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Screening for alcohol and drug use in pregnancy

Seib, Charrlotte A., Daglish, Mark, Heath, Renée, Booker, Catriona, Reid, Carol, & Fraser, Jennifer (2012) Screening for alcohol and drug use in pregnancy. Midwifery, 28(6), pp. 760-764.

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Abstract

Objective

this study examined the clinical utility and precision of routine screening for alcohol and other drug use among women attending a public antenatal service.

Study design

a survey of clients and audit of clinical charts.

Participants and setting

clients attending an antenatal clinic of a large tertiary hospital in Queensland, Australia, from October to December 2009.

Measurements and findings

data were collected from two sources. First, 32 women who reported use of alcohol or other drugs during pregnancy at initial screening were then asked to complete a full substance use survey. Second, data were collected from charts of 349 new clients who attended the antenatal clinic during the study period. Both sensitivity (86%, 67%) and positive predictive value (100%, 92%) for alcohol and other drug use respectively, were high. Only 15% of surveyed women were uncomfortable about being screened for substance use in pregnancy, yet the chart audit revealed poor staff compliance. During the study period, 25% of clients were either not screened adequately or not at all.

Key conclusions and implications for practise

despite recommended universal screening in pregnancy and the apparent acceptance by our participants, alcohol and other drug (A&OD) screening in the antenatal setting remains problematic. Investigation into the reasons behind, and ways to overcome, the low screening rate could improve health outcomes for mothers and children in this at-risk group. Targeted education and training for midwives may form part of the solution as these clinicians have a key role in implementing prevention and early intervention strategies.

Impact and interest:

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ID Code: 49831
Item Type: Journal Article
Keywords: Pregnancy, Alcohol and Other Drug Use, Clinical Assessment Tools, Prenatal Care
DOI: 10.1016/j.midw.2011.08.003
ISSN: 0266-6138
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > NURSING (111000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PAEDIATRICS AND REPRODUCTIVE MEDICINE (111400)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Nursing
Copyright Owner: Copyright 2011 Elsevier
Copyright Statement: This is the author’s version of a work that was accepted for publication in Midwifery. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Midwifery, [VOL 28, ISSUE 6, (2012)] DOI: 10.1016/j.midw.2011.08.003
Deposited On: 24 Apr 2012 10:50
Last Modified: 03 Jan 2014 03:09

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