Screening for alcohol and drug use in pregnancy

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• 作者：Charrlotte A. Seib ; PhD ; MN ; Grad Cert Health Studies (Sexual Health) ; RN^a ; ^{c.seib@qut.edu.au} (Women's Health Study Area Coordinator ; Lecturer) ; Mark Daglish ; BSc (Hons) ; MBChB ; FRANZCP ; MD^b ; ^c (Director of Addiction Psychiatry ; Senior Lecturer) ; René ; e Heath ; Grad Dip (Midwifery) ; BNPO ; RM ; RN^d (Principal Project Officer) ; Catriona Booker ; PhD ; MN ; RM ; RN^e (Assistant Nursing Director) ; Carol Reid ; PhD Candidate ; M App Sc (Research) ; Grad Cert Health Studies (Sexual Health) ; BHSc (Nursing)^f (Nurse Researcher) ; Jennifer Fraser ; PhD ; MN ; RN^g (Associate Professor)
• 关键词：Pregnancy ; Alcohol and other drug use ; Clinical assessment tools ; Prenatal care
• 刊名：Midwifery
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：28
• 期：6
• 页码：760-764
• 全文大小：142 K

文摘

Objective

this study examined the clinical utility and precision of routine screening for alcohol and other drug use among women attending a public antenatal service.

Study design

a survey of clients and audit of clinical charts.

Participants and setting

clients attending an antenatal clinic of a large tertiary hospital in Queensland, Australia, from October to December 2009.

Measurements and findings

data were collected from two sources. First, 32 women who reported use of alcohol or other drugs during pregnancy at initial screening were then asked to complete a full substance use survey. Second, data were collected from charts of 349 new clients who attended the antenatal clinic during the study period. Both sensitivity (86 % , 67 % ) and positive predictive value (100 % , 92 % ) for alcohol and other drug use respectively, were high. Only 15 % of surveyed women were uncomfortable about being screened for substance use in pregnancy, yet the chart audit revealed poor staff compliance. During the study period, 25 % of clients were either not screened adequately or not at all.

Key conclusions and implications for practise

despite recommended universal screening in pregnancy and the apparent acceptance by our participants, alcohol and other drug (A&OD) screening in the antenatal setting remains problematic. Investigation into the reasons behind, and ways to overcome, the low screening rate could improve health outcomes for mothers and children in this at-risk group. Targeted education and training for midwives may form part of the solution as these clinicians have a key role in implementing prevention and early intervention strategies.