Two prenatal alcohol use screening instruments compared with a physiologic measure

Area of Science:

• Obstetrics and Gynecology
• Addiction Medicine
• Public Health

Background:

• Prenatal alcohol exposure is a leading preventable cause of birth defects and developmental disabilities.
• Accurate screening for alcohol use during pregnancy is crucial for early intervention and improved outcomes.
• Existing screening tools vary in their effectiveness, necessitating comparative studies.

Purpose of the Study:

• To compare the sensitivity and specificity of two prenatal alcohol use screening instruments: the Prenatal Alcohol Use Interview (PAUI) and the ACOG Antepartum Record.
• To evaluate these instruments against a physiologic measure, CDTect, for detecting prenatal alcohol use.

Main Methods:

• A retrospective comparison of the PAUI and ACOG Antepartum Record was conducted.
• Data were collected from 56 women at their initial prenatal visits in an inner-city clinic.
• The study assessed the relative sensitivity and specificity of the screening instruments against CDTect.

Main Results:

• The PAUI identified significantly more women as 'Drinkers' (59%) compared to the ACOG Antepartum Record (19%) when compared against CDTect.
• The PAUI exhibited a lower false-negative rate (41%) than the ACOG Antepartum Record (80%).
• This indicates the PAUI is less likely to misclassify women who used alcohol as non-users.

Conclusions:

• The Prenatal Alcohol Use Interview (PAUI) demonstrates superior sensitivity for screening prenatal alcohol use compared to the ACOG Antepartum Record.
• The PAUI is recommended as the preferred instrument for routine prenatal alcohol use screening.
• Improved screening can facilitate timely interventions for pregnant individuals using alcohol.