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Do Pregnant Women Hide the Truth?

How trustworthy are folks when telling health researchers about their own behaviors?

A Swedish study in the April issue of the American Journal of Obstetrics & Gynecology shows that of 103 pregnant women asked about how much alcohol they had consumed during their pregnancies, 94 said they'd had none at all.

But the researchers had built in a sort of lie-detector test: They collected hair and urine samples, both of which carry reliable tell-tale signs of alcohol use and can even indicate how frequent and heavy that use is.

Whoops. The samples showed that 19 -- not just 9 -- of the women had imbibed, 7 of them heavily.

That's bad news for those women's babies: the American College of Obstetrics and Gynecology strongly cautions women who are either planning to become pregnant or who already are so to lay off the booze, as alcohol can cause birth-defects and poses other risks to fetuses.

This particular study's findings also make me wonder about all the other studies I read whose findings are based on people's own reports of their activities and behavior. How reliable are any of us, study participants or not, when asked to recount how many times we had a drink in the last month, or how many hours we sleep each night, or whatever?

Arthur A. Stone, vice chair of the department of psychiatry at Stony Brook University in New York and author of The Science of Real-Time Data Capture: Self Reports in Health Research, has given this matter a lot of thought. He says that while the medical research community "really relies heavily on self-reporting," people are inherently ill-equipped to accurately report what they've done and when. He says we tend to "telescope" events, thinking they happened earlier or later than they actually did, and to focus more on highlights (or lowlights) of our experience than on our day-to-day routines. Plus, when it comes to something socially and medically unacceptable such as drinking while pregnant, we're naturally hesitant to 'fess up.

One solution, Stone suggests, is for researchers to use daily diaries in which study participants record their activities in real time rather than expect them to later remember those activities all at once.

Maybe so. But since the average health-news consumer doesn't always have access to researchers' methodology, how much stock should we place in findings that come from self-report based studies?

I don't have the answer. My guess would be that we consume such studies with a good-sized grain of salt.

By Jennifer LaRue Huget  |  April 29, 2008; 7:00 AM ET
Categories:  Pyschology  
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Comments

What is with the title of this post? "Big Fat Liars?" Maybe the author is trying to be witty or cheeky, but on top of all the guilt about eating and drinking all the right things and avoiding environmental hazards, most pregnant women I know are pretty sensitive about the weight gain and body changes.

Posted by: sergio georgini | April 29, 2008 9:27 AM | Report abuse

I did a term paper on fetal alcohol syndrome in college. If you ever saw a baby born to an alcoholic mother, or even one who drank minimally during pregnancy, you'd never drink again. The blame is solely on the mother. It's not in the genes or the environment, the father had nothing to do with it. It rests completely on the mother and what she drank, injected, ate or didn't eat during pregnancy. Pregnant women, and subsequently mothers, want to be put on a pedastal because they laid down and spread their legs. Just because they produce a child they want the world to bow down and worship them. Sorry, girls, I'm not buying it. Just being able to produce a kid doesn't mean you're fit to raise it. Find other ways to make yourself useful, like get a job and stop whining about the high cost of living.

Posted by: Anonymous | April 29, 2008 10:06 AM | Report abuse

I think the biggest lies are in response to questions about church attendance.

Posted by: hihomoron | April 29, 2008 10:25 AM | Report abuse

The headline of this post is extremely offensive, as is the post by 10:06 a.m. I don't plan on reading "The Checkup" any longer.

Posted by: Tricia Long | April 29, 2008 10:35 AM | Report abuse

Contrary to Ms. Huget's assertion, most peer-reviewed medical research doesn't involve self-reporting. In fact, a lot of medical research doesn't involve any human interaction at all. Some studies I'm familiar with that involve self-reporting have attempted to address this very issue in numerous ways - by asking the same question in different ways, by keeping a "diary" (as mentioned by Ms. Huget), and by doing exactly what the Swedish team did, verifying the self-reporting with benchtop analysis.

Since I'm a bench scientist, not a psychologist, I'd be interested in the opinion of a scientist involved in these types of studies.

Posted by: Anonymous | April 29, 2008 10:49 AM | Report abuse

As a formerly pregnant woman and "subsequent mother," what I really want is for people to spell "pedestal" correctly.

Posted by: APL | April 29, 2008 11:16 AM | Report abuse

Thank you Commenters for your feedback on Jennifer's blog today. Neither Jennifer nor we editors intended to cause offense and we've changed the headline.

Posted by: Frances Stead Sellers | April 29, 2008 11:32 AM | Report abuse

As a genuinely fat woman I object to being confused with falsely fat pregnant liars.

Posted by: Anonymous | April 29, 2008 11:37 AM | Report abuse

Some of you are WAY too sensitive about the term "big fat liar". Most likely, it refers to the fact that the lie is a "big, fat" one -- i.e. not the person. However, in the attempt to turn the "lie" into the person doing the lying (i.e. the "liar"), the "big, fat" part is now modifying the person.

Regardless, it's unbelievably stupid to get that upset over a long-used phrase that is not even aimed at overweight people. So, please, grow up.

Oh, and Tricia Long, that's good. We certainly don't want people to encounter anything they disagree with on a daily basis. It might upset your fragile world view.

Posted by: Ryan | April 29, 2008 11:55 AM | Report abuse

I find the change to the headline of this post extremely offensive. As are the posts complaining about the headline and the dangers of fetal alcohol syndrome. Because I am offended by those who are offended I don't plan on reading "The Checkup" any longer.

Posted by: M Street | April 29, 2008 11:58 AM | Report abuse

I take all of the 'studies' mentioned in blogs with a BIG FAT grain of salt. The parenting and on balance blogs are always putting out invitations to debate on a particular study. Probably can't think of anything original to discuss so they rely on these 'studies' to spark conversation.

I did a study myself and discovered people who read the Washington Compost and participate in blogs are nuts and don't have anything worthwhile to take up their time.

Lunch hour is over, now get back to work.

Posted by: Anonymous | April 29, 2008 1:08 PM | Report abuse

why is it that American women can't have even one drink while pregnant while Euro women, living in countries with more universal health care and better infant mortality rates, are allowed to drink sensibly?

Could it be that these American women are LYING! GASP! because they're being lied to and don't want to be lectured, as well?

Posted by: Sharon | April 29, 2008 1:29 PM | Report abuse

Well, Sharon, why don't you just move to Europe where you can get snockered and still have healthy babies. The mother and the unborn baby share a blood supply. If you drink, that alcohol gets into your bloodstream. It also gets into the baby's bloodstream. If you drink enough to get just a slight buzz and you weigh, oh, perhaps 130-140 pounds, what does it do to an unborn baby who weighs 1-2 pounds? It can destroy developing brain and spinal cells. Your child can be born with severe mental and/or physical retardation. You want to gamble with that for a drink? Go right ahead, but don't blame anybody else but yourself. You sound like somebody who has had a few drinks while preggers and you dodged the bullet. Get snarky someplace else -- I can't hear you.

Posted by: Anonymous | April 29, 2008 2:06 PM | Report abuse

I wonder whether these research subjects were fully informed about the goals of the study. Think they would have participated if they knew their hair was going to be analysed for alcohol content?

What exactly was the goal of this study? It's sort of obvious that people will lie about things that make them look bad, especially to "official" people like doctors. One would expect that pregnant women who drink heavily would lie about it, since culturally such behavior is now verboten. So it's not totally clear to me that studies like this one really have any other aim than to provide traction for legislation to restrict the behavior of pregnant women. As in: pregnant women won't stop drinking just because some tv ads and obstetricians say so, so we have to make it illegal.

In fact, maybe we should just strap all pregnant women to gurneys for the duration of their pregnancies so we can exert complete control over their behavior and thus ensure optimal outcomes for their babies.

Posted by: jcadam | April 29, 2008 2:25 PM | Report abuse

Frances Stead Sellers, even though you changed the title of the article, the link to the page is still pretty clear: http://blog.washingtonpost.com/checkup/2008/04/are_pregnant_women_big_fat_lia.html

i do realize though that this may be something that you can't change at this late point in time.

Posted by: wdc | April 29, 2008 2:29 PM | Report abuse

To the "fetal alcohol expert" (who's credentials consist of writing a paper in college), I find your description of mothers as women who "laid down and spread their legs" interesting. (I'm not sure how to address you as you apparently don't have the courage to post your name). Your Mother's Day cards to your mom must have very interesting and colorful language. You are correct that just because you can give birth to a child doesn't mean you are fit to raise it. For example you mother raised a very judgmental, self righteous and misinformed child. You suggest that having a glass of wine during a pregnancy will result in fetal alcohol syndrome? Get off your high horse, go back to college and take a biology course.

Posted by: Stephanie | April 29, 2008 2:42 PM | Report abuse

wdc, WHO CARES?????!!!!??? Get over it. It's not a big deal, except to the overly sensitive, cry-at-spilled-milk types.

Posted by: Ryan | April 29, 2008 3:11 PM | Report abuse

I just had a baby. My sister is a nursing student who is having a blast calling me every week with health updates about babies. In the course of her studies, it turns out that for alcohol to cross the placenta and get to the babies blood stream (mom and baby don't "share a blood supply--otherwise they couldn't have different blood types), the mom has to get, and I quote, "snokered". Having a very occasional drink with dinner is not a risk.

Posted by: voiceofreason | April 29, 2008 3:17 PM | Report abuse

Shame is a really lousy motivator, especially with health behaviors.

Posted by: Anonymous | April 29, 2008 3:19 PM | Report abuse

Stephanie: I don't send my mother cards for Mother's Day. I see the *itch twice a year if she's lucky. She is one of those who was not fit to have children, but what the heck, it was the thing to do back in those days. All the problems of the world can be boiled down to bad mothering and the WaPo seems to attract the worst and the most self-righteous, including wiccans, bi-sexuals, and people who support Billary Clinton.

Your 'expertise' is probably the fact you had a kid, drank during pregnancy, and your kid turned out OK in your opinion. There are thousands of muthas who weren't so lucky. At what point is drinking safe? Doctors don't know. Is it OK during the first trimester? Or the last trimester? Why don't you get knocked up, have a few snorts and see what happens. Of course, the doctors say drinking in moderation is OK but what is moderation? One drink a day? One a week? One a month? Beer? Wine? Bourbon or gin? Then what about smoking joints? Everybody has done it, right? Give you flamers an inch and you'll take a mile and blame soembody else for the outcome.

Posted by: Anonymous | April 29, 2008 4:00 PM | Report abuse

Dear self righteous person with the Mommy issues. Are you saying you are a wiccan bisexual who supports Hillary Clinton?

Posted by: Anonymous | April 29, 2008 4:15 PM | Report abuse

No, I'm not a wiccan bi-sexual who supports Billary Clinton. The rest of you are. I'm not a mother.

Posted by: Anonymous | April 29, 2008 4:25 PM | Report abuse

I would rather be considered a Wiccan, bi-sexual "Billary Clinton" supporter than a wack-o nutt job idiot. Ask your college for your money back.

Posted by: Stephanie | April 29, 2008 5:23 PM | Report abuse

Just curious why people enjoy being self righteous. Anyway, I'm glad you're not my Mom!

Posted by: Curious | April 29, 2008 6:07 PM | Report abuse

Curious, how ironic that you would be self righteous in your response.

Posted by: Anonymous | April 29, 2008 6:51 PM | Report abuse

I'm sorry, but I believe that if a mother chooses to drink thats her choice. What happens to the child is defanitly due to her choices and circumstances however as a mother who carried a child for 9 months and then raised it she deserves respect. Whether or not you agree with her decisions does not matter. We should also respect each others' posts. I'm sorry if I may sound "self-righteous" I'm just so sick of the bickering (not so much here but in the world today when so many problems could be solved with better communication and less fighting.) So please respect my opinions and those of others.

Thank you.

Posted by: Sarah | April 29, 2008 7:07 PM | Report abuse

If a pregnant mother chooses to drink, she is a selfish imbecile. As a pregnant mother myself, it sickens me to think that women think their weakness or whims outweigh the rights of an unborn baby. Let me guess- they are flaming liberals....

Posted by: Ellen | April 29, 2008 7:36 PM | Report abuse

Sarah: I don't want to pay to support your brain-damaged mutant because you chose to drink while carrying it. Just like I don't want to support crack babies or give to AIDS/HIV research because AIDS is 99% preventable. You have to reap what you sow. Don't expect everybody else to help you out when you screwed up the life of the fruit of your loins.

Posted by: Anonymous | April 29, 2008 7:45 PM | Report abuse

I'm sorry if my statement was misunderstood, I didn't mean to advocate for drinking while pregnant I just meant that we need to respect others opinions. And as for the statement made addressed at me, I think you need to understand that I personally don't drink at all as I am not old enough(although I wouldn't drink anyway as the smell of alcohol bothers me). I have been strong enough to resist peer pressure and tend to think things through before making any huge decisions.

Posted by: Sarah | April 29, 2008 7:53 PM | Report abuse

The research on FAS has been grossly misrepresented. The only thing that has been proven is that women who drink chronically - that is, drinking all day every day - have a risk of damaging the baby. That's _all_ that is proven. And because of the sue-happy culture in the US, doctors err on the side of extreme paranoia. That's all. Not because "even one drink" poses a risk - it doesn't. In every other country in the world (where women are allowed alcohol at all), there is no such drastic prohibition. And FAS is not a problem - except, as expected, where the mother is a chronic alcoholic. The fear of lawsuits, as well as some scary backlashy impulse to police the woman's body, are the only reasons we've bought into the "one drink can kill your baby" crap.

Posted by: Alice | April 29, 2008 8:14 PM | Report abuse

Wow. Mr/Mrs. Term Paper, you certainly feel strongly toward pregnant women. You start out talking about FAS, then all of a sudden all pregnant women are lazy homemakers who happened to spread their legs and produce a child. Nice. A little therapy in your future maybe? Honestly, I believe most pregnant women truly will not drink alcohol while pregnant, and if they do have any it's usually BEFORE they know they're pregnant. I do not condone it at all. I agree FAS children are innocent victims that a whole society rears (financially, medically, etc). But your statements are hardly respectable.

ANyway, the writer's ultimate statement was to take these such studies with a grain of salt, not condemn pregnant women. A study with such a small focus group is hardly reliable anyway.

Posted by: Anonymous | April 29, 2008 8:26 PM | Report abuse

Ok... someone clearly has issues with their mommy. "Nameless" wasn't hugged as a child. Even so, you should never be disrespectful to the woman who gave you the gift of life. Its rude.

Posted by: Jess | April 29, 2008 8:28 PM | Report abuse

sounds interesting.

Posted by: Lina | April 29, 2008 8:30 PM | Report abuse

whom ever nameless is, needs not be so judgemental. if you have that strong an opinion i suggest you get a job/soap box where it is welcomed. everyone here has the right to voice there own opinion. i am pregnant and you, nor anyone else, has the right to judge my prenatal choices. Also, you have no right to come here and start throwing mud at people's children. In my opinion people like you are more harmful to our society than a pregnant woman that has a drink or two. GROW UP!

Posted by: dar51579 | April 29, 2008 9:04 PM | Report abuse

As I have been pregnant while overseas and have had a European doctor, in my opinion,I can honestly say that european doctors do not tell pregnant women to get snockered. I have been told a glass of wine now and then is fine. Most pregnant women here in Europe are not downing shots of hard liquor and getting plastered.

Posted by: American in Europe | April 29, 2008 11:25 PM | Report abuse

How about we respect each other and stop insulting each other for no apparent reason other than we have different opinions.

Posted by: Anonymous | April 29, 2008 11:28 PM | Report abuse

Wow. I think the person with the mother hate deal hasn't grown up yet. "It's everyone elses fault I'm a mess" Grow up. I certainly hope you haven't had any children of your own. You wouldn't want to carry on that lame tradition of getting married and having children.

Posted by: vettas | April 30, 2008 9:39 AM | Report abuse

"why don't you just move to Europe where you can get snockered and still have healthy babies. "

Too funny. But not fot the reasons you think. Guess all those European babies are born with FAS because their mothers had an occasional glass of wine with dinner? And they also poisoned their kids by eating brie and unpasturized cheese? Or maybe some Japanese women ate some sushi? The horror!!

FWIW, I don't even drink when I'm not pregnant. I just find the comments of someone who wrote a term paper (??) endlessly amusing.

Posted by: va | May 1, 2008 9:02 AM | Report abuse

www.cdc.gov/ncbddd/fas

Posted by: Anonymous | May 1, 2008 11:56 AM | Report abuse

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