Recording a History of Alcohol Use in Pregnancy: An Audit of the Knowledge, Attitude and Practices at a Child Development Service
J Popul Ther Clin Pharmacol Vol 19(2):e227-e233; June 23, 2012
Original Research
Raewyn Mutch, John Wray, Carol Bower

Aims

To assess the effectiveness of alcohol documentation, examining medical correspondence and medical files of patients referred to the State Child Development Service (SCDS) and (ii) To measure the knowledge, attitudes and clinical practice of health practitioners working at the child development service (CDS) in relation to asking about alcohol use in pregnancy.

Methods

Written documentation for children attending the State Child Development Centre (SCDC) in Western Australia were examined for documentation of alcohol use during pregnancy; a random sample of 40 medical records were examined and all correspondence authored by every paediatrician for the calendar year 2006 (n=210) were reviewed. (ii) A survey was completed of staff at the CDS, to assess their knowledge, attitudes, and clinical practice and their perceived importance of asking about alcohol and other drug use.

Results

Review of all written documentation, of both files and paediatric correspondence, found only three letters recording alcohol use in pregnancy; two of the letters recorded the index child displaying stigmata consistent with prenatal alcohol exposure, yet Fetal Alcohol Spectrum Disorders (FASD) were not considered within the concluding differential diagnoses. 56% of responding CDS staff (73% response) agreed it was important to ask about alcohol use when taking a pregnancy history, 20% indicated they routinely asked about alcohol exposure and 35% of staff said they never asked about alcohol use. 60% of the CDS staff completing the survey would welcome a proven technique to ask about alcohol use. 

Conclusions

There is a gap in clinical practice within this CDS in asking and/or recording information about alcohol use in pregnancy. The majority of CDS staff who completed the survey agreed that asking about alcohol use in pregnancy was important and welcomed a proven technique to do so.

Key Words: Prenatal alcohol exposure, fetal alcohol spectrum disorders (FASD), pregnancy history, differential diagnoses, developmental delays

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