Motherhood, a special journey for a woman’s body and a significant change to her lifestyle as she grows, cares and raises another life. However, would it be fair to assume that she was immediately ready for this responsibility? As the United States fights the war on drugs and others remain reluctant about the effects of substances on one’s body, mothers are caught in the crossfire of substance abuse and motherhood. According to a recent study, scientists at The Japan Environment and Child’s Study and others published their findings from a study on the maternal health effects of heavy alcohol consumption during pregnancy. Though there are differences in belief amongst the public about the effects of drinking, scientists and healthcare workers remain unanimous. From hypertensive disorders of pregnancy to preterm delivery, this study strived to uncover the overlooked health effects on mothers battling through substance abuse, specifically heavy alcohol consumption.
This study came to be when the scientists realized that most studies that have been done are on fetal health or studies which otherwise contradict each other due to inconclusive findings. Soon enough, interested scientists and the Japan Environment and Child’s Study (JECS) collaborated with each other to bring this study to the public. From January 2011 to March 2014, the JECS group was able to provide the researchers with 103,099 potential subjects from across their fifteen regional centers, out of which 76,940 subjects were chosen to be a part of the study. Many subjects were excluded from the study based on their potential for creating bias and contributing to the inconclusiveness of the study, which was previously observed. Alcohol and frankly any other drugs can contribute to fluctuations of nutrient intakes and levels in the body. During pregnancy, maintaining healthy levels of nutrients and minerals are key to physical health. From cannabis to opioids, any and all substances will affect levels of choline, folate, B12 and more (Sebastiani G, et. al 2018, 2). The removal of a substantial number of subjects was done for this exact reason, so that the study could avoid any chances of producing inconclusive results.
The researchers believed that it was crucial to have a study which would be able to prove the adverse maternal health effects of alcohol abuse. When conducting the experiment, the 76,940 subjects were then asked to fill out the T1 and T2 questionnaires. These questionnaires consisted of questions about their home environment, lifestyle, and most importantly, the amount of alcohol/ethanol consumed per week. Subjects were asked for consent and could choose to not answer specific questions throughout both questionnaires; both taken at different times. T1 was a very broad questionnaire, which the only options provided were “Never,” “Quit drinking,” and “Continue drinking during pregnancy”, leaving a lot of gray areas for answers which may lie in between. The T2 questionnaire strived to collect a better perspective on the condition of the pregnant women, by giving options such as “Never,” “Quit drinking before conception was recognized,” “Quit drinking after conception was recognized,” and “Continue drinking during pregnancy”. T2 also included further specification on how much alcohol was being consumed throughout the week and created a broad spectrum to ensure that it was enough and reasonable to find any significant relevance when analyzing the data.
This data was then utilized and compared to the latest health check-ups of the mothers after they had given birth. Hypertensive disorders of pregnancy (HDP), placenta previa, a condition when the sac that the baby grows in blocks the mother’s cervix, and preterm delivery were some of the effects observed, of which HDP is what the study primarily observed. The researchers were able to analyze this data to find the odds of developing these problems from the two groups created from the T1 and T2 questionnaires; the first group consisted of mothers who drank less than 150 grams of ethanol per week while the second group drank more than 150 grams of ethanol per week. These groups were created to ensure a clear division between those who would accidentally drink or drink at very low levels, compared to mothers who would intentionally drink and that would count as substance abuse and not accidental. Eventually, the data was able to conclude that, in a 95% confidence interval, there was a strong correlation between intentional heavy drinking and higher chances of developing HDP while there was a very weak correlation associated with accidental or a small amount of drinking with developing HDP or any other problems observed in the study.
The importance of this study was not only for the statistical and informational significance to that specific area of science but also to those who remained uncertain or careless about the maternal health effects of substance abuse. Everyone’s mother’s health, especially during pregnancy, affects them and their child’s future well-being, which makes the findings of this study relevant to everyone in society and should be a deeper concern in the healthcare field, as reluctance is increasingly observed with the abundance of substance accessibility. Recognizing that substance abuse may come from an ongoing addiction or household environment will help with the treatment of the addiction and the way mothers will be treated, without judgement. This particular study was able to clear the air for future research and for the public to educate themselves and to become aware. As a result, many therapies and addiction rehabilitation facilities have become more widespread and provide specialized help for expectant mothers.
As indicated by the article, the researchers recognize that selection bias and reverse causality may have occurred in their observational study, as has occurred in other similar studies at the time. The article refers to other studies which are similar to theirs and the problems the others encountered. Of the multiple flaws provided, which were valid, would be the addition of more drugs which could contribute to the intensity of the effects, specifically smoking (Iwama N. et al. 2019, 87, 92). There are no solutions provided for the flaws which are being observed. I believe bias can be easily eliminated from the experiment through a random selection process and more in depth and general further research will help the researchers create more specific and meaningful correlations and will help to detect all factors which may influence the degree of severity of the effects.
Research on maternal health has often taken the sidelines in this field of study. Mothers are often blamed for their carelessness and selfish manner for ignoring the health of their child by using and often abusing substances. Studies like these shine light on the harm that is also involved in the mother’s health and conclusive results, like the ones found in this study, are able to articulate the importance of future research and further knowledge of effects of substances at a time where all parts of the world are experiencing drug crises.
References:
Iwama N, Metoki H, Nishigori H, Mizuno S, Takahashi F, Tanaka K, Watanabe Z, Saito M, Sakurai K, Ishikuro M, Obara T, Tatsuta N, Mishijima I, Sugiyama T, Fujiwara I, Kuriyama S, Arima T, Nakai K, Yaegashi N, The Japan Environment & Children’s Study Group. 7 November 2018.Association between alcohol consumption during pregnancy and hypertensive disorders of pregnancy in Japan: the Japan Environment and Children’s Study. Hypertension Research. 2019; 42: 85-94. https://doi.org/10.1038/s41440-018-0124-3.
Sebastiani G, Borrás-Novell C, Alsina Casanova M, Pascual Tutusaus M, Ferrero Martínez S, Gómez Roig MD, García-Algar O.2 August 2018. The effects of alcohol and drugs of abuse on maternal nutrition profile during pregnancy. Nutrients. 2018; 10: 1008.
Featured Image Source:
iStockphoto.com, Creative Commons license.