期刊论文详细信息
BMC Pregnancy and Childbirth
Midwives’ knowledge, attitudes and practice about alcohol exposure and the risk of fetal alcohol spectrum disorder
Carol Bower2  Julie Whitlock2  Amanda Wilkins1  Raewyn Mutch2  Tracy Reibel2  Heather M Jones2  Rochelle E Watkins2  Janet M Payne2 
[1] Child and Adolescent Health Service, Department of Health Western Australia, Perth, Australia;Telethon Kids Institute, The University of Western Australia, Perth, Australia
关键词: Fetal alcohol spectrum disorder;    Pregnancy;    Alcohol;    Practice;    Attitude;    Knowledge;    Midwives;   
Others  :  1091858
DOI  :  10.1186/s12884-014-0377-z
 received in 2014-06-26, accepted in 2014-10-17,  发布年份 2014
PDF
【 摘 要 】

Background

Midwives are an influential profession and a key group in informing women about alcohol consumption in pregnancy and its consequences. There are no current quantitative Australian data on midwives’ knowledge, attitudes and practice in relation to alcohol consumption during pregnancy and Fetal Alcohol Spectrum Disorder. We aimed to reduce this knowledge gap by understanding midwives’ perceptions of their practice in addressing alcohol consumption during pregnancy.

Methods

This cross-sectional study was conducted at 19 maternity sites across the seven health regions of country Western Australia. A questionnaire was designed following review of the literature and other relevant surveys. Midwifery managers of the maternity sites distributed questionnaires to all midwives working in their line of management. A total of 334 midwives were invited to participate in the research and (n = 245, 73.4%) of these were eligible.

Results

The response fraction was (n = 166, 67.8%). Nearly all (n = 151, 93.2%) midwives asked pregnant women about their alcohol consumption during pregnancy and (n = 164, 99.4%) offered advice about alcohol consumption in accordance with the Australian Alcohol Guideline, which states “For women who are pregnant or planning a pregnancy, not drinking is the safest option”. Nearly two thirds (n = 104, 64.2%) of the midwives informed pregnant women about the effects of alcohol consumption in pregnancy, they did not always use the recommended AUDIT screening tool (n = 66, 47.5%) to assess alcohol consumption during pregnancy, nor conduct brief intervention when indicated (n = 107, 70.4%). Most midwives endorsed professional development about screening tools (n = 145, 93.5%), brief intervention (n = 144, 92.9%), and alcohol consumption during pregnancy and FASD (n = 144, 92.9%).

Conclusion

Nearly all midwives in this study asked and advised about alcohol consumption in pregnancy and around two thirds provided information about the effects of alcohol in pregnancy. Our findings support the need for further professional development for midwives on screening and brief intervention. Policy should support midwives’ practice to screen for alcohol consumption in pregnancy and offer brief intervention when indicated.

【 授权许可】

   
2014 Payne et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20150128174742414.pdf 293KB PDF download
【 参考文献 】
  • [1]Clarren SK, Smith DW: The fetal alcohol syndrome. N Engl J Med 1978, 298(19):1063-1067.
  • [2]Mattson SN, Schoenfeld AM, Riley EP: Teratogenic effects of alcohol on brain and behaviour. Alcohol Res Health 2001, 25:185-191.
  • [3]Streissguth AP, O'Malley K: Neuropsychiatric implications and long-term consequences of fetal alcohol spectrum disorders. Semin Clin Neuropsychiatry 2000, 5(3):177-190.
  • [4]O'Leary C: Fetal alcohol syndrome: a literature review. Canberra, Commonwealth of Australia; 2002.
  • [5]Riley EP, McGee CL, Sowell ER: Teratogenic effects of alcohol: a decade of brain imaging. Am J Med Genet 2004, 127C(1):35-41.
  • [6]Maconochie N, Doyle P, Prior S, Simmons R: Risk factors for first trimester miscarriage: results from a UK population-based case–control study. BJOG 2007, 114(2):170-186.
  • [7]Sampson PD, Streissguth AP, Bookstein FL, Little RE, Clarren SK, Dehaene P, Hanson JW, Graham JM Jr: Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopmental disorder. Teratology 1997, 56:317-326.
  • [8]Holman CDJ, English DR, Bower C, Kurinczuk JJ: NHMRC recommendations on abstinence from alcohol in pregnancy. Med J Aust 1996, 164(11):699.
  • [9]Elliott EJ, Bower C: Alcohol and pregnancy: the pivotal role of the obstetrician. ANZJOG 2008, 48(3):236-239.
  • [10]Burd L, Roberts D, Olson M, Odendaal H: Ethanol and the placenta: a review. J Matern Fetal Neonatal Med 2007, 20(5):361-375.
  • [11]Aliyu MH, Wilson RE, Zoorob R, Chakrabarty S, Alio AP, Kirby RS, Salihu HM: Alcohol consumption during pregnancy and the risk of early stillbirth among singletons. Alcohol 2008, 42(5):369-374.
  • [12]Kesmodel U, Wisborg K, Olsen SF, Henriksen TB, Secher NJ: Moderate alcohol intake during pregnancy and the risk of stillbirth and death in the first year of life. Am J Epidemiol 2002, 155:305-312.
  • [13]O'Leary C, Jacoby P, D'Antoine H, Bartu A, Bower C: Heavy prenatal alcohol exposure and increased risk of stillbirth. BJOG 2012, 119(8):945-952.
  • [14]Sokol RJ, Janisse JJ, Louis JM, Bailey BN, Ager J, Jacobson SW, Jacobson JL: Extreme prematurity: an alcohol-related birth effect. Alcohol Clin Exp Res 2007, 31(6):1031-1037.
  • [15]Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N: Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. Can Med Assoc J 2005, 172(5 Suppl):S1-S21.
  • [16]Barr HM, Streissguth AP: Identifying maternal self-reported alcohol use associated with fetal alcohol spectrum disorders. Alcohol Clin Exp Res 2001, 25(2):283-287.
  • [17]Watkins RE, Elliott EJ, Wilkins A, Mutch RC, Fitzpatrick JP, Payne JM, O'Leary CM, Jones HM, Latimer J, Hayes L, Halliday J, D’Antoine H, Miers S, Russell E, Burns L, McKenzie A, Peadon E, Carter M, Bower C: Recommendations from a consensus development workshop on the diagnosis of fetal alcohol spectrum disorders in Australia. BMC Pediatr 2013, 13(1):156.
  • [18]May PA, Gossage JP, Kalberg WO, Robinson LK, Buckley D, Manning M, Hoyme HE: Prevalence and epidemiologic characteristics of FASD from various research methods with an emphasis on recent in-school studies. Dev Disabil Res Rev 2009, 15(3):176-192.
  • [19]Chudley AE: Fetal Alcohol Spectrum Disorder: Counting the invisible - mission impossible? Arch Dis Child 2008, 93(9):721-722.
  • [20]Elliott E, Payne J, Morris A, Haan E, Bower C: Fetal alcohol syndrome: a prospective national surveillance study. Arch Dis Child 2008, 93:732-737.
  • [21]Harris KR, Bucens IK: Prevalence of fetal alcohol syndrome in the top end of the Northern Territory. J Paediatr Child Health 2003, 39:528-533.
  • [22]Mattson SN, Riley EP, Gramling L, Delis DC, Jones KL: Heavy prenatal alcohol exposure with or without physical features of fetal alcohol syndrome leads to IQ deficits. J Pediatr 1997, 131(5):718-721.
  • [23]O'Leary C, Leonard H, Bourke J, D'Antoine H, Bartu A, Bower C: Intellectual disability: population-based estimates of the proportion attributable to maternal alcohol use disorder during pregnancy. Dev Med Child Neurol 2013, 55(3):271-277.
  • [24]Mattson SN, Riley EP: A review of the neurobehavioral deficits in children with fetal alcohol syndrome or prenatal exposure to alcohol. Alcohol Clin Exp Res 1998, 22(2):279-294.
  • [25]Mattson SN, Riley EP, Delis DC, Stern C, Jones KL: Verbal learning and memory in children with fetal alcohol syndrome. Alcohol Clin Exp Res 1996, 20(5):810-816.
  • [26]Mattson SN, Riley EP: Implicit and explicit memory functioning in children with heavy prenatal alcohol exposure. J Int Neuropsychol Soc 1999, 5(5):462-471.
  • [27]Riley EP, McGee CL: Fetal alcohol spectrum disorders: an overview with emphasis on changes in brain and behavior. Exp Biol Med 2005, 230(6):357-365.
  • [28]Burden MJ, Jacobson SW, Jacobson JL: Relation of prenatal alcohol exposure to cognitive processing speed and efficiency in childhood. Alcohol Clin Exp Res 2005, 29(8):1473-1483.
  • [29]Rasmussen C: Executive functioning and working memory in fetal alcohol spectrum disorder. Alcohol Clin Exp Res 2005, 29(8):1359-1367.
  • [30]Streissguth AP, Bookstein FL, Barr HM, Sampson PD, O'Malley K, Young JK: Risk factors for adverse life outcomes in fetal alcohol syndrome and fetal alcohol effects. J Dev Behav Pediatr 2004, 25(4):228-238.
  • [31]Spohr HL, Willms J, Steinhausen HC: Fetal alcohol spectrum disorders in young adulthood. J Pediatr 2007, 150(2):175-179.
  • [32]Streissguth AP, Aase JM, Clarren SK, Randels SP, LaDue RA, Smith DF: Fetal alcohol syndrome in adolescents and adults. JAMA 1991, 265:1961-1967.
  • [33]Streissguth A: Fetal alcohol syndrome: a guide for families and communities. Baltimore, Paul H Brookes; 1997.
  • [34]Streissguth A, Barr H, Kogan J, Bookstein F: Primary and secondary disabilities in fetal alcohol syndrome. In The challenge of fetal alcohol syndrome: overcoming secondary disabilities. Edited by Streissguth A, Kanter J. University of Washington Press, Seattle; 1997.
  • [35]O'Leary CM, Bower C: Guidelines for pregnancy: what's an acceptable risk, and how is the evidence (finally) shaping up? Drug Alcohol Rev 2012, 31(2):170-183.
  • [36]Sokol R, Delaney-Black V, Nordstrom B: Fetal alcohol spectrum disorder. JAMA 2003, 290(22):2996-2999.
  • [37]Henderson J, Gray R, Brocklehurst P: Systematic review of the effects of low-moderate prenatal alcohol exposure on pregnancy outcome. BJOG 2007, 114(3):243-352.
  • [38]O'Leary C: Fetal Alcohol Syndrome. In Management guidelines: developmental disability. Volume Version 2. Therapeutic Guidelines Ltd, Melbourne; 2005.
  • [39]Australian Guidelines to Reduce Health Risks from Drinking Alcohol. Commonwealth of Australia, Canberra; 2009.
  • [40]Lupton C, Burd L, Harwood R: Cost of fetal alcohol spectrum disorders. Am J Med Genet 2004, 127C(1):42-50.
  • [41]Towards safer drinking cultures 2006–2009. Commonwealth Department of Health and Ageing, Canberra; 2006.
  • [42]Burns L, Black E, Elliott E: Monograph of the Intergovernmental Committee on Drugs Working Party on Fetal Alcohol Spectrum Disorders. Fetal Alcohol Spectrum Disorders in Australia: An Update. Sydney, National Drug and Alcohol Research Centre; 2009.
  • [43]Young A, Powers J: Australian women and alcohol consumption 1996–2003. Canberra, Commonwealth of Australia; 2005.
  • [44]Chikritzhs T, Catalano P, Stockwell T, Donath S, Ngo H, Young D, Matthews S: Australian alcohol indicators, 1990–2001. Perth, National Drug Research Institute; 2003.
  • [45]Alcohol consumption in Australia: a snapshot, 2004–05. Australian Government, Canberra; 2006.
  • [46]2010 National Drug Strategy Household Survey Report. Australian Institute of Health and Welfare, Canberra; 2011.
  • [47]Gladstone J, Nulman I, Koren G: Reproductive risks of binge drinking during pregnancy. Reprod Toxicol 1996, 10(1):3-13.
  • [48]Walker DS, Darling Fisher CS, Sherman A, Wybrecht B, Kyndely K: Fetal alcohol spectrum disorders prevention: an exploratory study of women's use of, attitudes toward, and knowledge about alcohol. J Am Acad Nurse Pract 2005, 17(5):187-193.
  • [49]Peadon E, Payne J, Bower C, Elliott E, Henley N, O'Leary C, D'Antoine H, Bartu A: Alcohol and pregnancy: women's knowledge, attitudes and practice. J Paediatr Child Health 2007, 43(7–8):A1. -A22, A12
  • [50]Allard-Hendren R: Alcohol use and adolescent pregnancy. MCN Am J Matern Child Nurs 2000, 25(3):159-162.
  • [51]Flanigan B, McLean A, Hall C, Propp V: Alcohol use as a situational influence on young women's pregnancy risk-taking behaviors. Adolescence 1990, 25(97):205-214.
  • [52]Colvin L, Payne J, Parsons D, Kurinczuk J, Bower C: Alcohol consumption during pregnancy in non-Indigenous West Australian women. Alcohol Clin Exp Res 2007, 31(2):276-284.
  • [53]Floyd RL, O'Connor MJ, Sokol RJ, Bertrand J, Cordero JF: Recognition and prevention of fetal alcohol syndrome. Obstet Gynecol 2005, 106(5 Pt 1):1059-1064.
  • [54]Floyd RL, Decoufle P, Hungerford DW: Alcohol use prior to pregnancy recognition. Am J Prev Med 1999, 17:101-107.
  • [55]Raymond N, Beer C, Glazebrook C, Sayal K: Pregnant women's attitudes towards alcohol consumption.BMC Public Health 2009, 9(175)ᅟ. doi:10.1186/1471-2458-1189-1175.
  • [56]O'Callaghan FV, O'Callaghan M, Najman JM, Williams GM, Bor W: Maternal alcohol consumption during pregnancy and physical outcomes up to 5 years of age: a longitudinal study. Early Hum Dev 2003, 71:137-148.
  • [57]Callinan S, Room R: Alcohol consumption during pregnancy: Results from the 2010 National Drug Strategy Household Survey. Melbourne, Centre for Alcohol Policy Research; 2012.
  • [58]Anderson AE, Hure AJ, Forder P, Powers JR, Kay-Lambkin FJ, Loxton DJ: Risky drinking patterns are being continued into pregnancy: a prospective cohort study. PLOS one 2014, 9(7):e86171.
  • [59]Anderson AE, Hure AJ, Forder P, Powers JR, Kay-Lambkin FJ, Loxton DJ: Predictors of antenatal alcohol use among Australian women: a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology 2013, 120(11):1366-1374.
  • [60]Jones SC, Eval M, Telenta J, Cert G, Shorten A, Johnson K: Midwives and pregnant women talk about alcohol: what advice do we give and what do they receive? Midwifery 2011, 27(4):489-496.
  • [61]Gilinsky A: Alcohol-related health promotion in maternity services: Factors associated with midwifery practice in NHS Tayside. Tayside, National Health Service; 2009.
  • [62]Kesmodel US, Kesmodel PS: Alcohol in pregnancy: attitudes, knowledge, and information practice among midwives in Denmark 2000 to 2009. Alcohol Clin Exp Res 2011, 35(12):2226-2230.
  • [63]Grol R: Successes and failures in the implementation of evidence-based guidelines in clinical practice. Med Care 2001, 39(8 supp 2):46-54.
  • [64]Goransson M, Faxelid E, Heilig M: Beliefs and reality: Detection and prevention of high alcohol consumption in Swedish antenatal clinics. Acta Obstet Gynecol Scand 2004, 83(9):796-800.
  • [65]Diekman ST, Floyd RL, De'coufle' P, Schulkin J, Ebrahim SH, Sokol RJ: A survey of obstetrician-gynecologists on their patients' alcohol use during pregnancy. Obstet Gynecol 2000, 95:756-763.
  • [66]Sharpe TT, Alexander M, Hutcherson J, Floyd RL, Brimacombe M, Levine R, Mengel M, Stuber M: Report from the CDC. Physician and allied health professionals' training and fetal alcohol syndrome. J Women's Health 2004, 13:133-139.
  • [67]Payne J, Elliott E, D'Antoine H, O'Leary C, Mahony A, Haan E, Bower C: Health professionals' knowledge, practice and opinions about fetal alcohol syndrome and alcohol consumption in pregnancy. Aust N Z J Public Health 2005, 29(6):558-564.
  • [68]Holmqvist M, Nilsen P: Approaches to assessment of alcohol intake during pregnancy in Swedish maternity care - a national-based investigation into midwives' alcohol-related education, knowledge and practice. Midwifery 2010, 26:430-434.
  • [69]Peadon E, Payne J, Henley N, O'Leary C, D’Antoine H, Bartu A, Bower C, Elliott E: How do women want to be informed about alcohol use in pregnancy? In Book of Abstracts 4th International Conference on Fetal Alcohol Spectrum Disorders The Power of Knowledge Integrating Research, Policy, and Promoting Practice Around the World. University of British Columbia, Vancouver; 2011.
  • [70]O'Connor MJ, Whaley SE: Brief intervention for alcohol use by pregnant women. Am J Public Health 2007, 97(2):252-258.
  • [71]Burns L, Breen C: It's time to have the conversation: Understanding the treatment needs of women who are pregnant and alcohol dependent. Sydney, National Drug and Alcohol Research Centre; 2013.
  • [72]Roche AM, Deehan A: Women's alcohol consumption: emerging patterns, problems an public health implications. Drug Alcohol Rev 2002, 21(2):169-178.
  • [73]Elliott E, Payne J, Haan E, Bower C: Diagnosis of foetal alcohol syndrome and alcohol use in pregnancy: a survey of paediatricians' knowledge, attitudes and practice. J Paediatr Child Health 2006, 42:698-703.
  • [74]Payne JM, France KE, Henley N, D'Antoine HA, Bartu AE, O'Leary CM, Elliott EJ, Bower C, Geelhoed E: RE-AIM evaluation of the alcohol and pregnancy project: educational resources to inform health professionals about prenatal alcohol exposure and fetal alcohol spectrum disorder. Eval Health Prof 2011, 34(1):57-80.
  • [75]Payne JM, France KE, Henley N, D'Antoine HA, Bartu AE, Mutch RC, Elliott EJ, Bower C: Paediatricians' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. J Paediatr Child Health 2011, 47:704-710.
  • [76]Payne J, France K, Henley N, D'Antoine H, Bartu A, O'Leary C, Elliott E, Bower C: Changes in health professionals' knowledge, attitudes and practice following provision of educational resources about prevention of prenatal alcohol exposure and fetal alcohol spectrum disorder. Paediatr Perinat Epidemiol 2011, 25(4):316-327.
  • [77]Clarke M, Tough SC, Hicks M, Clarren S: Approaches of Canadian providers to the diagnosis of fetal alcohol spectrum disorders. J FAS Int 2005, 3:e2.
  • [78]Tough SC, Clarke M, Hicks M, Clarren S: Attitudes and approaches of Canadian providers to preconception counselling and the prevention of fetal alcohol spectrum disorders. J FAS Int 2005, 3:e3.
  • [79]Herzig K, Huynh D, Gilbert P, Danley DW, Jackson R, Gerbert B: Comparing prenatal providers' approaches to four different risks: alcohol, tobacco, drugs, and domestic violence. Women Health 2006, 43(3):83-101.
  • [80]Reibel T: Prevention of alcohol and tobacco use in pregnancy: Audit of WA Department of Health antenatal services use of alcohol & tobacco brief interventions in pregnancy. Perth, Telethon Institute for Child Health Research; 2011.
  • [81]Seib CA, Daglish M, Heath R, Booker C, Reid C, Fraser J: Screening for alcohol and drug use in pregnancy. Midwifery 2012, 28(6):760-764.
  • [82]Version 20. SPSS Inc, New York; 2010.
  • [83]Kesmodel U, Schioler Kesmodel P: Drinking during pregnancy: attitudes and knowledge among pregnant Danish women, 1998. Alcohol Clin Exp Res 2002, 26:1553-1560.
  • [84]France K, Henley N, Payne J, D'Antoine H, Bartu A, O'Leary C, Elliott E, Bower C: Health professionals addressing alcohol use with pregnant women in Western Australia: barriers and strategies for communication. Subst Use Misuse 2010, 45(10):1474-1490.
  • [85]Cameron C, Davey T, Kendall E, Wilson AM,RJ: Changes in alcohol consumption in pregnant Australian women between 2007 and 2011. Med J Aust 2013, 199(5):355-357.
  • [86]Anderson A, Hure A, Powers J, Kay-Lambkin F, Loxton D: Determinants of pregnant women's compliance with alcohol guidelines: a prospective cohort study. BMC Public Health 2012, 12(1):777.
  • [87]Fiore M, Bailey W, Cohen S, Dorfman S, Goldstein M, Gritz E, Heyman R, Jaen C, Kottke T, Lando H, Mecklenburg R, Mullen P, Nett L, Robinson L, Stitzer M, Tommasello A, Villejo L, Wewers M: Treating tobacco use and dependence: clinical practice guideline. Rockville MD, US Department of Health and Human Services; 2000.
  • [88]Australian Alcohol Guidelines: Health Risks and Benefits. Commonwealth of Australia, Canberra; 2001.
  • [89]Anderson P, Kaner E, Wutzke S, Funk M, Heather N, Wensing M, Grol R, Gual A, Pas L: WBIS: Attitudes and managing alcohol problems in general practice: an interaction analysis based on findings from a WHO collaborative study. Alcohol Alcsm 2004, 39(4):351-356.
  • [90]Alcohol and Tobacco Brief Intervention Policy. Government of Western Australia, Perth; 2010.
  • [91]MR202E Alcohol and Tobacco Screening Tool. Government of Western Australia, Perth; 2010.
  • [92]AUDIT the alcohol use disorders identification test: guidelines for use in primary care. Word Health Organization, Geneva; 2001.
  • [93]Western Australian across sector statewide Implementation Plan for the Fetal Alcohol Spectrum Disorder Model of Care 2013–2018. Health Networks Branch, Department of Health Western Australia, Perth; 2013.
  • [94]National Woman Held Pregnancy Record. Australian Health Ministers' Advisory Council. Commonwealth of Australia, Canberra; 2013.
  文献评价指标  
  下载次数:11次 浏览次数:54次