Screening for alcohol related problems in the antenatal clinic; an assessment of different methods

This paper assesses different methods of asking about alcohol consumption in the antenatal clinic. Reliable screening methods are essential if appropriate intervention is to be accurately targeted. Women attending antenatal clinic for the first time were questioned about their alcohol consumption in the period immediately before confirmation of pregnancy. Quantity-frequency questions, a question about bingeing and the Cage Questions were asked as part of the routine clinical history by the interviewing doctor. In addition, the women were given a further self-completed questionnaire which contained more detailed questions about the usual quantity and frequency of drinking beers, wines and spirits, the Cage Questions again and the Brief Michigan Alcoholism Screening Test (BMAST). Asking simple quantity-frequency questions coupled with a question about bingeing during the clinical history was shown to be a quick and efficient method of estimating alcohol intake. Self-administered questionnaires were shown to be unnecessary and although the Cage Questions performed better than the BMAST, these alcoholism screening tests were found to be unreliable in this population in which drinking was generally at a low level.