MMWR Morb Mortal Wkly Rep. 2023 Jan 20;72(3):55-62. doi: 10.15585/mmwr.mm7203a2.
Alcohol use during pregnancy is a major preventable cause of adverse alcohol-related outcomes, including birth defects and developmental disabilities.* Alcohol screening and brief intervention (ASBI) is an evidence-based primary care tool that has been shown to prevent or reduce alcohol consumption during pregnancy; interventions have resulted in an increase in the proportion of pregnant women reporting abstinence (odds ratio = 2.26; 95% CI = 1.43-3.56) (1). Previous national estimates have not characterized ASBI in populations of pregnant persons. Using 2017 and 2019 Behavioral Risk Factor Surveillance System (BRFSS) data, CDC examined prevalence of ASBI and characteristics of pregnant persons and nonpregnant women aged 18-49 years (reproductive-aged women) residing in jurisdictions that participated in the BRFSS ASBI module. During their most recent health care visit within the past 2 years, approximately 80% of pregnant persons reported being asked about their alcohol use; however, only 16% of pregnant persons who self-reported current drinking at the time of the survey (at least one alcoholic beverage in the past 30 days) were advised by a health care provider to quit drinking or reduce their alcohol use. Further, the prevalence of screening among pregnant persons who did not graduate from high school was lower than that among those who did graduate from high school or had at least some college education. This gap between screening and brief intervention, along with disparities in screening based on educational level, indicate missed opportunities to reduce alcohol use during pregnancy. Strategies to enhance ASBI during pregnancy include integrating screenings into electronic health records, increasing reimbursement for ASBI services, developing additional tools, including electronic ASBI, that can be implemented in a variety of settings (2,3).
怀孕期间饮酒是导致不良酒精相关后果的主要可预防原因,包括出生缺陷和发育障碍。*酒精筛查和简短干预(ASBI)是一种基于证据的初级保健工具,已被证明可以预防或减少怀孕期间的饮酒量;干预措施已导致报告戒酒的孕妇比例增加(优势比=2.26;95%CI=1.43-3.56)(1)。以前的全国估计数并未描述孕妇人群中的 ASBI。使用 2017 年和 2019 年行为风险因素监测系统(BRFSS)数据,疾病预防控制中心检查了 ASBI 的流行情况以及居住在参与 BRFSS ASBI 模块的司法管辖区的 18-49 岁(育龄妇女)孕妇和非孕妇的特征。在过去 2 年内最近一次的医疗保健访问中,大约 80%的孕妇报告被询问过她们的饮酒情况;然而,在调查时自我报告当前饮酒的孕妇中,只有 16%的人被医疗保健提供者建议戒酒或减少饮酒量(至少在过去 30 天内喝过一次含酒精的饮料)。此外,未从高中毕业的孕妇接受筛查的比例低于高中毕业或至少接受过一些大学教育的孕妇。这种筛查和简短干预之间的差距以及基于教育程度的筛查差异表明,在怀孕期间减少饮酒的机会被错过了。在怀孕期间加强 ASBI 的策略包括将筛查纳入电子健康记录、增加 ASBI 服务的报销、开发其他工具,包括电子 ASBI,可以在各种环境中实施(2,3)。