Department of Biology, Texas A&M University, College Station, Texas.
Department of Health and Kinesiology, Texas A&M University, College Station, Texas.
J Midwifery Womens Health. 2020 Sep;65(5):634-642. doi: 10.1111/jmwh.13146. Epub 2020 Aug 26.
The constellation of birth defects seen in fetuses exposed to alcohol in utero have been described as fetal alcohol spectrum disorders. Evidence suggests that health care providers' communication practices regarding prenatal alcohol use could have beneficial outcomes. There is a paucity of investigations, however, that have examined the health professionals' personal alcohol use and prenatal alcohol recommendations they provide.
This study sought to examine and compare midwives' personal alcohol use and communication practices regarding prenatal alcohol consumption. Certified nurse-midwives (CNMs) and certified professional midwives (CPMs) in a southwestern US state participated. Inclusion criteria included training in prenatal care, labor, birth, and membership in a midwife professional organization. Personal drinking behaviors were assessed with Alcohol Use Disorder Identification Test-Consumption (AUDIT-C).
All midwives (N = 61; 100%) reported they typically screened a patient for alcohol use during an initial prenatal visit. However, 5 (8.2%) respondents opted for recommendations that advised patients to drink once in a while. Similarly, 4 (6.6%) midwives counseled no more than one drink per day. In the cohort of participants (n = 40) with AUDIT-C scores, 25 (62.5%) engaged in nonrisky drinking (AUDIT-C scores <3). Most respondents (n = 39 of 40; 97.5%) typically consumed 1 to 2 standard drinks on the day they drank. There was no statistically significant difference in mean overall AUDIT-C scores between CNMs and CPMs (P = .42). When examining midwives' (1) responses on the AUDIT-C questionnaire, (2) nonrisky or risky drinking behaviors, and 3) communication practices regarding prenatal alcohol use, Fisher's exact test showed no statistically significant differences between CNMs and CPMs.
Results of this study highlight the importance of advocating healthy lifestyles among health care professionals while also promoting communication practices that align with national alcohol guidelines. Future investigations that examine associations between health care professionals' personal alcohol use and type or effectiveness of services offered to patients may be beneficial.
在子宫内暴露于酒精的胎儿中出现的一系列出生缺陷被描述为胎儿酒精谱系障碍。有证据表明，医疗保健提供者关于产前酒精使用的沟通实践可能会产生有益的结果。然而，很少有研究调查过卫生专业人员的个人饮酒情况以及他们提供的产前酒精建议。
本研究旨在检查和比较产科医生在产前酒精摄入方面的个人饮酒情况和沟通实践。参与研究的是美国西南部一个州的认证护士助产士（CNM）和认证专业助产士（CPM）。纳入标准包括产前护理、分娩和助产士专业组织成员培训。个人饮酒行为通过酒精使用障碍识别测试-消费（AUDIT-C）进行评估。
所有助产士（N=61；100%）报告说，他们通常在初次产前就诊时筛查患者的酒精使用情况。然而，有 5 名（8.2%）受访者选择了建议患者偶尔饮酒的建议。同样，有 4 名（6.6%）助产士建议每天不超过一杯。在有 AUDIT-C 评分的参与者队列（n=40）中，25 名（62.5%）为无风险饮酒者（AUDIT-C 评分<3）。大多数受访者（n=39 名，占 40 名；97.5%）在饮酒当天通常饮用 1 至 2 标准饮品。CNM 和 CPM 之间的平均总体 AUDIT-C 评分没有统计学上的显著差异（P=0.42）。当检查助产士的（1）AUDIT-C 问卷回答，（2）无风险或风险饮酒行为，以及（3）关于产前酒精使用的沟通实践时，Fisher 精确检验显示 CNM 和 CPM 之间没有统计学上的显著差异。
本研究结果强调了在医疗保健专业人员中倡导健康生活方式的重要性，同时也促进了与国家酒精指南一致的沟通实践。未来的研究，检查医疗保健专业人员的个人饮酒情况与为患者提供的服务类型或效果之间的关联，可能会有所帮助。
