“When Was Your Last Drink?” – A Prenatal Screening in Brazzaville

Background: Prenatal alcohol exposure (PAE) is the leading identifiable cause of developmental disorders and birth defects in the world. Women continuing using alcohol post-pregnancy recognition put their pregnancy at the greatest risk. We could not identify any prevention programs or studies investigating PAE in the Republic of the Congo. In a population with high infant mortality, high maternal mortality, high birth rate, and low health care rankings, an examination of PAE is needed. Purpose: To determine the prevalence of PAE, especially late-term alcohol use, among pregnant women in Brazzaville, the largest city in the Republic of the Congo. Methods: 1142 pregnant women were screened using the "When Was Your Last Drink?” screen during a prenatal visit. Health professionals screened the women during prenatal care visits at 10 clinics in Brazzaville. Results/Conclusions: Of the 1142 women, 280 (24.5%) reported PAE. In South Africa, with the world's highest reported rate of fetal alcohol syndrome, the urban PAE rate is 34%, and in rural populations, the PAE rate is 46%-51%. In Brazzaville, the rate of third trimester PAE, after pregnancy recognition, is 9.4%. In the United States, third trimester PAE is about 5%. Brazzaville's PAE rates suggest that 1 in 11 births meet criteria for high levels of PAE. This increases risk for high prevalence of PAE related adverse outcomes, especially in a large population. Since PAE is preventable, emphasis on developing culturally appropriate, early pregnancy interventions are needed. Low-cost programs improving the capacity of prenatal care providers are urgently needed.