Pre-pregnancy drinking: How drink size affects risk assessment One of the leading causes of mental retardation in the United States is fetal alcohol syndrome or FAS. Alcohol is the most commonly abused substance by pregnant women because it's legal and socially acceptable. A greater majority of young women are not aware of the complications that are involved with pregnancy. They see pregnancy as a way of bringing a life into the world but do not use the necessary safety measure in their dietary habits to prevent such damage or inhibitions of such a life. By continuing on their drinking binge throughout their pregnancy, they can cause an inexplicable damage to herself and the fetus she is carrying.

In my opinion, any amount of alcohol combined with pregnancy can cause devastating effects to the fetus. 'Neuro behavioral deficits have been found in infants whose mothers reported fewer than seven standard drinks a week, and the effects of drinking in early pregnancy (the first trimester) are among the more severe of alcohol's effects on the fetus, causing irreversible facial malformations and neurological damage' (Kaskutas & Graves, 2001). Lee Ann Kaskutas and Karen Graves believes that the precision of measurement of how much a woman drinks throughout pregnancy is very important to the assessment of fetal risk (2001). The title of their study, 'Pre-pregnancy drinking: How drink size affects risk assessment', can help us conclude that the independent variables are the drink sizes and the dependent variable is the risk assessment. From the introduction section, I have learned that in the United States, American Indians and African Americans are at the highest risk for FAS.

Even though there have been advances in research methodology, people can have a misconception on the concept of what is a standard drink. When asked how much they drank on previous surveys, previous participants had a misconception on the drink sizes. 'This has implications for FAS risk assessment, as underestimates of alcohol consumptions could lead researchers to conclude that increasingly lower safe thresholds of consumption are called for' (Kaskutas & Graves, 2001). The authors found that half of the subjects under study have underestimated the amount of alcohol in their various drinks. The authors believed that most women are not aware of their pregnant status for several months, therefore their patterns of drinking during pregnancy may be best represented by their drinking during the 12 months prior to pregnancy. 'We report here on an innovative method that assessed drink size without reliance on research subjects' judgment of the number of ounces in their usual drinks, instead employing vessel models to enable research participants to indicate their drink sizes, for a period prior to knowing they were pregnant' (Kaskutas & Graves, 2001).

The subjects for this research were 221 women, mostly living in urban areas. 70 of them were Native Americans, 129 were African Americans and 22 were Caucasians. These women were drawn July 1996-97 from prenatal clinics, general health clinics and women-infant-children clinics in Los Angeles and San Francisco Bay area. These women were asked how much did they drink across beverage types ('graduated frequency' across beverages) and how big those drinks were (Respondent-defined drink sizes, by beverage). The self-defined size that the women drank is then compared to the standard size for that beverage. Through a series of calculations, Kaskutas & Graves figured out the amount of over- or under-reporting that is engendered by assuming respondents convert their actual drink sizes into requested standard drink sizes for beer, wine and spirits, and into ethanol-equivalent standard drink sizes for malt liquor, wine coolers and fortified wine (2001).

Wilcoxon's non-parametric statistical procedure was used to compare 'the number of drinks and the number of grams of ethanol based on standard drink size versus self-defined drink size, by beverage type and by risk categories' (Kaskutas & Graves, 2001). The subjects in this research consumed alcohol frequently during the 12 months prior to knowing that they were pregnant. On most cases, the self-selected drink sizes were significantly higher than the standard drink size. Also, the ethanol percentages were higher than most people would assume. Self-selected portion size was significantly greater than that of standard portion size. By looking at the tables in Kaskutas & Graves' research, one can see that the number of standard drink increase from 1.

7 to 4. 3 per day and grams of ethanol increased from 18. 7 to 46. 7 per day. 'These findings demonstrate that when asking some groups of women about their drinking, reliance on standard drinks results in considerable underestimation of alcohol consumption, especially among the heavier drinkers and those consuming higher alcohol content beverages' (Kaskutas & Graves, 2001). It is concluded in this research that standard drink sizes assume a much smaller size than self-defined drink sizes.

The authors did note that this study has several limitations. First, their sample included only few white subjects with no Hispanics, Asians and other ethnic groups. Also, 'the vessels methodology should be used with expanded samples to determine whether large drink sizes are represented among other groups of pregnant women' (Kaskutas & Graves, 2001). Future research could include specifications of standard drink size for different types of alcohol when assessing risk for FAS. 'Consideration of drink size represents a promising avenue both for alcohol research and for alcohol prevention and education, with pregnant women and more broadly with the general population' (Kaskutas & Graves, 2001). ReferenceKaskutas, L.

A. , Graves, K. (2001). Pre-pregnancy: How drink sizes affects risk assessment. Addiction, Vol 96 (8), 1199-1209.