Revista Brasileira de Ginecologia e Obstetrícia (Jul 2012)
Padrão do consumo de álcool em gestantes atendidas em um hospital público universitário e fatores de risco associados Alcohol use pattern in pregnant women cared for in a public university hospital and associated risk factors
Abstract
OBJETIVO: Verificar em puérperas internadas em um hospital universitário da região Sudeste do Brasil o padrão de consumo alcoólico antes e durante a gravidez, e fatores de risco associados a esse uso. MÉTODOS: Foram incluídas, consecutivamente, 493 puérperas entre junho e setembro de 2009. Foram excluídas puérperas com deficiência cognitiva. Para diagnosticar uso/abuso do álcool antes da gestação foram utilizados os questionários AUDIT e CAGE e, para o consumo durante a gravidez, também o T-ACE. Outro questionário foi aplicado para coleta de dados sociodemográficos, tais como, idade, escolaridade, situação conjugal e renda familiar. Para análise estatística foi utilizado o teste do χ² e calculou-se Odds Ratio (OR) e intervalo de confiança de 95% (IC95%). Valor pPURPOSE: To determine the pattern of alcohol use before and during pregnancy and associated risk factors in puerperal women hospitalized in a public university hospital in Southeastern Brazil. METHODS: Between June and September 2009, 493 puerperae were consecutively evaluated. Those with cognitive impairment were excluded from the study. The AUDIT and CAGE questionnaires were used to diagnose alcohol use/abuse before pregnancy, in addition to the T-ACE during pregnancy. Another questionnaire was applied to collect sociodemographic data, such as age, educational level, marital status, and household income. The χ² test was used in the statistical analysis and the Odds Ratio (OR) and 95% confidence interval (95%CI) were calculated. A p-value <0.05 was considered to be significant. RESULTS: Before pregnancy, the CAGE was positive in 50/405 (12.3%) women and the AUDIT identified alcohol use in 331 (67.1%), which was of low risk in 233 (47.3%), risky in 73 (14.8%), and harmful or indicating possible alcohol dependence in 25 (5%). During pregnancy, the CAGE was positive in 53/405 (13.1%) women and the T-ACE in 84 (17%); the AUDIT identified alcohol use in 114 women, which was of low risk in 73 (14.8%), risky in 27 (5.5%), and harmful or indicating possible alcohol dependence in 14 (2.8%). During pregnancy, alcohol use was more frequent (OR=2.8; 95%CI 1.2 - 6.2) among women with a lower educational level (8.8 versus 3.3%) and more frequent (OR=3.8; 95%CI 1.3 - 11.1) among those who did not cohabit with a partner (6 versus 1.7%). Among pregnant women who drank alcohol, 49/114 (43%) were advised to stop drinking. CONCLUSIONS: Alarming alcohol use was observed during pregnancy, especially among pregnant women with a lower educational level and those who did not cohabit with a partner. There was a low frequency of counseling aimed at abstinence and the AUDIT was the instrument that most frequently diagnosed alcohol consumption.
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