Objective: To evaluate the evolution of fetal alcohol spectrum disorder prevention practices including awareness and use of recently published tools.
Methods: Fellows of the American College of Obstetricians and Gynecologists were asked about their knowledge, opinions, and practice regarding alcohol-related care. Eight hundred obstetrician-gynecologists (ob-gyns) were selected; 48.1% returned the survey.
Results: The majority (66.0%) indicated that occasional alcohol consumption is not safe during any period of pregnancy. There was no consensus when asked if alcohol's effect on fetal development is clear (46.9% thought it was clear and 45.9% did not). Most (82.2%) ask all pregnant patients about alcohol use only during patients' initial visit, whereas 10.6% ask during initial and subsequent visits. Most (78.5%) advise abstinence when pregnant women report alcohol use. When asked which validated alcohol risk screening tool they most commonly use with pregnant patients, 57.8% said they use no tool. Although 71.9% felt prepared to screen for risky or hazardous drinking, older ob-gyns indicated feeling significantly more unprepared than younger ob-gyns. “Patient denial or resistance to treatment” was the top issue affecting alcohol screening and “referral resources for patients with alcohol problems” was the resource needed most. Most ob-gyns were not aware of the National Institute on Alcohol Abuse and Alcoholism “Clinician's Guide” or the American College of Obstetricians and Gynecologists “Fetal Alcohol Spectrum Disorder Prevention Tool Kit.”
Conclusions: There are few changes in the alcohol-related screening and treatment patterns of ob-gyns since 1999; although perceived barriers and needs have changed. Interventions, including referral resources and continuing medical education training, are warranted.
From the Department of Research (BLA, JS), The American College of Obstetricians and Gynecologists; Department of Psychology (BLA), American University; Division of Birth Defects and Developmental Disabilities (NCBDDD) (EPD, RLF), National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention; C.S. Mott Center for Human Growth and Development (RS), Wayne State University; Provider's Partnership (JM), and The American College of Obstetricians and Gynecologists, Washington, DC.
Received for publication April 15, 2009; accepted July 15, 2009.
Send correspondence and reprint requests to Britta Anderson, BA, Department of Research, The American College of Obstetricians and Gynecologists, 409 12th Street, SW, Washington, DC 20024. e-mail: firstname.lastname@example.org
Supported, in part, by the Centers for Disease Control and Prevention, Department of Health and Human Services (Cooperative Agreement U50/CCU323396) and by the Maternal and Child Health Bureau, Health Resources and Services Administration, Department of Health and Human Services (Grant R60 MC 05674).
The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.