Y2 Alcohol and smoking in pregnancy

Question 1

How many units does the average scottish woman drink/week?

Answer 1

8.6 units

Question 2

How many units/ week are considered high risk?

Answer 2

14 units (2:10 women)

Question 3

How many women in the uk continue drinking during pregnancy?

Answer 3

4:10

Question 4

Brittain is 4th in the world when it comes to women keeping drinking during pregnancy, True or false?

Answer 4

True

Question 5

Globally, how many babies are born with FAS?

Answer 5

1:63

Question 6

For every baby born with FAS, how many will be born with undiagnosed symptoms?

Answer 6

9-10 babies

Question 7

Which are the top three causes of premature death and disability globally?

Answer 7

Smoking, Obesity, alcohol.

Question 8

Why does alcohol affect women more than men?

Answer 8

Women have 10 % more body fat leading to higher promille per bloodvolume and lower alcohol dehydrogenase, an enzyme that breaks down alcohol. Women will therefor develop problems sooner and are likely to die younger,

Question 9

Alcohol abuse can lead to?

Answer 9

Weaker immune system 
Risk of DVT
Breast cancer
Decreased milk production
Menstrual disorders
Infertility
CNS suppression
Poor mental health
Hypertension
Strokes and heart attacks
Folic acid deficiency
Malnutrition
Dehydration
Liver disease, pancreatitis and cancer.

Question 10

How will alcohol abuse affect breast feeding?

Answer 10

It inhibits oxytocin production and therefor the milk ejection reflex. It can also lead to lower milk production

Question 11

How will alcohol consumption affect baby depending on which trimester it was consumed in?

Answer 11

1st trim: Birth defects

2nd trim: SGA

3rd trim: Developmental problems

Question 12

FASD- fetal alcohol spectrum disorders include?

Answer 12

• Fetal alcohol syndrom FAS
• Alcohol related neurodevelopmental disorders ARND
• Alcohol-related birth defects (ARBD)
• Fetal alcohol effects FAE
• partial FAS, pFAS

Question 13

Which women are more likely to smoke?

Answer 13

Women living in deprived areas
Younger mothers
Women living in Tayside or Ayrshire and Arran

Question 14

What limits data around alcohol and drinking in pregnancy?

Answer 14

Most data is collected at booking only, and it’s mostly self reported, leaving a large of uncertainty due to fear of stigma.

Question 15

Of what are women that smoke more at risk of?

Answer 15

DVTs
Decreased milk production (inhibits prolactin)
Infertility
BM lipids changed-> colicky baby
Miscarriage/ectopic
Hypertension
Stroke/heart attacks
Lung cancer/COPD
Preeclampsia
Placental abruption
Placenta previa
COPD

Question 16

Of what are babies of mothers who smokes more at risk of?

Answer 16

Low birth weight
Growth restrictions
Cleft lip/palate
Stillbirth
SIDS
Future cardiovascular disease
CO poisoning in utero

Question 17

What can passive smoking cause for the child ones born?

Answer 17

Asthma
Ear infections
Pneumonia
Attention problems
Hyper activity

Question 18

CO poisoning

Answer 18

Always higher in the baby than the mum. Baby has more haemoglobin in thier blood, meaning they retain more CO and poor oxygenation. This is reversed when mum stops smoking. Screening by CO monitor. Less than 4ppm, no problem.
More than 4ppm, arrange additional care.

Question 19

Care for women who smoke in pregnancy.

Answer 19

Screening- serial CO measurments, Serial growth scans, ??Intrapartum CTG, DVT profylaxis.
Referrals- Obstetric referral, cessation services, ?social services.
Feeding advice- minimise smoking, Breast feed!, No co-sleeping, SIDS prevention