Vivia V McCutcheon1, Kathleen K Bucholz2, Alexandra N Houston-Ludlam3, Mary Waldron4, Andrew C Heath2. 1. Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA. Electronic address: vmccutcheon@wustl.edu. 2. Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA. 3. Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA; Medical Scientist Training Program, Washington University School of Medicine in St. Louis, MO, USA; Human and Statistical Genetics, Division of Biology and Biomedical Sciences, Washington University School of Medicine in St. Louis, MO, USA. 4. Department of Psychiatry, Washington University School of Medicine, 660 S. Euclid Avenue, Box 8134, St. Louis, MO, 63110, USA; Department of Counseling and Educational Psychology, School of Education, Bloomington, Indiana University, IN, USA.
Abstract
BACKGROUND: We tested variation in the timing of child and maternal mortality associated with severe maternal AUD, as represented by recurrent arrests for driving under the influence of alcohol (rDUI). METHODS: rDUI mothers (N = 1614) and Controls with no alcohol-related driving offenses (N = 109,928) who gave birth in Missouri from 2000 to 2004 were identified using vital records. Propensity score matching adjusted for birth record measures including delayed prenatal care, smoking during pregnancy, relationship with reproductive partner [married/unmarried, paternity acknowledged/unacknowledged], partner DUI status from driving records, and for socioeconomic characteristics of maternal residential census tract at birth derived from census data. Survival analysis was used to test months from childbirth to child or maternal death as a function of lifetime rDUI status. RESULTS: Maternal rDUIs were associated with a consistently elevated probability of child mortality from birth through child age 17 after propensity score-adjustment (Hazard Ratio [HR] = 1.70, 95 % CI = 1.17-2.47). Maternal mortality was not elevated, relative to Controls, until child age 6-11 (HR = 1.58, 95 % CI = 1.05-2.35) and increased again from child age 12-17 (HR = 4.12, 95 % CI = 3.04-5.86). CONCLUSIONS: Severe maternal AUD, as characterized by rDUI, increases the risk for child mortality over that of Controls through age 17. Delays in rDUI maternal mortality until child age 6 may indicate a period when maternal referral for intervention to reduce harm to child and mother is likely to be especially effective.
BACKGROUND: We tested variation in the timing of child and maternal mortality associated with severe maternal AUD, as represented by recurrent arrests for driving under the influence of alcohol (rDUI). METHODS: rDUI mothers (N = 1614) and Controls with no alcohol-related driving offenses (N = 109,928) who gave birth in Missouri from 2000 to 2004 were identified using vital records. Propensity score matching adjusted for birth record measures including delayed prenatal care, smoking during pregnancy, relationship with reproductive partner [married/unmarried, paternity acknowledged/unacknowledged], partner DUI status from driving records, and for socioeconomic characteristics of maternal residential census tract at birth derived from census data. Survival analysis was used to test months from childbirth to child or maternal death as a function of lifetime rDUI status. RESULTS: Maternal rDUIs were associated with a consistently elevated probability of child mortality from birth through child age 17 after propensity score-adjustment (Hazard Ratio [HR] = 1.70, 95 % CI = 1.17-2.47). Maternal mortality was not elevated, relative to Controls, until child age 6-11 (HR = 1.58, 95 % CI = 1.05-2.35) and increased again from child age 12-17 (HR = 4.12, 95 % CI = 3.04-5.86). CONCLUSIONS: Severe maternal AUD, as characterized by rDUI, increases the risk for child mortality over that of Controls through age 17. Delays in rDUI maternal mortality until child age 6 may indicate a period when maternal referral for intervention to reduce harm to child and mother is likely to be especially effective.
Authors: Vivia V McCutcheon; Arpana Agrawal; Andrew C Heath; Howard J Edenberg; Victor M Hesselbrock; Marc A Schuckit; John R Kramer; Kathleen K Bucholz Journal: Alcohol Clin Exp Res Date: 2011-06-01 Impact factor: 3.455
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