Alcohol use in pregnancy: insights in screening and intervention for the clinician

Abstract

Alcohol consumption during pregnancy remains a common occurrence and is associated with a multitude of adverse birth and long-term outcomes. Binge drinking in particular is shown to be particularly harmful to the developing fetus. Effects include full fetal alcohol syndrome, with characteristic facial dysmorphology, growth restriction, and developmental to delays. Exposed children may also have partial fetal alcohol syndrome, alcohol-related birth defects, and alcohol-related neurodevelopmental disorders. These effects are preventable, and efforts must begin with accurate identification of women who consume alcohol during pregnancy. Several screening tools have been developed and validated for use in prenatal care settings, and the most recently proposed brief and easy to use T-ACER3 has demonstrated high sensitivity and specificity in both identifying risk drinking during pregnancy and predicting long-term neurobehavioral outcomes in exposed children. Once identified, effective interventions are available for use with pregnant women consuming alcohol. Brief interventions, which can be delivered by a health professional and involve motivational interviewing, have been demonstrated to significantly reduce alcohol consumption during pregnancy. These approaches, recommended by American College of Obstetricians and Gynecologist (ACOG), help move patients toward increased readiness to positively change their drinking behavior. Ultimately, all prenatal care providers should routinely screen all patients for alcohol use using validated tools, and where appropriate, should offer intervention.