Tough Suzanne C, Clarke Margaret, Hicks Matt, Clarren Sterling
Department of Paediatrics, University of Calgary, Calgary, Alberta, Canada.
Alcohol Clin Exp Res. 2004 Nov;28(11):1724-31. doi: 10.1097/01.alc.0000145692.06885.79.
National initiatives on fetal alcohol syndrome in Canada and the United States aimed at prevention, identification, and treatment of individuals who are affected by alcohol exposure in utero recommend that women abstain from consuming alcohol during pregnancy. Health care providers are key educators regarding appropriate alcohol use. The objective of this study was to describe characteristics of physicians who recommend alcohol abstinence during pregnancy with regard to knowledge of fetal alcohol syndrome and preconception counseling strategies.
A survey was mailed to Canadian physicians and midwives between 2001 and 2002. Participants consisted of a national random sample of 1090 Canadian obstetricians and gynecologists, midwives, and family physicians who were current members of provincial and national professional organizations. The main outcome measure was questionnaire responses to knowledge, prevention, and diagnosis of issues related to alcohol use during pregnancy.
Response rates ranged from 31.1% among family physicians to 63.5% among midwives. Overall, 91.2% of providers recommended abstinence from alcohol during pregnancy. These providers were significantly more likely to believe that there is sufficient information about alcohol use and that clients were interested in discussing alcohol (p < 0.05). They were also significantly more likely to discuss depression, personal alcohol use, partner's use of alcohol, and family history of alcohol misuse with women of childbearing age (p < 0.05). Once a patient became pregnant, fewer practice differences were noted, although those who recommended alcohol abstinence were significantly more likely to take clinical action when pregnant patients were consuming moderate amounts of alcohol (p < 0.05).
It is encouraging that almost 90% of Canadian health care providers recommend abstinence from alcohol during pregnancy. However, differences in clinical practice exist between providers who recommend alcohol abstinence during pregnancy as compared with those who recommend a "glass in moderation."
加拿大和美国针对胎儿酒精综合征开展的全国性倡议旨在预防、识别和治疗子宫内酒精暴露的个体，建议女性在孕期戒酒。医疗保健提供者是关于适当饮酒的关键教育者。本研究的目的是描述就胎儿酒精综合征知识和孕前咨询策略而言，建议孕期戒酒的医生的特征。
2001年至2002年间向加拿大医生和助产士邮寄了一份调查问卷。参与者包括从省级和国家级专业组织的现任成员中随机抽取的1090名加拿大产科医生、妇科医生、助产士和家庭医生组成的全国样本。主要结果指标是对孕期饮酒相关问题的知识、预防和诊断的问卷回复。
回复率从家庭医生中的31.1%到助产士中的63.5%不等。总体而言，91.2%的提供者建议孕期戒酒。这些提供者更有可能认为有足够的关于饮酒的信息，并且患者有兴趣讨论饮酒问题（p<0.05）。他们也更有可能与育龄女性讨论抑郁症、个人饮酒情况、伴侣饮酒情况以及酒精滥用家族史（p<0.05）。一旦患者怀孕，虽然建议戒酒的人在怀孕患者饮用适量酒精时更有可能采取临床行动（p<0.05），但观察到的实践差异较少。
令人鼓舞的是，近90%的加拿大医疗保健提供者建议孕期戒酒。然而，与建议“适量饮酒”的提供者相比，建议孕期戒酒的提供者在临床实践中存在差异。
