Reliability of a self-report Italian version of the AUDIT-C questionnaire, used to estimate alcohol consumption by pregnant women in an obstetric setting.

AIM: Alcohol consumption during pregnancy can result in a range of harmful effects on the developing foetus and newborn, called Fetal Alcohol Spectrum Disorders (FASD). The identification of pregnant women who use alcohol enables to provide information, support and treatment for women and the surveillance of their children. The AUDIT-C (the shortened consumption version of the Alcohol Use Disorders Identification Test) is used for investigating risky drinking with different populations, and has been applied to estimate alcohol use and risky drinking also in antenatal clinics. The aim of the study was to investigate the reliability of a self-report Italian version of the AUDIT-C questionnaire to detect alcohol consumption during pregnancy, regardless of its use as a screening tool. METHODS: The questionnaire was filled in by two independent consecutive series of pregnant women at the 38th gestation week visit in the two birth locations of the Local Health Authority of Treviso (Italy), during the years 2010 and 2011 (n=220 and n=239). Reliability analysis was performed using internal consistency, item-total score correlations, and inter-item correlations. The "discriminatory power" of the test was also evaluated. Results. Overall, about one third of women recalled alcohol consumption at least once during the current pregnancy. The questionnaire had an internal consistency of 0.565 for the group of the year 2010, of 0.516 for the year 2011, and of 0.542 for the overall group. The highest item total correlations' coefficient was 0.687 and the highest inter-item correlations' coefficient was 0.675. As for the discriminatory power of the questionnaire, the highest Ferguson's delta coefficient was 0.623. CONCLUSIONS: These findings suggest that the Italian self-report version of the AUDIT-C possesses unsatisfactory reliability to estimate alcohol consumption during pregnancy when used as self-report questionnaire in an obstetric setting.

Evaluation of a Multilevel and Integrated Program to Raise Awareness of the Harmful Effects of Prenatal Alcohol Exposure in a Local Community.

AIMS: To evaluate a multilevel program to raise awareness of the risks of prenatal exposure to alcohol in the area of Treviso (Italy). The program started in 2008 and consists of an action-research experience involving health professionals of maternal-child services, and in the campaign 'Mamma Beve Bimbo Beve', targeted to the childbearing-aged population. METHODS: A comparative study was carried out in 2013. Surveys using semi-structured self-report questionnaires were carried out among professionals and pregnant women in Treviso, and among control groups belonging to another local area of Italy (Verona). The questionnaires investigated awareness and opinions about alcohol and pregnancy, as well as sources and kind of information provided and received. RESULTS: Health professionals in Treviso, who had been exposed both to the action-research experience and to the campaign, showed a more rational approach to alcohol than colleagues in the control group, and were more aware and sensitized about the risks of alcohol consumption during pregnancy. Physicians and midwives had a higher probability of having advised pregnant women to abstain from alcohol in Treviso. Pregnant women in Treviso, who had received information through the campaign and from professionals, had a higher probability of having received only correct advice about the issue of alcohol and pregnancy, but did not hold perceptions different to women in Verona. CONCLUSIONS: The multilevel program carried out in the Treviso area was effective in increasing awareness and improving attitudes towards the risks of alcohol use during pregnancy among local healthcare professionals, compared with the control group.