Detection of Maternal Alcohol Use Problems in the Pediatric Emergency Department

Maternal alcohol use problems may impact the health and well-being of children, but often remain unrecognized. Mothers of young children seldom seek outpatient care for themselves; thus, pediatric settings may present an opportunity for the detection of maternal alcohol use problems. This study examines the feasibility of screening for and prevalence of alcohol use problems in mothers of young children in the context of seeking pediatric emergency care. We also examined the relationship of maternal alcohol use problems with use of pediatric emergency care. Methods : A total of 361 English-speaking mothers of children aged 7 and younger completed screening measures during their child's emergency care visit. TWEAK was used to screen for alcohol use problems. The screening survey also included information on children's health status and health care use, demographics, and the Center for Epidemiological Studies Depression Scale. Results : Of the women approached, 90% agreed to complete the screening measure. On the basis of cutoff score of 2 or more, 7% of women had elevated TWEAK scores. Those women with a TWEAK score >2 reported greater use of the pediatric emergency department (PED) than women scoring below the cutoff. On the basis of multivariate analyses, significant predictors of recent PED use included the presence of child chronic illness, younger maternal age, and TWEAK score. Conclusions : Screening for alcohol use problems among mothers of young children using the TWEAK appears to be feasible in a busy PED setting. The PED setting is promising for identifying risk drinking among women who may be less likely to be otherwise detected and for whom alcohol use may be impacting child outcomes.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/66222/1/j.1530-0277.2006.00132.x.pd

A retrospective review of self-reported alcohol intake among women attending for antenatal care in Far North Queensland

Background: Fetal alcohol syndrome and fetal alcohol spectrum disorder are known to occur among children\ud delivered to women in Far North Queensland; to date, the problem has not been quantified or related directly to\ud maternal alcohol consumption during pregnancy.\ud Aims: To identify the characteristics of women who consume alcohol during pregnancy, in order to identify ‘highrisk’\ud women to whom educational intervention regarding fetal alcohol syndrome may be targeted.\ud Methods: A retrospective descriptive study using the case notes of all women attending the antenatal booking clinic\ud in Cairns Base Hospital over the 3-month period from April to June 2005. Obstetric and demographic information\ud and self-reported alcohol intake before and during pregnancy were noted and self-reported alcohol intake before\ud and during pregnancy.\ud Results: Five hundred and forty-one women were included in this study. Of these women, 24.6% were found to\ud consume alcohol during pregnancy and 57.7% were found to consume alcohol before pregnancy, indicating a\ud reduction in alcohol consumed once women became aware of pregnancy. The most significant indicator for alcohol\ud consumption during pregnancy was found to be alcohol consumption before pregnancy. Of women who consumed\ud alcohol in pregnancy, 71.5% drank moderate amounts of alcohol before pregnancy and 28.7% drank heavily before\ud pregnancy.\ud Conclusion: Alcohol consumption during pregnancy is common in Far North Queensland. Methods currently used\ud during antenatal booking visits to determine alcohol consumption before and during pregnancy are unreliable. Strategies\ud to identify women consuming alcohol before and during pregnancy and education programs are vitally important if\ud the incidence of fetal alcohol syndrome and spectrum disorder is to be reduced

Maternal drinking behavior and Fetal Alcohol Spectrum Disorders in adolescents with criminal behavior in southern Brazil

Prenatal alcohol exposure can have serious and permanent adverse effects. The developing brain is the most vulnerable organ to the insults of prenatal alcohol exposure. A behavioral phenotype of prenatal alcohol exposure including conduct disorders is also described. This study on a sample of Brazilian adolescents convicted for criminal behavior aimed to evaluate possible clinical features of Fetal Alcohol Syndrome (FAS). These were compared to a control group of school adolescents, as well as tested for other environmental risk factors for antisocial behavior. A sample of 262 institutionalized male adolescents due to criminal behavior and 154 male students aged between 13 and 21 years comprised the study population. Maternal use of alcohol was admitted by 48.8% of the mothers of institutionalized adolescents and by 39.9% of the school students. In this sample of adolescents we could not identify individual cases with a clear diagnosis of FAS, but signs suggestive of FASD were more common in the institutionalized adolescents. Social factors like domestic and family violence were frequent in the risk group, this also being associated to maternal drinking during pregnancy. The inference is that in our sample, criminal behavior is more related to complex interactions between environmental and social issues including prenatal alcohol exposure