Brief screening questionnaires to identify problem drinking during pregnancy: a systematic review.

Area of Science:

• Obstetrics and Gynecology
• Addiction Medicine
• Public Health

Background:

• Prenatal care guidelines recommend screening for problem drinking during pregnancy.
• However, there is a lack of guidance on specific screening instruments for this population.
• Identifying at-risk drinking is crucial for maternal and fetal health outcomes.

Purpose of the Study:

• To investigate the sensitivity, specificity, and predictive value of brief alcohol screening questionnaires.
• To evaluate their effectiveness in identifying problem drinking among pregnant women.

Main Methods:

• A systematic review of electronic databases and reference lists was conducted.
• Included studies compared brief alcohol screening questionnaires with structured interviews for detecting at-risk drinking, alcohol abuse, or dependency.
• Seven instruments were evaluated: TWEAK, T-ACE, CAGE, NET, AUDIT, AUDIT-C, and SMAST.

Main Results:

• Five studies with 6724 participants were included. T-ACE, TWEAK, and AUDIT-C demonstrated high sensitivity and specificity for detecting at-risk drinking.
• AUDIT-C showed high sensitivity for past-year alcohol dependence and alcohol use disorder.
• CAGE and SMAST performed poorly, and AUDIT performed poorly for lifetime alcohol dependency.

Conclusions:

• T-ACE, TWEAK, and AUDIT-C show potential for screening at-risk drinking during pregnancy.
• AUDIT-C may also aid in identifying alcohol dependency or abuse.
• Further evaluation of these and other questionnaires as standalone tools for prenatal alcohol use screening is warranted.