A comprehensive local program for the prevention of fetal alcohol syndrome

A hospital based, comprehensive approach to the prevention of Fetal Alcohol Syndrome and Fetal Alcohol Effects that combines clinical assessment, community outreach, and epidemiologic knowledge to attack alcohol-related birth defects is described. The program includes training of clinicians and members of the community, baseline screening of suspected children, and alcohol consumption screening of pregnant women in prenatal clinics. The major, although not exclusive, focus of the program is on tertiary prevention undertaken with women defined as "high risk" for producing alcohol affected children. Of the 48 women referred to the program at the Tuba City, AZ, Indian Medical Center between January 1988 and July 1989, 39 (81 percent) became participants. Complete followup was possible on 31; 17 of them reported alcohol abstinence in July 1989, 18 months into the program. Of the 29 referred women who were pregnant at the time, 21 agreed to participate; of these, 19 (85.7 percent) were abstinent by the third trimester of pregnancy; 5 voluntarily accepted offers of contraceptive measures after the birth of their child.