Severe alcohol withdrawal during pregnancy or early postpartum: maternal and fetal outcomes

TL;DR

Severe alcohol withdrawal during pregnancy is linked to serious maternal and neonatal complications, including ICU admissions, miscarriage, and developmental issues in newborns.

Contribution

This study provides new clinical insights into the severity and outcomes of alcohol withdrawal syndrome in pregnant women.

Findings

37.5% of pregnant women with AWS experienced miscarriage or stillbirth.

20% of newborns required NICU admission, and 40% had developmental problems.

AWS during pregnancy is associated with high ICU admission rates and severe maternal complications.

Abstract

Alcohol withdrawal syndrome (AWS) during pregnancy is under-researched despite growing concerns about increased alcohol use among pregnant women. This study aims to explore the severity of AWS and its impact on maternal and fetal outcomes.

This retrospective study reviewed the medical records of patients admitted to the Mayo Clinic who underwent the CIWA-Ar protocol for AWS from June 2019 through June 2022. Pregnant women identified in this cohort had their pregnancy, labor, and neonatal data analyzed for alcohol-related complications and outcomes.

Out of the medical records reviewed, 8 cases involved pregnant women experiencing AWS. These cases showed a high severity of withdrawal symptoms, with a median peak CIWA-Ar score of 17 (IQR = 14). Maternal complications included a high rate of ICU admissions (37.5%; n = 3) and significant rates of miscarriage and stillbirth (37.5%; n = 3). Fetal outcomes were concerning, with 1 out of 5 (20%) neonates requiring NICU admission and experiencing conditions such as respiratory failure and neonatal abstinence syndrome. Developmental problems were noted in 2 out of 5 (40%) newborns.

The findings highlight the severe implications of AWS during pregnancy, impacting both maternal and fetal health. The severity of AWS requires attentive clinical management and preventative interventions. Future research should focus on larger, prospective studies to better understand and address the risks associated with AWS in pregnant women and to improve health outcomes for mothers and their children.

• Severe AWS during pregnancy leads to high ICU admissions and adverse neonatal outcomes.

• 37.5% of pregnant women with AWS experienced miscarriage or stillbirth.

• 20% of newborns from mothers with AWS required NICU admission for serious conditions; 40% of newborns had developmental problems.

• Findings underscore the need for specialized treatment protocols to improve outcomes for pregnant women and their newborns.