Elliott Elizabeth J, Payne Jan, Haan Eric, Bower Carol
Discipline of Paediatrics and Child Health, University of Sydney, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
J Paediatr Child Health. 2006 Nov;42(11):698-703. doi: 10.1111/j.1440-1754.2006.00954.x.
To measure paediatricians' knowledge, attitudes and practices regarding foetal alcohol syndrome (FAS) and alcohol use during pregnancy.
Postal survey of paediatricians in Western Australia in 2004. Of 179 eligible paediatricians, 132 (73.7%) responded (90 consultant paediatricians and 42 paediatric trainees).
Of the 132 respondents, 18.9% identified all four essential diagnostic features for FAS. Only 49.2% had previously diagnosed FAS (range 1-30 cases) but 91.7% had seen children diagnosed by others; 76.5% had suspected but not diagnosed FAS; 12.1% had been convinced of but not recorded the diagnosis; and 31.8% had referred children for diagnostic confirmation. Although 79.6% agreed early diagnosis might be advantageous, 69.6% said diagnosis might be stigmatising and 36.4% thought parents might resist referral for assessment and treatment. Although 78.2% agreed avoiding binge drinking may reduce FAS, only 43.9% believed women should abstain from using alcohol in pregnancy. Only 4.5% felt very prepared to deal with a patient with FAS: most wanted educational materials for themselves (69.7%) and child carers (71.2%). Only 23.3% routinely ask about alcohol use when taking a pregnancy history and 4.2% routinely provide information on the consequences of alcohol use. Only 11.4% had read the current Australian national health guideline regarding alcohol consumption in pregnancy and 9.1% provided advice consistent with the guideline.
Paediatricians identified the need for educational materials about FAS and alcohol use in pregnancy for themselves and their clients. Lack of knowledge about FAS diagnosis and management will limit opportunities for diagnosis, prevention and early intervention.
评估儿科医生对胎儿酒精综合征（FAS）及孕期饮酒的知识、态度和行为。
2004年对西澳大利亚州的儿科医生进行邮寄调查。179名符合条件的儿科医生中，132名（73.7%）回复（90名儿科顾问医生和42名儿科实习医生）。
132名受访者中，18.9%能识别出FAS所有四项基本诊断特征。仅49.2%曾诊断过FAS（范围为1至30例），但91.7%见过他人诊断的患儿；76.5%曾怀疑但未诊断出FAS；12.1%曾确信诊断但未记录；31.8%曾转诊患儿进行诊断确认。尽管79.6%同意早期诊断可能有益，但69.6%表示诊断可能带来污名化，36.4%认为家长可能抗拒转诊进行评估和治疗。尽管78.2%同意避免暴饮可能减少FAS，但仅43.9%认为女性孕期应戒酒。仅4.5%觉得自己完全有能力应对FAS患儿：大多数希望为自己（69.7%）和儿童护理人员（71.2%）获取教育资料。仅23.3%在询问孕产史时常规询问饮酒情况，4.2%常规提供饮酒后果的信息。仅11.4%阅读过当前澳大利亚关于孕期饮酒的国家健康指南，9.1%提供与该指南一致的建议。
儿科医生认识到需要为自己及其患者提供有关FAS和孕期饮酒的教育资料。对FAS诊断和管理知识的缺乏将限制诊断、预防和早期干预的机会。
