Maternal Weight and Diet as Protective Factors Against the Adverse Effects of Prenatal Alcohol Exposure

Background: Alcohol is a known teratogen, and the prevalence of fetal alcohol spectrum disorders in the Western Cape Province of South Africa is estimated to be 17 - 28%. Yet the individual variation in child outcomes is not fully explained by the quantity, frequency, or gestational timing of prenatal alcohol exposure. Methods: We examined the influence of maternal weight on the physical and neurocognitive development of infants with and without prenatal alcohol exposure. We compared the physical growth, dysmorphology, and neurocognitive trajectories of infants to understand similarities and differences in birth measurements and rate of change, from birth to 9 months, associated with alcohol exposure and maternal weight. We also examined the role of alcohol consumption and maternal dietary intake on infant physical development in early life.Results: In this population where stunting remains a concern, higher maternal weight was associated with larger, less dysmorphic, infants with better neurodevelopmental outcomes. But the rate of change over time was similar among all infants regardless of maternal weight. Alcohol exposure consistently resulted in poorer growth and more dysmorphic infants. Most women in this population were not achieving adequate micronutrient intake for pregnant women and malnutrition remains a concern for this population. Alcohol had a direct adverse effect on maternal dietary intake.Conclusion: This research attempted to better understand maternal weight and dietary intake as factors which may mitigate some of the adverse effects of prenatal alcohol exposure in the early infancy period. Alcohol was adversely associated with maternal dietary intake and infant outcomes. Maternal weight may be somewhat protective and may partially explain some of the individual variation in infant physical and neurocognitive outcomes, but higher maternal weight does not overcome the majority of the negative, teratogenic effects of prenatal alcohol exposure. These studies affirm that there is no known safe level of alcohol exposure during pregnancy.Doctor of Philosoph

NC Latina BEAUTY: Formative Research, Design, Implementation, and Evaluation of a Salon-based Health Promotion Pilot Program in a Latino Salon in the NC Triangle Area

Background: Latino beauty salons have the potential to provide a unique opportunity to reach the U.S. Latino population with information and activities that will promote healthy behaviors, reduce risk, prevent chronic disease and improve quality of life. Methods: By conducting a pilot test in a Latino salon, the Capstone team explored the feasibility of a physical activity intervention, adapted from a previous physical activity campaign included as part of the NC BEAUTY and Health Project. The adaptation was informed by engaging with multiple community members, conducting formative research, and a literature review. Results: The formative research aided the team in developing an intervention and evaluation plan including: evaluation and intervention materials and trainings of lay health educators and salon stylists. Results from the implementation of the pilot intervention, which includes 3 weeks of recruitment and baseline assessment, 6 weeks of intervention activities, and 2-3 weeks of post-intervention assessment, will likely be used in the development of a grant proposal and a manuscript, helping to fill the gap in evidence-based literature about health interventions in Latino beauty salons. Discussion: Although this Capstone project succeeded at developing a pilot test study and engaging with a Latino beauty salon, ongoing challenges include time constraints, insufficient formative research, language barriers, lack of entrée into the community, and threats to sustainability. Recommendations for next steps are discussed.Master of Public Healt

Maternal nutritional status as a contributing factor for the risk of fetal alcohol spectrum disorders

Compare nutritional status of 57 South African mothers of children with fetal alcohol spectrum disorders (FASD) with 148 mothers of controls

The continuum of fetal alcohol spectrum disorders in four rural communities in south africa: Prevalence and characteristics

Prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in previously unstudied rural, agricultural, lower socioeconomic populations in South Africa (ZA)

Breastfeeding and maternal alcohol use: Prevalence and effects on child outcomes and fetal alcohol spectrum disorders

Determine any effects that maternal alcohol consumption during the breastfeeding period has on child outcomes

The continuum of fetal alcohol spectrum disorders in a community in South Africa: Prevalence and characteristics in a fifth sample

The prevalence and characteristics of the continuum of diagnoses within fetal alcohol spectrum disorders (FASD) were researched in a fifth sample in a South African community

Prevalence and characteristics of fetal alcohol syndrome and partial fetal alcohol syndrome in a Rocky Mountain Region City

The prevalence and characteristics of fetal alcohol syndrome (FAS) and partial FAS (PFAS) in the United States (US) are not well known

Maternal alcohol consumption producing fetal alcohol spectrum disorders (FASD): Quantity, frequency, and timing of drinking

Concise, accurate measures of maternal prenatal alcohol use are needed to better understand fetal alcohol spectrum disorders (FASD)

Alcohol use, working conditions, job benefits, and the legacy of the "Dop" system among farm workers in the Western Cape Province, South Africa : hope despite high levels of risky drinking

CITATION: Gossage, J.P. et al. 2014. Alcohol use, working conditions, job benefits, and the legacy of the "Dop" system among farm workers in the Western Cape Province, South Africa: hope despite high levels of risky drinking. International Journal of Environmental Research and Public Health, 11(7):7406-7424, doi:10.3390/ijerph110707406.The original publication is available at http://www.mdpi.com/journal/ijerphThis study describes alcohol consumption in five Western Cape Province communities. Cross-sectional data from a community household sample (n = 591) describe the alcohol use patterns of adult males and females, and farm workers vs. others. Data reveal that men were more likely to be current drinkers than women, 75.1% vs. 65.8% (p = 0.033); farm laborers were more likely to be current drinkers than individuals in other occupations 83.1% vs. 66.8% (p = 0.004). Group, binge drinking on weekends was the norm; men were more likely to be binge drinkers in the past week than women 59.8% vs. 48.8% (p = 0.086); farm workers were more likely to binge than others 75.0% vs. 47.5% (p < 0.001). The legacy of “Dop” contributes to current risky drinking behaviors. Farm owners or managers were interviewed on 11 farms, they described working conditions on their farms and how the legacy of “Dop” is reflected in the current use of alcohol by their workers. “Dop” was given to farm workers in the past on six of the 11 farms, but was discontinued for different reasons. There is zero tolerance for coming to work intoxicated; farm owners encourage responsible use of alcohol and assist farm workers in getting help for alcohol problems when necessary. The farm owners report some positive initiatives, were ahead of the movement to provide meaningful wages, and provide other important amenities. Further research is needed to assess whether progressive practices on some farms will reduce harmful alcohol use.http://www.mdpi.com/1660-4601/11/7/7406Publisher's versio

Assessing the sensitivity and specificity of phosphatidylethanol (PEth) cutoffs to identify alcohol exposed pregnancies

In the literature on alcohol use biomarkers, there has been debate as to what a valid and/or utilitarian cut off level should be for various research applications. In this manuscript, we assessed the sensitivity and specificity of multiple cutoff values for phosphatidylethanol (PEth) from bloodspots relative to self-report, the Alcohol Use Disorder Identification Test (AUDIT) scores, and another alcohol use biomarker ethyl glucuronide (EtG) from fingernails in a sample of 222 pregnant women in the Western Cape Province of South Africa. Receiver operating characteristic (ROC) curves were used to assess the area under the curve (AUC) and assess PEth cutoff values of ≥2, ≥4, ≥8, ≥14, and ≥20 nanograms per milliliter (ng/ml). The highest AUC value was attained when PEth was compared to an AUDIT score of 1 or more. Depending on the cutoff used to determine alcohol consumption, PEth identified 47%–70% of the individuals as alcohol-consuming while 62.6%–75.2% were identified by self-reported measures, and 35.6% were identified by EtG. In this sample, sensitivity and accuracy were highest at less stringent PEth cutoffs when compared to self-report, AUDIT score of 1 or more, 5 or more, 8 or more, and EtG ≥ 8 picograms per milligram (pg/mg). For research purposes, less stringent cutoffs, such as PEth ≥ 8 ng/ml, may be considered a valid, positive cutoff for identifying women who consume alcohol during pregnancy in this population. A cutoff of PEth ≥ 20 ng/ml may miss individuals who reported consuming alcohol (false negatives)