Department of Family Medicine, School of Medicine, Oregon Health and Science University, Portland, OR 97239, USA.
Obstet Gynecol Surv. 2013 May;68(5):367-78. doi: 10.1097/OGX.0b013e31828736d5.
Fetal alcohol exposure is the leading preventable cause of birth and developmental defects in the United States. Despite a growing body of knowledge about the spectrum of disorders resulting from fetal alcohol exposure, 1 in 9 pregnant women continues to drink alcohol during pregnancy, and a small percentage of pregnant women continues to binge drink. Health care providers do not consistently screen pregnant women for alcohol use, nor do health professionals necessarily know how to counsel pregnant women effectively about the risks of fetal alcohol exposure. In this article, we review the epidemiology of fetal alcohol exposure and discuss current strategies for screening and prevention of fetal alcohol exposure. We also explore the multiple barriers that exist toward reducing alcohol-exposed pregnancies from the patient, provider, and systems perspectives. Finally, we make recommendations for improved clinical and public health strategies to eliminate fetal alcohol exposure in the United States.
Obstetricians and gynecologists, family physicians.
After completing this CME activity, physicians should be better able to describe rates of fetal alcohol exposure in the United States, describe the demographic characteristics of women at highest risk for fetal alcohol exposure, counsel patients appropriately regarding the risk of poor fetal outcomes in association with fetal alcohol exposure, and understand the barriers to effective counseling about fetal alcohol exposure.
在美国,胎儿酒精暴露是导致出生缺陷和发育缺陷的主要可预防原因。尽管人们对胎儿酒精暴露导致的一系列疾病有了越来越多的了解,但仍有 1/9 的孕妇在怀孕期间继续饮酒,还有一小部分孕妇继续狂饮。医疗保健提供者并未始终对孕妇进行酒精使用筛查,卫生专业人员也不一定知道如何有效地就胎儿酒精暴露的风险对孕妇进行咨询。在本文中,我们回顾了胎儿酒精暴露的流行病学,并讨论了目前筛查和预防胎儿酒精暴露的策略。我们还探讨了从患者、提供者和系统角度来看,存在着多种减少酒精暴露妊娠的障碍。最后,我们提出了改进临床和公共卫生策略的建议,以消除美国的胎儿酒精暴露。
妇产科医生、家庭医生。
完成这项 CME 活动后,医生应能够更好地描述美国胎儿酒精暴露的发生率,描述面临胎儿酒精暴露风险最高的妇女的人口统计学特征,就与胎儿酒精暴露相关的不良胎儿结局风险向患者进行适当咨询,并了解有效咨询胎儿酒精暴露的障碍。