Mei-Sang Yang

BETEL QUID CHEWING AND RISK OF ADVERSE BIRTH OUTCOMES AMONG ABORIGINES IN EASTERN TAIWAN

It is known that substance abuse during pregnancy is associated with increased risk of adverse birth outcomes. The aim of this study was to determine the use of alcohol, cigarettes, betel quid, and drugs among pregnant aboriginal women and to assess the risk of adverse effects of betel quid use on birth outcomes in eastern Taiwan. Of a total of 229 women recruited into this study, 32 women with adverse birth outcomes constituted the case group. Analyses revealed that adverse birth outcomes were associated with maternal betel quid chewing and maternal age. After adjusting for maternal age, the risk of adverse birth outcome was five times higher among betel quid chewing women as compared to substance nonusers. Based on this finding, it is suggested health education, especially when concerned with the harmful effects of substance abuse, which includes betel quid use during pregnancy, should be stressed in concert with routine prenatal care.

The effect of maternal betel quid exposure during pregnancy on adverse birth outcomes among aborigines in Taiwan

In considering documented developmental toxicity and teratogenicity found in earlier research, maternal betel quid chewing may very well be linked to a higher risk of adverse birth outcomes. The aim of this study was to investigate the significance of betel quid chewing, together with the use of cigarettes or alcohol, either independently or combined, on birth-related outcomes. A total of 1264 aboriginal women who had just given birth in 10 hospitals in Southern and Eastern Taiwan were recruited. Information on their maternal and newborn characteristics was obtained from medical charts and by performing personal interviews using a validated questionnaire. Maternal areca nut chewing during pregnancy was found to be significantly associated with both birth weight loss (-89.54 g) and birth length reduction (-0.43 cm). A significantly lower male newborn rate (aOR=0.62) was observed among aboriginal women with a habit of betel quid chewing during pregnancy. The use of this substance conveyed a 2.40- and 3.67-fold independent risk of low birth weight and full-term low birth weight, respectively. An enhanced risk (aOR=3.26-5.99) of low birth weight was observed among women concomitantly using betel quid, cigarette and alcohol during gestation. Our findings suggest that betel quid chewing during pregnancy has a substantial effect on a number of birth outcomes, including sex ratio at birth, lower birth weight and reduced birth length.

Intimate partner violence and minor psychiatric morbidity of aboriginal Taiwanese women.

Objectives. Experiences of abuse increase the risk of psychiatric morbidity in women. This study assesses the prevalence of intimate partner violence and minor psychiatric morbidity and analyzes their association among aboriginal women in Taiwan. Methods. Using system random sampling, 840 aboriginal women between the ages of 18 and 50 years old were recruited from four townships with aboriginal communities in southern Taiwan. Trained primary care nurses interviewed the participants at home by structured questionnaire. Results. One hundred twenty-six of 840 (15%) of the aboriginal women had experienced physical abuse perpetrated by an intimate partner (her husband or cohabitant) during their lifetime; 10.1% had experienced it during the past 12 months; 4.0% had experienced sexual abuse by the partner; and 6.3% had experienced physical abuse during childhood at the hands of one or both parents. Multiple logistic regression revealed that after adjusting for womens age, alcohol and drug use, religious activity and husbands employment status, the experience of abuse (including partner physical abuse, partner sexual abuse, and childhood physical abuse) was significantly associated with suicidal ideation and depression. Conclusions. Health care professionals need to provide adequate support and health education, develop interventions, and use referrals in primary care in the community in order to reduce and prevent domestic violence against aboriginal women in Taiwan.

EPA-0221 - Betel-quid use is associated with the metabolic syndrome among adult aborigines in taiwan

Introduction Betel-quid use, the forth addictive habit in the world after nicotine, alcohol, and caffeine use, and was widespread in southern Asia. Betel-quid use has been associated with obesity and hyperglycemia. It is a popular habit among aborigines in Taiwan. Little research describing the association of the betel-quid use contributes to the metabolic syndrome in aborigines in Taiwan. Aims The aim of the study was to assess the prevalence of metabolic syndrome in adult aborigines and to test whether betel-quid use contributes to the metabolic syndrome. Methods A cross-sectional survey was conducted and 558 aborigines, aged? 40 years who had undergone the health examination in a aboriginal health care center were recruited into this study. The metabolic syndrome was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP/ATP III). Information on substance use (betel-quid, cigarette, alcohol) and depression were obtained by performing personal interviews using a validated questionnaire. Results The prevalence of metabolic syndrome in adult aborigines was 30.6%, the prevalence rate was significantly higher in women than that of men (34.1% compared with 24.1%, OR: 1.57, 95% CI: 1.06-2.36). After covariate adjustment, betel-quid users were more likely to have metabolic syndrome (AOR: 1.51, 95% CI: 1.04-2.21). However, depression was not associated with metabolic syndrome. Conclusions These data suggest that betel-quid use is independently and positively associated with metabolic syndrome in adult aborigines.

494 – Gender difference in harmful alcohol use and adverse drinking consequences among taiwanese aborigines

Introduction Alcohol consumption is a part of the aboriginal culture. It was found that is a predominant health problem in aboriginal community. There was little research describing whether gender differences in harmful drinking and adverse drinking consequence among aborigines. Thus, it is important to evaluate such differences in order to provide evidence for developing interventions in problem drinking. Aims The aim of the study is to examine the gender differences in the prevalence, correlates, and adverse drinking consequences among harmful alcohol users in Taiwanese aborigines. Methods A cross-sectional survey was conducted. 449 study participants, aged 18-60, were recruited into the study from community-dwelling aborigines in southern Taiwan. Alcohol Use Disorders Identification Test (AUDIT) was used to collect information regarding harmful alcohol drinking. Personal characteristics, related risk factors and adverse drinking consequences were assessed by questionnaire. Results The result revealed that the prevalence of harmful drinking in male users was 71.6%, female users were 49.2%. The results showed that female harmful alcohol users were more likely to have poor mental health, 58% of them with suicidal ideation, 50% with depression, more inactive in religious practice, and unemployed. It was also found that more than half of the male harmful alcohol users have adverse drinking consequence, including accidental injury, quarreled with others, and unable to work. Conclusions Harmful drinking was a predominant health problem in aborigines. This finding suggested that depression and suicidal ideation should be routinely evaluated for female harmful alcohol users by the professional of primary care.

P-1484 - The associations between menopausal syndrome and depression during pre-, peri-, and postmenopausal period among taiwanese female aborigines

Introduction Menopausal syndrome has been reported to be a worldwide womens mental health problem. Aborigines in rural areas have poorer access to mental health services. Thus, it is important to evaluate such symptoms of female aborigines with different menopausal statuses and their association with depression. Aim The aim of the study is to evaluate the association between physiological menopausal symptoms and depression during different menopausal period among female Taiwanese aborigines. Methods A total of 672 Taiwanese aboriginal women, aged 40–60, were recruited in the interviewing study and classified as pre-, peri-, and postmenopausal according to menstrual bleeding patterns in the previous 12 months. Then, the postmenopausal symptoms, depression, self-perceived health, family support, and associated demographic variables were assessed by questionnaire based on the results of interviewing by research assistants. Results The results revealed that perimenopausal statuses were associated with depression and women with a perimenopausal status had a higher prevalence of depression than those with a premenopausal status. A higher score on physiological postmenopausal symptoms was found to be significantly associated with depression. Furthermore, somatic symptoms were associated with depression for pre-, peri-, and postmenopausal statuses. Moreover, sexual dysfunction and vasomotor symptoms were associated with depression only in the premenopausal status and postmenopausal status, respectively. Conclusions Depression should be routinely evaluated for female Taiwanese aborigines consulting with physicians for menopause symptoms, especially for somatic symptoms. Furthermore, attention should be provided to premenopausal women with sexual dysfunction and postmenopausal women with vasomotor symptoms for depression.