Screening for alcohol consumption in pregnant women and appropriate management of positive cases

Screening for alcohol consumption is recommended for all pregnant women attended by nursing staff, as alcohol consumption during pregnancy has a significant impact on the health of both the mother and the fetus, being a substance with proven teratogenic capacity and for which there is no known safe dose. In cases where active consumption is identified, screening for the use of other drugs, legal and illegal, should also be conducted.

Throughout this assessment, we must consider the possibility that women may be somewhat reluctant to answer questions about their consumption, as substance use during pregnancy can be stigmatizing. The Audit-C test can be used for this screening, and in case of detecting consumption, brief intervention is recommended, as it has been shown to improve patients’ motivation to maintain abstinence or reduce consumption. Additionally, multidisciplinary work is necessary, involving collaboration with the rest of the healthcare and social team to address cases.

It should be emphasized that reducing or eliminating alcohol consumption is beneficial at any stage of pregnancy, so screening is recommended regardless of the weeks of gestation and intervening, if necessary, with the aim of eliminating or reducing consumption.

It is recommended to adopt an attitude that does not show judgment, in order to establish a therapeutic relationship that allows working on existing consumption.

The main objective is to identify alcohol consumption, and potentially other substances, during pregnancy and to establish interventions aimed at reducing or eliminating the consumption detected.

Alcohol cessation in pregnant women at any time during pregnancy has been shown to be beneficial for the fetus compared to cases where cessation does not occur. Additionally, controlled and randomized trials have shown that alcohol consumption outcomes improve in cases where brief intervention is implemented compared to those where no intervention is provided.

Bibliography: Chang, G. (2020). Alcohol intake and pregnancy. UpToDate.

Substance

Alcohol

Preventive intervention level

Selective

Setting

Primary Care, Hospital, Specialized care, Community settings

Gender

Women

Age range

18 a 64

Keywords

alcohol, anamnesis, audit, audit-c, clinical interview, consumption, Hospital care, primary care, risk factors, screening, woman

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