Li C, Olsen Y, Kvigne V, Welty T
Harvard University Medical School, USA.
S D J Med. 1999 Feb;52(2):59-64.
To reduce women's consumption of alcohol and other drugs during pregnancy, the Department of Epidemiology for the Aberdeen Area Indian Health Service (AAIHS) promoted a maternal substance use screening program for prenatal clinics in 1992. This report describes the adherence to the screening protocol at AAIHS facilities and barriers to such screening.
Prenatal clinic staff members at 20 AAIHS health care facilities were surveyed to determine the extent of prenatal substance use screening and the barriers to its implementation. The medical records of a random sample of 235 women who sought prenatal care at five hospitals were reviewed to determine whether prenatal clinic staff adhered to the screening protocol.
Of the 20 health care facilities, 13 (65%) had implemented the screening. The major barriers to implementing screening were lack of training in prenatal substance use screening and lack of clinic staff designated to administer the screening protocol. Though not statistically significant, our data suggest that women not administered the screening questionnaire were more likely to be multiparous (prevalence ratio = 2.1; 95% confidence interval = 0.9, 4.5).
To improve screening of pregnant women for substance use, prenatal clinic staff members should address administrative barriers and assess adherence of health care providers and patients to the screening protocol. Training of prenatal clinic personnel is essential to implement optimal maternal substance use screening in prenatal clinics.
为减少孕期女性的酒精及其他药物使用量，阿伯丁地区印第安卫生服务部（AAIHS）的流行病学部门于1992年为产前诊所推行了一项孕产妇物质使用筛查项目。本报告描述了AAIHS机构对筛查方案的遵守情况以及此类筛查的障碍。
对20家AAIHS医疗机构的产前诊所工作人员进行调查，以确定产前物质使用筛查的程度及其实施障碍。审查了在五家医院寻求产前护理的235名女性的随机样本的病历，以确定产前诊所工作人员是否遵守筛查方案。
在20家医疗机构中，13家（65%）实施了筛查。实施筛查的主要障碍是缺乏产前物质使用筛查方面的培训，以及缺乏指定执行筛查方案的诊所工作人员。尽管无统计学意义，但我们的数据表明，未接受筛查问卷的女性更有可能是经产妇（患病率比=2.1；95%置信区间=0.9，4.5）。
为改善对孕妇物质使用情况的筛查，产前诊所工作人员应解决管理障碍，并评估医疗服务提供者和患者对筛查方案的遵守情况。对产前诊所人员进行培训对于在产前诊所实施最佳的孕产妇物质使用筛查至关重要。
