Megan Jongekrijg, Tori Ellens, Grace HaEun Lee and Tega Ebeye, Nursing Students; Dr. Adejoke B. Ayoola, Advisor
Calvin College, Grand Rapids, MI
search terms:
Preconception
Alcohol
Minority
Low income
Women
Low income women
African American(s)
Background
• Currently, 3.4 million out of the 6.6 million (51%)
pregnancies in the U.S. are unintended
• The highest rates of unintended pregnancies are
among poor and low-income women, minority women,
women aged 18-24, and cohabitating women
• The rate of unintended pregnancy among poor women
(those with incomes at or below the federal poverty
level) in 2008 was 137 per 1,000 women aged 15–44,
more than five times the rate among women at the
highest income level (26 per 1,000)
• Unintended pregnancies are associated with higher risk
for birth defects, such as Fetal Alcohol Syndrome (FAS)
• The incidence rate of FAS is 1.5 case per 1,000 live
births in the United States
Characteristics of Reviewed Studies
% (n = 24)
Study Design
Quantitative
100% (24)
Level of
Evidence
II – Evidence obtained from at
4.17% (1)
least one well-designed
Randomized Controlled Trial (RCT)
Objective
IV– Evidence from well-designed
case-control and cohort studies
• To determine the prevalence of preconception
alcohol consumption among low-income
minority women
Literature Review Exclusion Process
Sample size
Literature search based on keywords
N = 108,044
Literature search limited to U.S. & Canada, Ages 18-44,
Years 1994-2014, & English
N = 3,231
Age
Race
Articles limited based on title and abstract, eliminated
duplicates
N = 49
Read through articles and removed articles that did not
meet inclusion criteria
N = 24
Latina(s)
Hispanic(s)
White(s)
Caucasian(s)
Asian(s)
Native American(s)
Indian(s)
databases:
-CINAHL
-PUBMED
-MEDLINE with
WEB OF SCIENCE
-PSYCINFO
Income Level
VI – Evidence from a single
descriptive or qualitative study
≥ 200
8.33% (2)
Findings
•5 out of the 15 articles (33%) comparing
ethnicities and alcohol consumption say
frequent drinking or binge drinking (4+ drinks
per single occasion) is associated with white
race, higher income, and more education
•4 out of the 15 (26.7%) articles found that
non-Hispanic Black women had the highest
rates of alcohol consumption after pregnancy
recognition
•Multiple articles (12.5%) discussed the
inaccuracy of current data regarding alcohol
consumption due to self-report bias and
hindsight bias
87.5% (21)
83.33% (20)
100-199
8.33% (2)
≤ 99
18-44
8.33% (2)
54.17% (13)
Child-bearing age
41.67% (10)
Not Specified
All Minorities (AHANA)
4.17% (1)
4.17% (1)
General Population (U.S.)
33.3% (8)
African-American Majority
8.33% (2)
Hispanic Majority
16.67% (4)
American Indian Majority
4.17% (1)
White and Minorities
29.17% (7)
Not Specified
Low-income Only
4.17% (1)
62.50% (15)
General Population (U.S.)
33.33% (8)
Not Specified
4.17% (1)
References
• Tracking Fetal Alcohol Syndrome (FAS). (2014, April 21). Centers for Disease Control and Prevention. Retrieved July 30, 2014, from http://www.cdc.gov/ncbddd/fasd/research-tracking.html
• Unintended Pregnancy in the United States. (n.d.). Unintended Pregnancy in the United States. Retrieved July 30, 2014, from http://www.guttmacher.org/pubs/FB-Unintended-Pregnancy-US.html
Implications
•New methods of alcohol screening need to be
implemented to obtain more accurate numbers
of alcohol consumption among women during
pre- and post-conception stages
•Nurses and other health professionals need to
educate all women in the pre- and postconception stages on health behaviors,
specifically alcohol consumption and its effects
on the unborn baby
Funding Sources
- Robert Wood Johnson Foundation
- Calvin Alumni Association
- Calvin Summer Research Grant