BORN WITHOUT OH: an Innovating Model for Preventing and Managing the Neurodevelopmental Disorders Caused by Alcohol and Drug Prenatal Exposure In a Mediterranean Region

Abstract

Background: Born without OH is a comprehensive program of prevention, reduction of harm and management of neurobehavioral disorders associated with prenatal exposure to alcohol and other drugs through the pediatric environmental health from the beginning of pregnancy until the end of adolescence. Our objective is to prevent and reduce damage from exposure to alcohol and other drugs during critical periods of development (periconceptional until the end of adolescence). Methods: Beginning in 2009, at the University Clinical Hospital Virgen de la Arrixaca (Murcia, Spain), the GREEN SHEET was implemented in hospital and primary care. It is a set of basic and concise questions for women in the 1st trimester of pregnancy to detect the environmental risk factors related to alcohol and other drugs in early pregnancy. Those with high-risk criteria of prenatal exposure to alcohol and other drugs pass to a follow-up program called ELIJO MAS SANO (CHOOSE HEALTHIER): early and comprehensive intervention for the management and monitoring of pregnant women and / or children at risk of fetal alcohol spectrum disorders (FASD). Results: In the follow-up of 200 children in the program ELIJO MÁS SANO, there was a significant decrease (p <0.05) in women who drank some alcohol in early pregnancy and the amount of alcohol drunk by the couple. There was a decrease in the number of newborns with congenital heart disease associated with intrauterine exposure to ethanol controlled by the number of births and abortions. There were 6 children diagnosed with fetal alcohol syndrome (FAS) (in 1500 pregnant couples), estimating a prevalence of 4 cases of FAS per 1,000 newborns in the region of Murcia. Conclusions: The Born without OH programme has been implemented with good preliminary results: reducing the consumption of alcohol during pregnancy, decreased congenital heart diseases related to intrauterine exposure to alcohol and registration of syndromes and alcohol-related birth defects.

Full text

Paediatric Environmental Health Speciality Unit.
Psychology of Children and Adolescents.
Paediatrics Service. Laboratory Environment and
Human Health. IMIB. Clinical Universitary Hospital
Virgen de la Arrixaca, Murcia, Spain
PROGRAMA NACER Y CRECER SIN OH:
AN INNOVATING MODEL FOR PREVENTING AND
MANAGING THE NEURODEVELOPMENTAL DISORDERS
CAUSED BY ALCOHOL AND DRUG PRENATAL
EXPOSURE IN A MEDITERRANIAN REGION
8th INTERNATIONAL NETWORK ON CHILDREN´S
HEALTH, ENVIROMENT AND SAFETY
Azurmendi Funes M.L., Tobarra Sánchez E.,
Sánchez Sauco M.F., Cárceles Alvarez A.,
Campillo i López F., Jaimes Vega D.C,
Pernas Barahona A., Saura Martínez I.,
Orozco Llamas M.A., Ortega García J.A

BIRTH AND GROWTH
WITHOUT OH
INTRODUCTION
BIRTH AND GROWTH
WITHOUT OH:
BIRTH AND GROWTH
WITHOUT OH:
Birth and without OH is a comprehensive
program of prevention, reduction of harm and
management of neurobehavioral disorders
associated with prenatal exposure to alcohol
and other drugs through the pediatric
environmental health from the beginning of
pregnancy until the end of adolescence.
Nacer sin OH=
Birth without OH
Nacer y crecer sin OH=
Birth and growth without OH

BIRTH AND GROWTH
WITHOUT OH
OBJETIVES
PREVENT AND REDUCE DAMAGE FROM
EXPOSURE TO ALCOHOL AND OTHER
DRUGS DURING CRITICAL PERIODS OF
DEVELOPMENT (PERICONCEPTIONAL
UNTIL THE END OF ADOLESCENCE).
INCREASE THE NUMBER OF HEALTHY
PREGNANCIES FROM EARLY PREGNANCY
IN REGION OF MURCIA, SPAIN.

OBJETIVES


EMPOWER PREGNANT COUPLES AND
TEENAGERS, NOT TO DRINK OR USE
OTHER DRUGS, THROUGH THE CREATION
OF HEALTHIER ENVIRONMENTS FROM THE
PERSPECTIVE OF HUMAN ECOLOGY
IMPROVE ACADEMIC PERFORMANCE AND
SOCIAL INTEGRATION OF CHILDREN / AND
ADOLESCENTS AFFECTED BY PRENATAL
EXPOSURE TO ALCOHOL AND OTHER
DRUGS IN THE REGION OF MURCIA, SPAIN
BIRTH AND GROWTH
WITHOUT OH

BIRTH AND GROWTH WITHOUT OH: 3 PARTS
BIRTH AND GROWTH
WITHOUT OH
PRENATAL
     HOJA VERDE 

     HOJA VERDE 

CAMPAIGNS    
      
      
      
      

CAMPAIGNS    
      
      
      
      

     MOBILE APP MHEALTH
      
        
       

     MOBILE APP MHEALTH
      
        
       


BORN WITHOUT OH: 3 PARTS
BIRTH AND GROWTH
WITOUT OH
NEONATAL
LEAFLETS ON ALCOHOL AND PREGNANCY 


LEAFLETS ON ALCOHOL AND PREGNANCY 


FOREST FOR HEALTH CAMPAIGN
        
       
       

FOREST FOR HEALTH CAMPAIGN
        
       
       


BORN WITHOUT OH: 3 PARTS
BIRTH AND GROWTH
WITOUT OH
POSTNATAL
(childhood-
adolescence)
 GOOD ENVIROMENTAL HEALTH PRACTICES 
       

 GOOD ENVIROMENTAL HEALTH PRACTICES 
       

CONTEST HIGH SCHOOL 



CONTEST HIGH SCHOOL 



VISITS TO FOREST HEALTH 

VISITS TO FOREST HEALTH 


MATERIAL AND METHODS
BEGINNING IN 2009 AT THE UNIVERSITARY CLINICAL HOSPITAL
VIRGEN DE LA ARRIXACA (MURCIA, SPAIN).
IMPLEMENTATION IN HOSPITAL CARE AND PRIMARY
CARE OF THE HOJA VERDE: A SET OF BASIC AND
CONCISE QUESTIONS TO WOMEN IN THE 1ST
TRIMESTER OF PREGNANCY TO DETECT THE
ENVIRONMENTAL RISK FACTORS RELATED TO
ALCOHOL AND OTHER DRUGS AMONG OTHERS
ENVIROMENTAL RISK FACTORS (socioeconomic,
obstetric-reproductive history, ionizing radiation, drugs,
occupational exposures, legal and illegal drugs, hobbies
of chemical risk, pesticide exposure)
LA HOJA VERDE
BIRTH AND GROWTH
WITOUT OH

Those with high-risk criteria by
prenatal exposure to alcohol and
other drugs proceed to a follow-up
program called ELIJO MAS SANO:
early and comprehensive
intervention for the management and
monitoring of pregnant women and /
or children at risk of Fetal Alcohol
Spectrum Disorders (FASD).
ELIJO MAS SANO REGISTRY
INCLUSION CRITERIA
(periconceptional, gestation or
lactation stages)
> 20 g/day ALCOHOL
3 INCIDENTS OF BINGE
DRINKING OF ≥ 40 g/day
FETAL EXPOSURE TO ANY ILLEGAL
DRUG IN LEAST ONCE A WEEK
BIRTH AND GROWTH
WITOUT OH
CHOOSE HEALTHIER REGISTRY=
REGISTRO ELIJO MAS SANO
CHOOSE HEALTHIER REGISTRY=
REGISTRO ELIJO MAS SANO

ELIJO MAS SANO: AN EARLY
INTERVENTION PROGRAM
BIRTH AND GROWTH
WITOUT OH
     
       
        

     
       
        

      

   

      

   

   
POSSIBLE ACTIONS
   
POSSIBLE ACTIONS

INDIVIDUALIZED INTERVENTION OF HARM REDUTION
BIRTH AND GROWTH
WITOUT OH
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1
2
3
4
5

RESULTS
BIRTH AND GROWTH
WITOUT OH
3600 GREEN LEAVES MADE
TRACKING 212 CHILDREN OF HIGH ENVIRONMENTAL RISK IN
ELIJO MAS SANO PROGRAM.
COMMISSIONING OF THE HOJA VERDE APP.
FOREST HEALTH CAMPAIGN: MORE THAN 870 SEEDLINGS
PLANTED IN NOVEMBER 2015
SIGNIFICANT DECREASE (P <0.05) OF WOMEN WHO DRINK
SOME ALCOHOL IN EARLY PREGNANCY AND THE AMOUNT OF
ALCOHOL IN THE COUPLE.

RESULTS
BIRTH AND GROWTH
WITOUT OH
DECREASE IN THE NUMBER OF NEWBORNS WITH CONGENITAL
HEART DISEASE ASSOCIATED WITH INTRAUTERINE EXPOSURE
TO ETHANOL CONTROLLED BY THE NUMBER OF BIRTHS AND
ABORTIONS.
6 CHILDREN DIAGNOSED WITH FETAL ALCOHOL SYNDROME
BORN IN THE FIRST 1500 PREGNANT COUPLES.

CONCLUSIONS
BIRTH AND GROWTH
WITOUT OH
The program of prevention and harm reduction by intrauterine exposure
to alcohol and other drugs has been implemented with good preliminary
results:
REDUCING THE CONSUMPTION OF ALCOHOL DURING PREGNANCY
DECREASED CONGENITAL HEART DISEASES RELATED TO INTRAUTERINE EXPOSURE TO
ALCOHOL
REGISTRATION OF SYNDROMES AND ALCOHOL-RELATED BIRTH DEFECTS

YOU CAN FOLLOW US ON OUR BLOG!!!!!
BIRTH AND GROWTH
WITOUT OH
http://www.pehsu.org/wp

8th CONFERENCE
BARCELONA
14-16th SEPTEMBER 2016
•Mount Sinai International Exchange Program for
Minority Students (grant MD001452) from the
national Center on Minority Health and Health
Disparities of the U.S. National Institutes of Health
•Nacer y Crecer sin OH Program Regional
cordination of DG Public Health and Drug
Addiction, The Regional Ministry of Health, Murcia,
Spanish National Plan on Drugs , Ministry of
Health, Social Services and Equality, Madrid,
Spain.
ACKNOWLEDGMENTS