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Has files: YesSubject: search.filters.subject.Fetal Alcohol Syndrome

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    Pregnant woman's perceptions and knowledge regarding alcohol use during pregnancy
    (2014-03-31) Le Roux, Chanelle
    The teratogenic effects of prenatal alcohol exposure can significantly influence the development of a child, which may result in a range of structural, cognitive and behavioural abnormalities. The severity of these effects can vary and fall under the fetal alcohol spectrum disorder (FASD). South Africa hosts the highest prevalence rate (12%) of this disorder in the world. All conditions included in the FASD spectrum are completely preventable through maternal abstinence of alcohol during pregnancy. At present, very limited information is available regarding how much pregnant women in South Africa know about adverse effects caused by prenatal alcohol exposure. This study aimed to determine pregnant women’s awareness of alcohol’s potential teratogenic effects on pregnancy and their knowledge of the features and characteristics associated with fetal alcohol syndrome (FAS), the most severe of the FASD conditions. Additionally, the study compared the awareness and knowledge of pregnant women attending private antenatal centres, to those attending an antenatal clinic at Charlotte Maxeke Johannesburg Academic Hospital, a state hospital in the Johannesburg area. Participants (n=211) completed a self-administered questionnaire at their private antenatal class or state clinic. A total of 211 questionnaires were analysed; 107 questionnaires from the state antenatal clinic and 104 from the private antenatal centres. The awareness levels regarding alcohol use in pregnancy were found to be very similar amongst the private (52%) and state (55%) participants. However, results indicated that significantly more private participants (19%), compared to state participants (3%) could be classified as having knowledge of the condition FAS. Overall, this study found that pregnant women from various backgrounds have limited knowledge of the harms caused by alcohol use during pregnancy. Misconceptions about the acceptable levels of maternal alcohol consumption and the effects thereof were also evident. The results of this research highlights that prevention strategies and awareness campaigns regarding alcohol use during pregnancy should incorporate information on the severity and permanent nature of FAS, as well as highlighting the fact that all types of alcoholic beverages can result in this condition. Also, these campaigns should focus on informing women that no level of alcohol is acceptable during pregnancy, as any amount may have potentially teratogenic effects on the developing fetus.
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    Effect of alcohol on global and locus specific DNA methylation in spermatozoa: implications for fetal alcohol spectrum disorders (FASD)
    (2013-04-24) Patel, Sanam
    Fetal alcohol spectrum disorders (FASD) is an umbrella term that describes a range of symptoms associated with prenatal alcohol exposure. Fetal Alcohol Syndrome (FAS) is the most severe disorder in the spectrum and is a major health problem in South Africa, with a prevalence rate of 68.0-89.2 per 1000 children of school-going age. The primary cause of FAS is in utero alcohol exposure. However, secondary factors that contribute to the syndrome include various genetic, epigenetic and additional environmental factors. The proposal that paternal preconception alcohol exposure has adverse effects on offspring development is supported by children born with FASD-like characteristics whose mothers did not drink but whose fathers were alcoholics. Mouse models further support these findings. One of the main epigenetic factors that have been shown to be affected by alcohol is DNA methylation. This chemical modification of DNA is associated with developmentally important genes known as imprinted genes. Imprinted genes are expressed in a parent of origin specific manner. Methylation occurs at specific regions in these genes known as differentially methylated regions (DMRs) or imprinting control regions (ICRs). Alcohol’s ability to alter DNA methylation at imprinted genes raises the possibility that epigenetic disruption could contribute to the clinical features seen in FASD. The main aim of this research was to examine global DNA methylation and locus specific H19 ICR DNA methylation in spermatozoa, related to alcohol exposure. This was done using the luminometric methylation assay (LUMA) and bisulfite based quantitative pyrosequencing, respectively. In this study there was no significant correlation between alcohol exposure and global DNA methylation (p = 0.17), nor was there a significant correlation with drinking frequency (p = 0.31). Although not significant, a slight trend towards decreased global DNA methylation in alcohol-exposed spermatozoa was observed. This suggests that either alcohol does not affect global sperm DNA methylation or that the technique used in this study was not sensitive enough to detect minor changes in global DNA methylation percentage. There was also no significant correlation between alcohol exposure and average H19 ICR DNA methylation (p = 0.051), nor was there a significant correlation with drinking frequency (p = 0.47). There was no significant correlation between alcohol exposure and DNA methylation at individual CpG sites except for CpG 3, where there was a significant increase in DNA methylation in the drinking group (p = 0.03). The findings of this study together with the findings of significant selective demethylation at individual CpG sites within the IG-DMR from another study on the same sperm samples, suggest that alcohol may have the ability to affect DNA methylation levels in spermatozoa at certain loci within the sperm genome. However, these loci-specific effects are not reflected in global DNA methylation levels. These findings do not disprove the hypothesis that there is an epigenetic mechanism responsible for the paternal effects seen in FASD. Instead they suggest that the techniques used in this study were not sensitive enough to detect these changes in DNA methylation or alternatively, alcohol may be exerting its effects through other epigenetic mechanisms.
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    Fetal alcohol spectrum disorder (FASD) from infancy to childhood: neuropsychological development and maternal depression
    (2012-07-16) Chetty-Makkan, Candice Maylene
    Fetal Alcohol Spectrum Disorder (FASD) is a preventable cause of intellectual delay. Highly prevalent in South Africa, it has become a public health concern. Effective screening measures to identify women at risk of producing a FASD child is therefore important. This study postulated that a distinctive maternal profile may exist for mothers with FASD infants compared to a comparison group. Consequently, the study investigated the occurrence of maternal depression and its potential association with maternal risk factors and infant development respectively; differences in the profiles of mothers; as well as developmental differences in FASD and No FASD groups of children. An ex-post facto design was implemented, where the sample comprised of dyads that completed initial (infants 9-18 months) and follow-up (children 18-45 months) assessments. Severity of maternal depression (measured on the Beck Depression Inventory); maternal current mood states (measured on the Profile of Mood States) and infant developmental differences (measured with the Griffiths Mental Developmental Scales) were assessed. The results showed no distinct patterns in maternal depression in the FASD versus the No FASD groups; maternal depression was not significantly correlated with infant development; infants with FASD showed impaired overall development, with especially poor social adjustment; and all infants (FASD and No FASD) performed lower than the expected developmental norms. Maternal alcohol use was the only significant covariate associated with infant development. Identifying the predictors of high risk behaviour during pregnancy is complex, where prenatal alcohol exposure cannot be viewed in isolation from contextual factors, as limited resources, historical factors, cultural/community knowledge, a lack of stimulation and malnutrition prevail in many areas of South Africa. Profiling maternal predisposition to prenatal alcohol use is essential in reducing the incidence of FASD in South Africa and implementing social skills intervention programs could aid the long-term adjustment of FASD infants.
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    The relationship between knowledge of alcohol effects on pregnancy and alcohol use among a sample of urban women
    (2012-01-19) Chandu, Lehlohonolo Tebogo
    Alcohol is a major public health problem globally. According to the World Health Organization (WHO) report, alcohol accounts for 2.5 million deaths (4% of total) and 69.4 million (4.5% of total) of Disability-Adjusted Life Years (DALYs), (WHO, 2002, 2011). In South Africa, alcohol was found to be the third highest contributor to death and disability (Parry, 2007/8). Among the many far-reaching consequences of alcohol use in South Africa, Fetal Alcohol Syndrome (FAS) in certain regions in the country, rates among the highest in the world (May et al., 2007). Despite higher comparative levels of FAS in rural areas, almost one third of the population in urban sites (Gauteng) demonstrates that FAS is not exclusively a problem of South African rural areas. This study hypothesized that higher knowledge levels about the effects of alcohol on pregnancy may deter use among women. Employing secondary data analysis from a 2006 cross-sectional household survey, this study explored the prevalence of alcohol use among urban women (18-44 years) in the Tshwane Municipality, in general and in pregnancy. It also examined the relationship between knowledge of alcohol effects on pregnancy and alcohol use. A significant association was found between employment status, pregnancy outcome and general alcohol use among women. An almost significant association was found between knowledge of alcohol effects on pregnancy and past month alcohol use, knowledge levels and alcohol use during pregnancy. Findings partially support the hypothesis. However, knowledge of alcohol effects on pregnancy alone cannot deter women from using alcohol. Multiple influencing factors should be considered in planning prevention programmes for urban women’s alcohol use. Further research with larger sample sizes of pregnant women is suggested to explore the associations conclusively.