Göransson Mona, Magnusson Asa, Bergman Hans, Rydberg Ulf, Heilig Markus
Division of Psychiatry, Neurotec, Karolinska Institute, Stockholm, Sweden.
Addiction. 2003 Nov;98(11):1513-20. doi: 10.1046/j.1360-0443.2003.00498.x.
Maternal alcohol consumption is a major health hazard for the fetus. Sweden has an extensive system of public antenatal care clinics, whose mission is to detect and prevent this type of health hazards. However, very few cases of alcohol consumption during pregnancy are detected. The aim of this study was to examine the prevalence of hazardous or harmful alcohol consumption during pregnancy in a consecutive series of Swedish pregnant females.
DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS: The Alcohol Use Disorders Identification Test (AUDIT) was used to collect anonymous data from consecutive pregnant subjects admitted during 1 year to an antenatal clinic in Stockholm, and signing up for parental education offered routinely (n = 1327). Data were obtained from 1101 subjects, typically in pregnancy week 30. A complete AUDIT form was filled out referring to alcohol use during the year prior to pregnancy. A separate form with the consumption items from AUDIT was filled out to report behaviour during pregnancy.
For the year preceding pregnancy, 17% of subjects reported AUDIT scores of 6 or higher, indicating hazardous or harmful alcohol use in women. Few individuals reported scores of 13 or higher (indicating abuse or dependence), but almost half the subjects (46%) reported binge drinking (six standard drinks on a single occasion) once/month or more often, and 6% reported binge drinking on every occasion of alcohol consumption. One-third of the subjects (30%) continued regular alcohol use during pregnancy, and 6% reported consumption two to four times/month. In a logistic regression model, AUDIT scores for the year prior to pregnancy and subject age, but not education level were significant predictors of continued alcohol use during pregnancy.
Alcohol use during pregnancy is more extensive than has been presumed in Sweden. Simple, clinically useful screening methodology detects hazardous consumption during pregnancy in a manner which regular antenatal care does not. If this methodology can be shown to have similar sensitivity when administered under non-anonymous conditions, it should be made part of routine antenatal care.
孕妇饮酒对胎儿是一个重大的健康危害。瑞典拥有广泛的公共产前保健诊所系统，其任务是检测和预防这类健康危害。然而，孕期饮酒的案例极少被检测出来。本研究的目的是调查瑞典一系列连续怀孕女性中孕期危险或有害饮酒的患病率。
设计、地点、参与者和测量方法：酒精使用障碍识别测试（AUDIT）用于从连续一年内在斯德哥尔摩一家产前诊所就诊并报名参加常规提供的家长教育课程的孕妇（n = 1327）中收集匿名数据。数据来自1101名受试者，通常处于怀孕第30周。填写一份完整的AUDIT表格，涉及怀孕前一年的饮酒情况。填写一份单独的包含AUDIT消费项目的表格，以报告孕期行为。
在怀孕前一年，17%的受试者报告AUDIT分数为6分或更高，表明女性存在危险或有害饮酒行为。很少有人报告分数为13分或更高（表明滥用或依赖），但几乎一半的受试者（46%）报告每月一次或更频繁地狂饮（单次饮用六标准杯酒），6%的人报告每次饮酒时都狂饮。三分之一的受试者（30%）在孕期继续经常饮酒，6%的人报告每月饮酒两至四次。在逻辑回归模型中，怀孕前一年的AUDIT分数以及受试者年龄，但不是教育水平，是孕期继续饮酒的显著预测因素。
瑞典孕期饮酒的情况比之前推测的更为普遍。简单且临床实用的筛查方法能够检测出孕期的危险饮酒行为，而常规产前护理却无法做到。如果这种方法在非匿名条件下实施时能显示出相似的敏感性，就应成为常规产前护理的一部分。
