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Reducing Fetal Alcohol Exposure in the United States

Waterman, Emily H. MD, MPH*; Pruett, Dawn MA; Caughey, Aaron B. MD, PhD

Obstetrical & Gynecological Survey: May 2013 - Volume 68 - Issue 5 - p 367–378
doi: 10.1097/OGX.0b013e31828736d5
CME Articles: Reducing Fetal Alcohol Exposure

Fetal alcohol exposure is the leading preventable cause of birth and developmental defects in the United States. Despite a growing body of knowledge about the spectrum of disorders resulting from fetal alcohol exposure, 1 in 9 pregnant women continues to drink alcohol during pregnancy, and a small percentage of pregnant women continues to binge drink. Health care providers do not consistently screen pregnant women for alcohol use, nor do health professionals necessarily know how to counsel pregnant women effectively about the risks of fetal alcohol exposure. In this article, we review the epidemiology of fetal alcohol exposure and discuss current strategies for screening and prevention of fetal alcohol exposure. We also explore the multiple barriers that exist toward reducing alcohol-exposed pregnancies from the patient, provider, and systems perspectives. Finally, we make recommendations for improved clinical and public health strategies to eliminate fetal alcohol exposure in the United States.

Target Audience: Obstetricians and gynecologists, family physicians

Learning Objectives: After completing this CME activity, physicians should be better able to describe rates of fetal alcohol exposure in the United States, describe the demographic characteristics of women at highest risk for fetal alcohol exposure, counsel patients appropriately regarding the risk of poor fetal outcomes in association with fetal alcohol exposure, and understand the barriers to effective counseling about fetal alcohol exposure.

*Resident, Department of Family Medicine, †Medical Student, School of Medicine, and ‡Professor and Chair, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR

All authors and staff in a position to control the content of this CME activity and their spouses/life partners (if any) have disclosed that they have no financial relationships with, or financial interests in, any commercial organizations pertaining to this educational activity.

Correspondence requests to: Emily Waterman, MD, MPH, Department of Family Medicine, OHSU, 3181 SW Sam Jackson Park Rd, Portland, OR 97239. E-mail:

© 2013 by Lippincott Williams & Wilkins.