Huang AM, Neale MN, Darveau SC, Sagliba MJ, Moreno AJ, Urbina MPG, Tallo V, McDonald EA, Jiz MA and Friedman JF (2023) Knowledge, attitudes, practices, and beliefs regarding prenatal alcohol consumption among women in Leyte, the Philippines. Front. Glob. Womens Health 4:1156681. doi: 10.3389/fgwh.2023.1156681
Objectives: Fetal alcohol spectrum disorder (FASD) captures the broad range of emotional, cognitive, behavioral, and congenital abnormalities associated with maternal alcohol consumption, and women living in resource-limited settings may be higher risk. This study aims to examine knowledge, attitudes, practices, and beliefs (KAPB) of women in Leyte, The Philippines regarding prenatal alcohol consumption.
Methods: One hundred postpartum women were recruited from a birth cohort in Leyte. A prenatal alcohol use KAPB survey was constructed in Waray, the local language. The survey was administered in June-September 2019. Descriptive statistics, chi-squared test, and Fisher’s exact test were used to analyze responses.
Results: Seventy-five percent of subjects reported drinking tuba, a local palm wine, during pregnancy. Most participants (75%) did not believe tuba contained alcohol. Women who believed tuba contains no alcohol were more likely to drink tuba during pregnancy (81.3%) than women who believed tuba contains alcohol (56.0%), X2(1, N = 100) = 6.41, p = .011. Women who drank tuba during pregnancy were more likely to believe tuba has health benefits (60%) than women who did not drink tuba during pregnancy (12%), Fisher’s exact p < .05, citing increased red blood cell count and unproven antiparasitic qualities. Fifteen percent of subjects reported having fed their babies tuba. Nearly all (98%) were willing to attenuate tuba/alcohol consumption if told that this practice negatively impacts pregnancies.
Conclusion: Misinformation about tuba appears widespread in Leyte. Educating women of reproductive age in Leyte regarding prenatal tuba use may lead to a reduction in tuba use.
Detailed key findings/implications
• Currently, little is known about prenatal alcohol consumption and FASD in low- and middle-income countries (LMICs). FASD is entirely preventable if pregnant women abstain from alcohol during pregnancy. It is likely that women in resource limited settings, such as Leyte, The Philippines, may be at high risk of giving birth to children with FASD due to a lack of systemic preventative education surrounding alcohol use in pregnancy, later confirmation of pregnancy, and consumption of unregulated alcohol brews that are locally made. This study examines the knowledge, attitudes, practices, and beliefs surrounding prenatal alcohol consumption, with a focus on tuba, a local, unregulated and commonly consumed palm wine in Leyte, The Philippines.
• Our findings are potentially generalizable to other regions of the world, specifically LMICs, where similar practices exist. Per this study, many women may be unaware that locally fermented beverages contain alcohol and that alcohol may harm the fetus. Thus, opportunities exist to target interventions that address this knowledge gap, helping decrease the risk of fetal alcohol spectrum disorder worldwide.
• Misinformation about tuba as an alcoholic beverage appears to play a role in the practices surrounding maternal and pediatric tuba consumption in Leyte, The Philippines. Most participants in our study reported consumption of alcohol during pregnancy. Future work should focus on incorporating tuba screening into already existing structures for alcohol and tobacco smoking screening at prenatal visits. Data from this study can inform local health departments in the creation of health education materials and/or programs addressing prenatal alcohol use for women of childbearing age.