Assessing Prenatal Alcohol Exposure History for Pediatric Patients: Practices Among U.S. Clinicians

Area of Science:

• Pediatric healthcare
• Public health
• Clinical practice guidelines

Background:

• The American Academy of Pediatrics recommends screening for prenatal alcohol exposure (PAE) in pediatric patients.
• Screening facilitates identification of fetal alcohol spectrum disorders (FASDs) and access to interventions.

Purpose of the Study:

• To evaluate the frequency of PAE history assessment by clinicians in pediatric patient interactions.
• To determine the methods used by clinicians to ascertain PAE information.

Main Methods:

• Analysis of data from the Fall 2020 DocStyles web-based survey of 1754 primary healthcare professionals.
• Calculation of PAE assessment frequency by clinician specialty (pediatricians, family practitioners, NP/PAs) and patient population.
• Statistical comparison of assessment frequency across specialties using chi-square and Bonferroni tests.

Main Results:

• Approximately 70.5% of clinicians often/always obtained PAE history for children with developmental issues, 63.0% for adopted/foster children, and 60.7% for newborns.
• Less than half collected PAE history from parents of infants (47.6%) and new patients (38.2%).
• Pediatricians were more likely than family practitioners to collect PAE history for adopted/foster children (71.5% vs. 57.7%).

Conclusions:

• Prenatal alcohol exposure (PAE) history is not routinely obtained for all pediatric patients.
• Findings indicate a need for enhanced clinician training and practice support.
• Improved screening can aid in identifying and treating children at risk for FASDs.