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FAS Primary Prevention In a FAS Diagnostic Clinic

FAS Primary Prevention In a FAS Diagnostic Clinic. Susan J. Astley, Ph.D. Sterling K. Clarren, M.D. Diane Bailey, M.N. Christina Talbot, M.S.W. Washington State FAS Diagnostic and Prevention Network (FAS DPN). Primary Questions. Primary Questions

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FAS Primary Prevention In a FAS Diagnostic Clinic

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  1. FAS Primary PreventionIn a FAS Diagnostic Clinic Susan J. Astley, Ph.D. Sterling K. Clarren, M.D. Diane Bailey, M.N. Christina Talbot, M.S.W. Washington State FAS Diagnostic and Prevention Network (FAS DPN)

  2. Primary Questions Primary Questions 1. What is the profile of this high-risk population? 2. What factors enhanced / hindered their ability to achieve sobriety and practice effective birth control? Maternal Interview 3-4 hour personal interview (87% enrollment success) Key topics Sociodemographics (age, race, education) Social support network Lifetime adverse events Mental health profile Alcohol use and treatment history Family planning history and preferences

  3. Maternal Age at Key Events (n = 80) Age MeanMin-Max At first drink 15 7 - 30 At maximum drinking 23 10 - 41 At first attempt to stop 26 14 - 47 At birth of child with FAS 27 18 - 41 At most successful sobriety 31 20 - 52 At diagnosis of child with FAS 35 21 - 52 At interview 38 23 - 55

  4. Maternal Age

  5. Maternal Race, Education

  6. Maternal IQ

  7. Lifetime Abuse of Mother

  8. Maternal Mental Health

  9. Maternal Mental Health

  10. Earliest Age of Onset of Mental Health Disorder N% Childhood (0 - 8 years) 33 (45 %) Adolescent (9 - 17 years) 31 (42 %) Adult (18+ years) 10 (14 %)

  11. Maternal Drug Use

  12. Why she did not want to reduce alcohol use

  13. Why she did not seek Alcohol Treatment

  14. Reproductive History meanmaximum Proportion of Pregnancies/woman Unplanned 77 % 100 % No birth control 81 % 100 % Exposed to alcohol 73 % 100 %

  15. Maternal Contraceptive Preference

  16. Children At Risk

  17. Parity of Child with FAS

  18. Significant Contrasts Between Women Who Had And Had Not Achieved Abstinence Abstinent at Time of Interview Yes (n=50)No (n=25) Mean IQ 96 82 Married 52 % 44 % Low Income: yearly income less than $10,000 50 % 76 % Reported a religious affiliation 72 % 44 % Parents had a problem with alcohol use 88 % 64 % Most # of drinks/occasion prior to pregnancy 34 17 Mean # of individuals in social support network 17 11 Mean # of mental health disorders per woman 5 5 Received mental health treatment* 52 % 26 %

  19. Unintended Pregnancies • This study suggested women were more successful at • stopping drinking ( 75 %) than avoiding unintended pregnancy ( 22 %). • 30 years after US Supreme Court legalized contraception • 57 % of U.S. pregnancies unintended (Forrest ‘94) • 78 % pregnancies unintended in women with FAS kids • May be due in part to lack of access to contraception. • 1998 WA State Survey of Health Insurance Plans • Only 30 % paid for contraception. • 77 % paid for abortions • 4 out of 5 women did not have contraceptive coverage

  20. Treatment for Alcoholism • 1992 Survey of 79 King County Alcohol/Drug Treatment Agencies • 33 % of clientele were women • 54 % had no medical or MH services • 84 % had no on-site child care • 44 % had no on-site recovery support groups • Among 80 birth mothers of children with FAS • 96 % had mental health disorders. • Those who received MH treatment more likely to achieve abstinence. • 70 % had children. • Those who entered support groups more likely to achieve abstinence.

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