In order to prevent FASD, it is important for professionals who work with pregnant women, such as midwives and nurses, to properly screen for alcohol use, educate on the impact of alcohol use during pregnancy, and provide intervention support for pregnant women.

The authors of this study surveyed 578 midwives, nurses, and nurse practitioners in the United States who provide care to pregnant women on their knowledge of the effects and prevalence of alcohol consumption during pregnancy, knowledge and prevalence of FASD, attitude toward prenatal alcohol consumption, screening practices used, and perceived limitations in screening and intervention.

Some of the main findings of the study include:

Knowledge and Attitudes

• 7% of participants thought that alcohol consumption during pregnancy is safe during at least one trimester
• Most who considered alcohol consumption safe felt that the third trimester was the most safe
• 3% said that consuming alcohol is safe during two or more trimesters
• 7% considered 0 drinks per occasion as acceptable, while 43.6% considered 1 drink per occasion acceptable
• Among the group who thought alcohol was safe during at least one trimester, 83.6% felt that 1 drink per occasion was acceptable

 Knowledge of FASD Prevalence

• 2% of participants knew the US prevalence rate of FASD
• 9% of participants reported lower FASD prevalence rates in their community, and 0.9% reported higher rates

 Screening Practices

• Only 23.3% of participants confirmed that they use an alcohol screening tool as part of their practice, the most common tool being CAGE, followed by T-ACE and AUDIT
• 6% reported screening patients all the time, 8.6% most of the time, and 15.1% screened some of the time

 Interventions

• When women say they have been drinking during pregnancy, only 56% of midwives and nurses recommend abstinence

 FASD Knowledge by Safety and Screening Practices

• Participants who considered alcohol during pregnancy as safe had less knowledge regarding the effects of alcohol use during pregnancy compared to those who reported alcohol consumption during pregnancy as unsafe

 Perceived Barriers to Screening

• Barriers seen as having the greatest impact on screening for alcohol use during pregnancy included patient denial/treatment resistance and time limitations

 Preparedness to Screen

• The less knowledge participants had about the risks of alcohol use during pregnancy, the less likely they were to screen, intervene, and refer patients to resources

Take-home message
Nurses and midwives should be further educated on the potential effects of consuming alcohol during pregnancy, so that knowledge can be translated to practice with their patients and so appropriate supports can be provided when needed. Providing a reliable screening tool is an important part of nurse/midwives’ clinical practice, in order to improve the delivery of prevention and intervention strategies for pregnant women.

Authors: Lisa M. Chiodo, Caitlin Cosmian, Kristy Pereira, Nicole Kent, Robert J. Sokol, John H. Hannigan

Journal: Alcoholism: Clinical and Experimental Research