fetus winning: Prenatal Alcohol Exposure Rates and Results

THIRD IN A SERIES by BRUCE RITCHIE

OBJECTIVE: To estimate the incidence of FASD.

Exposure Rates

As the Statistics Canada, Canadian Community Health Survey, 2000/01 was conducted in 2000/01; the corresponding 2001 statistics for live births and population were used.

For those who binge drink 1 to 11 times per year, the median would be 6 times. It is assumed those events are spread throughout the year. For the group identified as binge drinking 12 or more times per year, it is a much broader range of binge events, from 12 to 365 times. Pregnancy is usually not detected until 2 or 3 months along. People tend to greatly underestimate both the frequency and quantity of their drinking.

When a pregnancy is confirmed, many women will stop drinking. However, meconium assays for Fatty Acid Ethyl Esters (FAEE) show 15% to 18% will continue to drink throughout the pregnancy, 4% at elevated levels.

While rates of binge drinking may vary between communities, cultures and sub-cultures, this study identifies the overall rates for Canada. Alcohol abuse is found across the full spectrum of Canadian society, rich or poor, of all cultures and ages. For many, binge drinking begins as an adolescent sport, propelled by peer pressure, discount “Happy Hour”, games, and loud music. For others, it starts as an attempt to “kill the pain” of physical, mental or sexual abuse, grinding poverty, loneliness or depression. For some it ends in a coffin - by accident, suicide, violent event or alcohol induced disease.

There can be the perception that alcohol abuse is primarily among the poor. This perception may be because they are often under the microscope of social services and other agencies. However, those in the higher socio-economic groups are in a better position to hide substance abuse, particularly for economic reasons. The families and co-workers become complicit in the substance abuse by enabling the abuser to continue undetected. One does not kill the goose that lays the golden egg.

About 50% of pregnancies are unplanned. Most girls are 2 to 3 months pregnant before they find out. In some cases, it is much longer. The baby may have been swimming in alcohol at many parties before the pregnancy was known. If she stops drinking then, she will often assume no damage has been done, or she may worry throughout the pregnancy about the damage she may have already done. Some will continue to drink throughout the pregnancy.

“In Ontario, 83% of Grade 12 students drink, and 45% have had at least one episode of binge drinking in the previous 4 weeks, according to the 2003 Ontario Student Drug Use Survey. While the percentage of students binge drinking increases with each grade, the biggest single increase – from 8 to 24 percent – occurs between Grades 8 and 9.” A significant number of kids are starting very young.

“A 2003 survey of British Columbia high-school students conducted by the McCreary Centre Society found that 46 percent of males and 43% of females in high school who admitted to drinking had engaged in binge drinking in the previous month.”

“The Canadian Campus Survey in 2000 found that 63% of students reported consuming 5 or more drinks in a single sitting in the previous year.”

These results compare to those included in the Centers for Disease Control CDC Behavioral Risk Factor Surveillance System and the SAMSHA National Household Survey on Drug Abuse (U.S.A. Substance Abuse and Mental Health Services Administration - http://www.samhsa.gov).