Shaun Daidone, Hayrunnisa Unlu, Asmaa Yehia, Nan Zhang, Osama A Abulseoud
{"title":"Severe alcohol withdrawal during pregnancy or early postpartum: maternal and fetal outcomes.","authors":"Shaun Daidone, Hayrunnisa Unlu, Asmaa Yehia, Nan Zhang, Osama A Abulseoud","doi":"10.1007/s00737-024-01531-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Alcohol withdrawal syndrome (AWS) during pregnancy is under-researched despite growing concerns about increased alcohol use among pregnant women. This study aims to explore the severity of AWS and its impact on maternal and fetal outcomes.</p><p><strong>Methods: </strong>This retrospective study reviewed the medical records of patients admitted to the Mayo Clinic who underwent the CIWA-Ar protocol for AWS from June 2019 through June 2022. Pregnant women identified in this cohort had their pregnancy, labor, and neonatal data analyzed for alcohol-related complications and outcomes.</p><p><strong>Results: </strong>Out of the medical records reviewed, 8 cases involved pregnant women experiencing AWS. These cases showed a high severity of withdrawal symptoms, with a median peak CIWA-Ar score of 17 (IQR = 14). Maternal complications included a high rate of ICU admissions (37.5%; n = 3) and significant rates of miscarriage and stillbirth (37.5%; n = 3). Fetal outcomes were concerning, with 1 out of 5 (20%) neonates requiring NICU admission and experiencing conditions such as respiratory failure and neonatal abstinence syndrome. Developmental problems were noted in 2 out of 5 (40%) newborns.</p><p><strong>Conclusions: </strong>The findings highlight the severe implications of AWS during pregnancy, impacting both maternal and fetal health. The severity of AWS requires attentive clinical management and preventative interventions. Future research should focus on larger, prospective studies to better understand and address the risks associated with AWS in pregnant women and to improve health outcomes for mothers and their children.</p><p><strong>Article highlights: </strong>• Severe AWS during pregnancy leads to high ICU admissions and adverse neonatal outcomes. • 37.5% of pregnant women with AWS experienced miscarriage or stillbirth. • 20% of newborns from mothers with AWS required NICU admission for serious conditions; 40% of newborns had developmental problems. • Findings underscore the need for specialized treatment protocols to improve outcomes for pregnant women and their newborns.</p>","PeriodicalId":8369,"journal":{"name":"Archives of Women's Mental Health","volume":" ","pages":""},"PeriodicalIF":3.2000,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Women's Mental Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00737-024-01531-4","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: Alcohol withdrawal syndrome (AWS) during pregnancy is under-researched despite growing concerns about increased alcohol use among pregnant women. This study aims to explore the severity of AWS and its impact on maternal and fetal outcomes.
Methods: This retrospective study reviewed the medical records of patients admitted to the Mayo Clinic who underwent the CIWA-Ar protocol for AWS from June 2019 through June 2022. Pregnant women identified in this cohort had their pregnancy, labor, and neonatal data analyzed for alcohol-related complications and outcomes.
Results: Out of the medical records reviewed, 8 cases involved pregnant women experiencing AWS. These cases showed a high severity of withdrawal symptoms, with a median peak CIWA-Ar score of 17 (IQR = 14). Maternal complications included a high rate of ICU admissions (37.5%; n = 3) and significant rates of miscarriage and stillbirth (37.5%; n = 3). Fetal outcomes were concerning, with 1 out of 5 (20%) neonates requiring NICU admission and experiencing conditions such as respiratory failure and neonatal abstinence syndrome. Developmental problems were noted in 2 out of 5 (40%) newborns.
Conclusions: The findings highlight the severe implications of AWS during pregnancy, impacting both maternal and fetal health. The severity of AWS requires attentive clinical management and preventative interventions. Future research should focus on larger, prospective studies to better understand and address the risks associated with AWS in pregnant women and to improve health outcomes for mothers and their children.
Article highlights: • Severe AWS during pregnancy leads to high ICU admissions and adverse neonatal outcomes. • 37.5% of pregnant women with AWS experienced miscarriage or stillbirth. • 20% of newborns from mothers with AWS required NICU admission for serious conditions; 40% of newborns had developmental problems. • Findings underscore the need for specialized treatment protocols to improve outcomes for pregnant women and their newborns.
期刊介绍:
Archives of Women’s Mental Health is the official journal of the International Association for Women''s Mental Health, Marcé Society and the North American Society for Psychosocial Obstetrics and Gynecology (NASPOG). The exchange of knowledge between psychiatrists and obstetrician-gynecologists is one of the major aims of the journal. Its international scope includes psychodynamics, social and biological aspects of all psychiatric and psychosomatic disorders in women. The editors especially welcome interdisciplinary studies, focussing on the interface between psychiatry, psychosomatics, obstetrics and gynecology. Archives of Women’s Mental Health publishes rigorously reviewed research papers, short communications, case reports, review articles, invited editorials, historical perspectives, book reviews, letters to the editor, as well as conference abstracts. Only contributions written in English will be accepted. The journal assists clinicians, teachers and researchers to incorporate knowledge of all aspects of women’s mental health into current and future clinical care and research.