Alcohol Use in Pregnancy: in Screening and Intervention for the Clinician

Abstract: Alcohol consumption during pregnancy re-mains a common occurrence and is associated with amultitude of adverse birth and long-term outcomes.Binge drinking in particular is shown to be particu-larly harmful to the developing fetus. Effects includefull fetal alcohol syndrome, with characteristic facialdysmorphology, growth restriction, and developmen-tal to delays. Exposed children may also have partialfetal alcohol syndrome, alcohol-related birth defects,and alcohol-related neurodevelopmental disorders.These effects are preventable, and efforts must beginwith accurate identification of women who consumealcohol during pregnancy. Several screening toolshave beendeveloped and validatedfor use in prenatalcaresettings,andthemostrecentlyproposedbriefandeasy to use T-ACER3 has demonstrated high sensi-tivity and specificity in both identifying risk drinkingduring pregnancy and predicting long-term neuro-behavioral outcomes in exposed children. Onceidentified, effective interventions are available foruse with pregnant women consuming alcohol. Briefinterventions, which can be delivered by a healthprofessional and involve motivational interviewing,have been demonstrated to significantly reduce alco-hol consumption during pregnancy. These ap-proaches, recommended by American College ofObstetricians and Gynecologist (ACOG), help movepatients toward increased readiness to positivelychange their drinking behavior. Ultimately, all pre-natal care providers should routinely screen all pa-tients for alcohol use using validated tools, andwhereappropriate, should offer intervention.Key words: alcohol use, fetal alcohol syndrome, alco-hol screening tests, brief interventions