OB-GYNs Surveyed on Patients' Alcohol Use During Pregnancy

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Efforts should be made to provide practicing obstetrician-gynecologists (ob-gyns) with updates on the adverse effects of alcohol use by pregnant women and with effective methods for screening and counseling women who report alcohol use during pregnancy. A study in Obstetrics & Gynecology surveyed practicing ob-gyns on their knowledge, attitudes, current clinical practices, and educational needs regarding patients' alcohol use during pregnancy.

A survey was sent to 1,000 physicians, with 60% responding. Findings include the following:

• 97% of the respondents reported asking their pregnant patients about alcohol use. When a patient said she used alcohol, most ob-gyns reported that they always discuss adverse effects and advise abstinence;
• 20% of respondents cited abstinence as the safest way to avoid the four adverse pregnancy outcomes associated with alcohol use (i.e., spontaneous abortion, central nervous system impairment, birth defects, and fetal alcohol syndrome);
• 13% of respondents were unsure about levels associated with all of the four adverse outcomes;
• 4% of respondents reported that consuming eight or more drinks per week did not increase the risk for any of the four adverse outcomes; and
• Respondents said that they needed these resources in order to improve their ability to assess pregnant women's alcohol use: 1) information on thresholds for adverse reproductive outcomes (83%) and 2) referral resources for patients who misuse alcohol (63%).

The authors note that the study's limitations include the possibility of self-reporting bias (i.e., participants may have given socially desirable responses to questions).

The article states that since 1981 federal advisories have called for pregnant women to abstain from alcohol. Nonetheless, "results of this survey indicate that many clinicians are not convinced that total abstinence from alcohol use is necessary for a pregnant woman. This disparity in viewpoints should be given attention by encouraging meaningful dialogue between professional organizations and public health agencies on this issue." Furthermore, survey results call for "renewed and combined efforts of federal, professional, and nonprofit agencies ... in raising public awareness of the potential risks of moderate and heavy alcohol use during pregnancy" and in helping physicians assess and counsel pregnant women.

Diekman ST. 2000. A survey of obstetrician-gynecologists on their patients' alcohol use during pregnancy. Obstetrics & Gynecology 95(5):756-763.

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MCH Alert. 2001. Arlington, VA: National Center for Education in Maternal and Child Health. http://www.ncemch.org/alert.