School of Nursing and Midwifery, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Queensland 4059, Australia.
Midwifery. 2012 Dec;28(6):760-4. doi: 10.1016/j.midw.2011.08.003. Epub 2011 Sep 21.
this study examined the clinical utility and precision of routine screening for alcohol and other drug use among women attending a public antenatal service.
a survey of clients and audit of clinical charts.
clients attending an antenatal clinic of a large tertiary hospital in Queensland, Australia, from October to December 2009.
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.
本研究旨在检验对参加公共产前服务的女性进行常规酒精和其他药物使用筛查的临床实用性和精确性。
对客户进行调查并审核临床病历。
2009 年 10 月至 12 月期间，在澳大利亚昆士兰州一家大型三级医院的产前诊所就诊的客户。
数据来自两个来源。首先，对在初始筛查中报告妊娠期使用酒精或其他药物的 32 名女性进行了一项完整的药物使用调查。其次，从研究期间参加产前诊所的 349 名新客户的病历中收集了数据。酒精和其他药物使用的灵敏度（86%，67%）和阳性预测值（100%，92%）均较高。仅 15%接受调查的女性对在妊娠期间接受药物使用筛查感到不适，但病历审核显示工作人员的合规性较差。在研究期间，25%的客户没有或没有充分接受筛查。
尽管推荐在妊娠期间进行普遍筛查，且我们的参与者显然接受了这一建议，但产前环境中的酒精和其他药物（A&OD）筛查仍然存在问题。调查低筛查率背后的原因以及克服该问题的方法，可能会改善该高危人群中母亲和儿童的健康结局。针对助产士的针对性教育和培训可能是解决方案的一部分，因为这些临床医生在实施预防和早期干预策略方面发挥着关键作用。
