ABSTRACT
Because alcohol is a known teratogenic substance that negatively affects the fetus, screening for alcohol use is included in maternal child texts for nurses. They present no standard screening approach, however. In the general literature, a multitude of screening instruments exist for the purpose of detecting maternal alcohol dependence but few allow the nurse to detect fetal alcohol exposure in the absence of maternal alcohol dependence. After a comparative analysis of existing screening instruments, we concluded that the Timeline Followback method has the most utility as a screening instrument to detect fetal exposure to alcohol. The purpose of this article is to present a critical review of current screening instruments related to alcohol consumption in pregnant women and to propose the use of the Timeline Followback method as the preferred approach.
Subject(s)
Alcohol Drinking , Alcoholism/diagnosis , Fetal Alcohol Spectrum Disorders/diagnosis , Mass Screening/methods , Pregnancy Complications/diagnosis , Alcohol Drinking/prevention & control , Alcoholism/prevention & control , Algorithms , Decision Trees , Female , Fetal Alcohol Spectrum Disorders/prevention & control , Humans , Mass Screening/standards , Nursing Assessment/methods , Pregnancy , Pregnancy Complications/prevention & control , Prenatal Care/methods , Sensitivity and Specificity , Substance Abuse Detection/methods , Time FactorsABSTRACT
Alcohol is a known teratogenic substance that operates under a dose-response mechanism. Before we conducted a larger study that examines the use of alcohol both before pregnancy and during pregnancy, it was important to pilot our method for measuring a pregnant mother's alcohol use that would allow us to capture the number of drinks consumed per day while addressing recall bias. The purpose of this study was 1) to pilot the Time Line Followback (TLFB) method developed by Sobell and Sobell (1992, Measuring Alcohol Use. Totowa, NJ: Humana Press) as a method for examining alcohol use during pregnancy and 2) to determine if the use of a study protocol that included biological markers of alcohol use would affect our ability to recruit subjects. Using a descriptive design, we tested our protocol for collecting alcohol use data with 10 mothers receiving prenatal care. We measured alcohol use using the TLFB method (Sobell and Sobell, 1992, Measuring Alcohol Use. Totowa, NJ: Humana Press, 1996). We also collected collected biological blood markers for heavy alcohol use. Of the 10 maternal subjects we recruited, 5 mothers (50%) reported alcohol use during pregnancy. We successfully recruited 10 out of 11 mothers approached and had a 100% retention rate for the second interview. The TLFB method is viable for measuring fetal alcohol exposure over the pregnancy, and the collection of blood samples did not impact our ability to recruit or retain mothers.
