A survey of obstetrician–gynecologists on their patients’ alcohol use during pregnancy

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Abstract

Objective: To examine knowledge, attitudes, current clinical practices, and educational needs of obstetrician–gynecologists regarding patients’ alcohol use during pregnancy.

Methods: A 20-item, self-administered questionnaire on patients’ prenatal alcohol use was sent to 1000 active ACOG fellows. Responses were analyzed using univariate and multivariate statistical techniques.

Results: Of the 60% of the obstetrician–gynecologists who responded to the survey, 97% reported asking their pregnant patients about alcohol use. When a patient reports alcohol use, most respondents reported that they always discuss adverse effects and always advise abstinence. One fifth of the respondents (20%) reported abstinence to be the safest way to avoid all four of the adverse pregnancy outcomes cited (ie, spontaneous abortion, central nervous system impairment, birth defects, and fetal alcohol syndrome); 13% were unsure about levels associated with all of the adverse outcomes; and 4% reported that consumption of eight or more drinks per week did not pose a risk for any of the four adverse outcomes. The two resources that respondents said they needed most to improve alcohol-use assessment were information on thresholds for adverse reproductive outcomes (83%) and referral resources for patients with alcohol problems (63%).

Conclusion: Efforts should be made to provide practicing obstetrician–gynecologists with updates on the adverse effects of alcohol use by pregnant women and with effective methods for screening and counseling women who report alcohol use during pregnancy.

Section snippets

Materials and methods

This survey was conducted by ACOG; a questionnaire was mailed to a sample of obstetrician–gynecologists who were members of ACOG and actively engaged in providing obstetric services at the time of the survey. The primary sampling frame for the survey was the active membership file of ACOG. A systematic, random sample of 800 physicians was drawn from this population. In addition, questionnaires were sent to the 200 members of the Collaborative Ambulatory Research Network, which consists of ACOG

Results

Overall, 60% of the respondents were male. The respondents’ ages ranged from 27 to 89 years, with a median age of 41 years. Male respondents tended to be older than female respondents (47 compared with 39 years). Forty-four percent of the respondents were 27–39 years in age, 45% were 40–59, and 11% were 60 or older. The age and gender distributions of survey respondents were similar to those of ACOG members overall. Year of medical school graduation ranged from 1930 to 1997, with a median of

Discussion

We found that almost all obstetrician–gynecologists query their patients about substance use at least once during their pregnancy, usually at the initial visit. These findings confirm those of other studies17, 18 and are encouraging in light of the most recent recommendations from ACOG that advise clinicians to question pregnant women at their first prenatal visit about past and present alcohol, nicotine, and other drug use.8 In addition to asking their patients about alcohol use, 90% of

References (28)

  • L.W Green et al.

    Preventive practices by physiciansBehavioral determinants and potential interventions

    Am J Prev Med

    (1988)
  • Guidelines for Perinatal Care. 4th ed. Elk Grove Village (IL): American Academy of Pediatrics; Washington (DC):...
  • Substance abuse in pregnancy. ACOG technical bulletin no. 195

    (1994)
  • Anonymous. Surgeon General’s advisory on alcohol and pregnancy. FDA Drug Bull...
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