RECORDING A HISTORY OF ALCOHOL USE IN PREGNANCY: AN AUDIT OF THE KNOWLEDGE, ATTITUDES AND PRACTICE AT A CHILD DEVELOPMENT SERVICE

Main Article Content

Raewyn Mutch
John Wray
Carol Bower

Keywords

Prenatal alcohol exposure, fetal alcohol spectrum disorders (FASD), pregnancy history, differential diagnoses, developmental delays

Abstract

Aims


To assess the effectiveness of alcohol documentation, examining medical correspondence and medical files of patients referred to the State Child Development Service (SCDS) and (ii) To measure the knowledge, attitudes and clinical practice of health practitioners working at the child development service (CDS) in relation to asking about alcohol use in pregnancy.


 


Methods


Written documentation for children attending the State Child Development Centre (SCDC) in Western Australia were examined for documentation of alcohol use during pregnancy; a random sample of 40 medical records were examined and all correspondence authored by every paediatrician for the calendar year 2006 (n=210) were reviewed. (ii) A survey was completed of staff at the CDS, to assess their knowledge, attitudes, and clinical practice and their perceived importance of asking about alcohol and other drug use.


 


Results


Review of all written documentation, of both files and paediatric correspondence, found only three letters recording alcohol use in pregnancy; two of the letters recorded the index child displaying stigmata consistent with prenatal alcohol exposure, yet Fetal Alcohol Spectrum Disorders (FASD) were not considered within the concluding differential diagnoses. 56% of responding CDS staff (73% response) agreed it was important to ask about alcohol use when taking a pregnancy history, 20% indicated they routinely asked about alcohol exposure and 35% of staff said they never asked about alcohol use. 60% of the CDS staff completing the survey would welcome a proven technique to ask about alcohol use.


 


Conclusions


There is a gap in clinical practice within this CDS in asking and/or recording information about alcohol use in pregnancy. The majority of CDS staff who completed the survey agreed that asking about alcohol use in pregnancy was important and welcomed a proven technique to do so.

Abstract 254 | PDF Downloads 135

References

1. Batra S, Wrigley ECW. Alcohol: the teratogen. J Obstet Gynaecol 2005 Apr;25(3):308-9.
2. National Health and Medical Research Council, Australian Government Department of Health and Ageing. Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Commonwealth Copyright Administration, Attorney-General’s Department, Robert Garran Offices, National Circuit, Canberra ACT 2600 posted at: http://www.ag.gov.au/cca; 2009.
3. Randall CL. Alcohol and pregnancy: highlights from three decades of research. J Stud Alcohol 2001 Sep;62(5):554-61.
4. Payne J, Elliott E, D'Antoine H, O'Leary C, Mahony A, Haan E, et al. Health professionals' knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy. Aust N Z J Public Health 2005 Dec;29(6):558-64.
5. Telethon Institute for Child Health Research AaP. Alcohol and Pregnancy Project. Alcohol and Pregnancy and Fetal Alcohol Spectrum Disorder: a Resource for Health Professionals (1st revision). Perth: Telethon Institute for Child Health Research 2009.
6. Coulton S, Drummond C, James D, Godfrey C, Bland JM, Parrott S, et al. Opportunistic screening for alcohol use disorders in primary care: comparative study.[see comment]. BMJ. 2006 Mar 4;332 (7540):511-7.
7. Reinert DF, Allen JP. The alcohol use disorders identification test: an update of research findings. Alcohol Clin Exp Res. 2007 Feb;31(2):185-99.
8. Washington State Department of Health. Substance Abuse During Pregnancy: Guidelines for Screening. In: Maternal and Child Health, editor.: Washington State Department of Health 2009;1-50.
9. US Department of Health and Human Services. Alcohol Alert: Screening for Alcohol use and Alcohol related problems. In: National Institute of Health (NIH), (NIAAA) NIoAAaA, editors: NIAAA;2005.
10. Mutch R, Peadon E, Elliot EJ, Bower C. Need to establish a national diagnostic capacity for fetal alcohol spectrum disorders. Journal of Paediatrics and Child Health 2009;45:79-81.