Case-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposure

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dc.contributor.advisorLondon, Leslieen_ZA
dc.contributor.authorKatwan, Elizabethen_ZA
dc.date.accessioned2014-11-08T14:32:49Z
dc.date.available2014-11-08T14:32:49Z
dc.date.issued2010en_ZA
dc.descriptionIncludes bibliographical references.en_ZA
dc.description.abstractBackground Prenatal alcohol exposure can result in a range of permanent birth defects known as Fetal Alcohol Spectrum Disorders (FASD). Fetal Alcohol Syndrome (FAS), which detrimentally affects the neurodevelopmental, physical, and social capabilities of children, is the most severe diagnosis on this scale of disorders. Research suggests that FASD rates exceed FAS in various populations. South Africaâs Western Cape region has one of the highest rates of FAS in the world. Hypothesis In populations where the prevalence of full-blown FAS is already known to be high, such as the Western Cape, other, less severe childhood developmental and behavioural disorders may be due to prenatal alcohol exposure. Objectives The aim of this research was to determine the odds of maternal alcohol use in children with behavioural and/or developmental disorders (BDD) in comparison to children free from behavioural disorders. This project also examined the average utilisation of health services by children with BDD as an arm of a larger study on the economic burden of FAS in South Africa. Methods Opportunistic sampling was employed to select parents or caretakers of 110 children aged 4 to 12 for interviews at a tertiary childrenâs public hospital in Cape Town. Health service utilization and maternal alcohol consumption habits were compared between 55 cases, children with BDD and 55 controls, children free from such disorders. Univariate analyses and logistic regression methods were used to determine these associations. Ethics The University of Cape Town Research Ethics Committee approved this study. Dr. T. Blake, Senior Medical Superintendent of Red Cross War Memorial Childrenâs Hospital granted access to Red Cross Hospital. Before each study interview was conducted, informed consent, which emphasized confidentiality of responses and the right to refuse to answer a question or withdraw from the interview, was taken from the adult respondent. We also explained to participants that they would remain anonymous and that their answers would not affect their childâs treatment in the clinics. Results BDD were significantly associated with current maternal alcohol consumption, maternal binge drinking in the last six months, and maternal alcohol use six months before pregnancy, but not significantly with reported maternal gestational drinking. The median number of visits to a clinic in the last six months was significantly higher for cases than for controls. Conclusions Childhood BDD among our study participants were not attributed to prenatal alcohol exposure. Current maternal alcohol consumption has a significant impact on BDD in children, possibly serving as a proxy for unstable home environments. The competing environmental factors that influence childhood BDD warrants further research.en_ZA
dc.identifier.apacitationKatwan, E. (2010). <i>Case-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposure</i>. (Thesis). University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/9409en_ZA
dc.identifier.chicagocitationKatwan, Elizabeth. <i>"Case-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposure."</i> Thesis., University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2010. http://hdl.handle.net/11427/9409en_ZA
dc.identifier.citationKatwan, E. 2010. Case-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposure. University of Cape Town.en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Katwan, Elizabeth AB - Background Prenatal alcohol exposure can result in a range of permanent birth defects known as Fetal Alcohol Spectrum Disorders (FASD). Fetal Alcohol Syndrome (FAS), which detrimentally affects the neurodevelopmental, physical, and social capabilities of children, is the most severe diagnosis on this scale of disorders. Research suggests that FASD rates exceed FAS in various populations. South Africa&amp;amp;acirc;s Western Cape region has one of the highest rates of FAS in the world. Hypothesis In populations where the prevalence of full-blown FAS is already known to be high, such as the Western Cape, other, less severe childhood developmental and behavioural disorders may be due to prenatal alcohol exposure. Objectives The aim of this research was to determine the odds of maternal alcohol use in children with behavioural and/or developmental disorders (BDD) in comparison to children free from behavioural disorders. This project also examined the average utilisation of health services by children with BDD as an arm of a larger study on the economic burden of FAS in South Africa. Methods Opportunistic sampling was employed to select parents or caretakers of 110 children aged 4 to 12 for interviews at a tertiary children&amp;amp;acirc;s public hospital in Cape Town. Health service utilization and maternal alcohol consumption habits were compared between 55 cases, children with BDD and 55 controls, children free from such disorders. Univariate analyses and logistic regression methods were used to determine these associations. Ethics The University of Cape Town Research Ethics Committee approved this study. Dr. T. Blake, Senior Medical Superintendent of Red Cross War Memorial Children&amp;amp;acirc;s Hospital granted access to Red Cross Hospital. Before each study interview was conducted, informed consent, which emphasized confidentiality of responses and the right to refuse to answer a question or withdraw from the interview, was taken from the adult respondent. We also explained to participants that they would remain anonymous and that their answers would not affect their child&amp;amp;acirc;s treatment in the clinics. Results BDD were significantly associated with current maternal alcohol consumption, maternal binge drinking in the last six months, and maternal alcohol use six months before pregnancy, but not significantly with reported maternal gestational drinking. The median number of visits to a clinic in the last six months was significantly higher for cases than for controls. Conclusions Childhood BDD among our study participants were not attributed to prenatal alcohol exposure. Current maternal alcohol consumption has a significant impact on BDD in children, possibly serving as a proxy for unstable home environments. The competing environmental factors that influence childhood BDD warrants further research. DA - 2010 DB - OpenUCT DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Case-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposure TI - Case-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposure UR - http://hdl.handle.net/11427/9409 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/9409
dc.identifier.vancouvercitationKatwan E. Case-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposure. [Thesis]. University of Cape Town ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2010 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/9409en_ZA
dc.language.isoengen_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.titleCase-control study of the association of use of health services by children with behavioural and developmental disorders with prenatal alcohol exposureen_ZA
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationnameMPHen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceThesisen_ZA
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