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

Janae Dunkley1,2, Nicholas P Deputy3,4, Clark H Denny3

  • 1Division of Birth Defects and Infant Disorders, National Center On Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, 4770 Buford Hwy NE, Atlanta, Chamblee, GA, 30341, USA. janae.dunkley@emory.edu.

Maternal and Child Health Journal
|November 20, 2024
PubMed

Insights

Clinicians rarely screen for prenatal alcohol exposure (PAE) in all pediatric patients, missing opportunities to identify children with fetal alcohol spectrum disorders (FASDs). Improved training and support are needed for routine PAE history collection.

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.
Abstract

Keywords:
Developmental disabilitiesDevelopmental/behavioral issuesFetal alcohol spectrum disordersFetal alcohol syndromePrenatal alcohol exposure

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