related to lower vitamin C intake. Insufficient intake was reported by >85% of women for 10 of 22 key nutrients, and >50% for an additional 3 nutrients. Conclusions Alcohol consumption during pregnancy was not associated with meaningful changes in diet or anthropometric measures in this population, suggesting that poor nutrition among drinkers does not confound the extensively reported effects of prenatal alcohol exposure on growth and neurobehavior. The poor gestational weight gain and high rates of insufficient intake for several nutrients in both the alcohol‐exposed and control groups are also of public health importance. Despite studies documenting increased prevalence of poor dietary intake among non‐pregnant alcohol abusers, the nutritional status of heavy drinking pregnant women remains largely unstudied. In this prospective study of heavy drinking pregnant women and abstainers/light‐drinkers in Cape Town, South Africa, poor gestational weight gain and insufficient nutrient intake were common. However, alcohol consumption during pregnancy was not associated with meaningful changes in diet or anthropometric measures, suggesting that poor nutrition among drinkers does not confound FASD outcomes reported in this community.