Screening Instruments and Brief Interventions for Prenatal Alcohol Use

Objective In the United States, guidelines indicate all pregnant women should be screened for and counseled on alcohol use to prevent adverse perinatal outcomes due to alcohol consumption. The objective of this study was to describe sociodemographic factors associated with receipt of prenatal alcohol counseling and perinatal alcohol use among US women. Methods State health departments collected data for the Pregnancy Risk Assessment Monitoring System Phase 7 during 2012-2015, and we restricted the sample to a complete case analysis (N = 135 111). The 3 dichotomous outcomes were preconception alcohol use (3 months before pregnancy), prenatal alcohol use (during last 3 months of pregnancy), and prenatal alcohol counseling. Predictor variables were age, race, Hispanic ethnicity, education, marital status, health insurance status, and previous live births. We estimated survey-weighted logistic regression models for each outcome. Results Half (56.0%) of pregnant women reported preconception alcohol use, 70.5% received prenatal alcohol counseling, and 7.7% reported prenatal alcohol use during the last 3 months of pregnancy. Black women were significantly less likely than White women (odds ratio [OR] = 0.49; 95% CI, 0.46-0.52) and Hispanic women were significantly less likely than non-Hispanic women (OR = 0.62; 95% CI, 0.58-0.66) to report preconception alcohol use. We found similar patterns for prenatal alcohol use among Black women. Black women were significantly more likely than White women (OR = 1.66; 95% CI, 1.55-1.77) and Hispanic women were significantly more likely than non-Hispanic women (OR = 1.51; 95% CI, 1.40-1.61) to receive prenatal alcohol counseling. We found similar patterns for age, education, and health insurance status. Conclusion Disparities in alcohol counseling occurred despite the national recommendation for universal screening and counseling prenatally. Continued integration of universal screening for alcohol use during pregnancy is needed.

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Increasing the Report of Alcohol Use among Low-Income Pregnant Women

American Journal of Health Promotion ◽

10.4278/0890-1171-17.6.369 ◽

2003 ◽

Vol 17 (6) ◽

pp. 369-372 ◽

Cited By ~ 9

Author(s):

Shannon E. Whaley ◽

Mary J. O'Connor

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Low Income ◽

Repeated Measures ◽

Screening Tool ◽

Community Setting ◽

Alcohol Exposure ◽

Public Health Issue ◽

Prenatal Alcohol Use ◽

Prenatal Alcohol

Purpose. To increase the report of prenatal alcohol use in a community setting. Methods. A self-administered alcohol screening tool was developed and introduced at 12 randomly selected sites that administer the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). A matched sample of 12 WIC sites continued to use the existing verbal standard of care for assessing alcohol use. Results. Rates of reported prenatal alcohol consumption at the 12 WIC intervention sites were compared with rates at 12 control WIC sites using a repeated-measures analysis of variance (ANOVA) and independent-samples t-tests. Within 8 months of study commencement, rates of reported prenatal alcohol consumption were significantly higher at the intervention sites than at the control sites. Discussion. Use of a brief, self-administered screening tool in the WIC setting significantly increased reports of prenatal alcohol use, a key first step in the reduction of prenatal alcohol use. The WIC setting represents an excellent place to address the significant public health issue of prenatal alcohol exposure.

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