Sleep and Maternal Report of Sleep Habits and Temperament Following Prenatal Alcohol Exposure

1. Sleep and Maternal Report of Sleep Habits and Temperament Following Prenatal Alcohol Exposure Christopher Sherman & Matthew J. Parisot University of Maine, Department of Psychology Introduction Results Scatterplots Prenatal alcohol exposure is associated with persistent, adverse neurobehavioral functioning during early development.In our rural, Caucasian cohort, maternal levels of alcohol intake are high, and neonates whose mothers had a history of high pre-pregnancy alcohol intake showed sleep onset difficulty and sleep fragmentation during a laboratory nap study. In a previous study, we reported that the prevalence of pre-pregnancy alcohol abuse was 25% in 217 pregnant women who delivered at a family practice clinic in Northern Maine (Hayes et al., 2002). As shown in Table 1, pre-pregnancy alcohol intake levels and years of alcohol use were associated with alcohol intake during pregnancy. Participants were mother-infant dyads (N=37) recruited from a prenatal clinic serving primarily disadvantaged families in Northeastern Maine. Previously, we established that women from this cohort were primarily Caucasian, had high alcohol and tobacco use, but less use of other intoxicating substances (Hayes et al., 2002). r=.468, p=.033, n=21 Table 1. Alcohol in Pregnancy Standard Parameter p Coefficient Estimate t (2-tailed) Years of Alcohol Use 0.225 0.165 2.82 0.006* Drinks/Day Pre-pregnancy 0.216 0.011 2.70 0.008* Drug History 0.174 0.110 2.14 0.034* FO Alcohol Problem 0.134 0.088 1.73 0.086 FOB Alcohol Problem -0.202 -0.143 -2.63 0.001* FO Drug History -0.145 -0.096 -1.78 0.078 Multiple regression for social variables (FO = family of origin; FOB = father of the baby) and maternal use history. Additional variables were self alcohol problem, FOB drug history, tobacco use pre- and during pregnancy, and abuse victimization. Regression solution was F(6,138) = 6.66, p < .0001. (Hayes et al., 2002). Conclusion Preliminary results (Table 3) showed that mothers rated infant temperament as less alert as frequency of binge drinking episodes (r = -.76, p<.01) and amount consumed during bingeing (r = -.57, p<.01) increased. Infant irritability also increased with consumption during bingeing (r=.50, p<.05) as well as absolute alcohol per drinking day pre-pregnancy (AA/DD: r=.47, p<.05). For infant sleep habits (Table 2), co-sleeping between mother and child was associated with both pre-pregnancy binge drinking episodes and MAST scores, particularly following night waking. Bedtime routine and regular bedtime and rise time were lower with higher estimates of alcohol consumption pre-pregnancy (AA/DD; AA/D). Maternal alcohol use and infants’ alertness, irritability, and poor sleep habits are functionally consistent with our prior finding of poor settling, sleep fragmentation and increased arousals in offspring of women with increased alcohol use. Prenatal Alcohol Exposure Estimates: increased co-sleeping decreased bedtime routine decreased alertness increased irritability Hypothesis In this study, maternal reports of infant temperament and sleep habits were examined in relation to maternal drinking patterns with the hypothesis that maternal alcohol reports would be associated with infant difficult temperament and poor sleep habits. Procedure • Maternal Assessments. Pregnant women are interviewed for alcohol ingestion during the third trimester using the quantity-frequency-variability method (Jacobson et al., 1991). Infants of women reporting no alcohol use will be compared to those with a history of significant use. Table 5 shows the means of selected maternal measures. • Michigan Alcohol Screening Test (MAST; Selzer, 1971) is a structured interview consisting of 25 questions that emphasize a history of problems associated with alcohol. • T-ACE (Sokol, Martier, & Ager, 1989) is used as a screening tool to determine tolerance plus three questions from the CAGE (Russell, 1994) for alcohol addiction. • TWEAK (Chan, Pristach, Welte, & Russell, 1993) is a 6 question screening tool used to identify women who are risk drinkers. • Infant Assessments.At well-child checkups during the first 6 months, mothers reported on infant behavior and responsiveness using the Mother and Baby Scales (MABS), and the Sleep Habits Inventory • 1. Mother and Baby Scales(MABS; Wolke & St. James-Roberts, 1987) is a 43-item self- • report questionnaire that includes 5 subscales: Unsettled-Irregular, Alertness-Responsiveness, • Easiness, Parental Lack of Confidence in Caretaking, and Global Parental Confidence. • 2. Sleep Habit Inventory (SHI; modeled after Crowell, et al. 1987) measures each child’s sleep habits, nighttime behaviors, as well as parent-child interactions around, and parental guidelines for bedtime, rise time, night waking, problem sleep, sleep onset, sleep aids, and unusual sleep occurrences during the past week. References Behnke, M., & Eyler, F. D. (1993). The consequences of prenatal substance use for the developing fetus, newborn, and young child. International Journal of Addiction, 28, 1341-1391. Hayes, M. J., Brown, E., Hofmaster, P. A., Davare, A. A., Parker, K. G., & Raczek, J. A. (2002). Prenatal alcohol intake in a rural, Caucasian clinic. Family Medicine, 34(2), 120-125. Jacobson, S. W., Jacobson, J. L., Sokol, R. J., Martier, S. S., Ager, J. W., & Kaplan, M. G. (1991). Maternal recall of alcohol, cocaine, and marijuana use during pregnancy. Neurotoxicology & Teratology, 13(5), 535-540.   Scher, M. S., Richardson, G. A., Coble, P. A., Day, N. L., & Stoffer, D. S. 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