Consumo de álcool na gestação: desempenho da versão brasileira do questionário T-ACE

Abstract

OBJETIVO: Avaliar as características de desempenho da versão brasileira do questionário Tolerance, Annoyed, Cut down e Eye-opener (T-ACE), para rastreamento do consumo de álcool na gestação. MÉTODOS: Estudo observacional, transversal, em amostra seqüencial de 450 mulheres no terceiro trimestre de gestação, assistidas em maternidade no município de Ribeirão Preto, estado de São Paulo, em 2001. Foram aplicados: questionário para coleta de dados sociodemográficos, T-ACE, questionário para levantamento da história de consumo de álcool ao longo da gestação e entrevista clínica para identificação de uso nocivo e dependência ao álcool, segundo critérios diagnósticos da CID-10. Foram feitos testes de concordância entre diferentes entrevistadores e de confiabilidade teste/re-teste. RESULTADOS: Do total, 100 gestantes (22,1%) foram consideradas positivas pelo T-ACE. Os índices kappa para concordância e confiabilidade foram 0,95, com 97% de respostas concordantes. Quando comparado aos parâmetros da CID-10 e ao padrão de consumo, o T-ACE com ponto de corte igual ou acima de dois pontos, apresentou coeficientes de sensibilidade e especificidade de 100% e 85% e de 97,9% e 86,6% respectivamente. CONCLUSÕES: A versão brasileira do T-ACE mostrou preencher adequadamente os critérios de desempenho que a qualificam ao papel de instrumento básico para o rastreamento do consumo de álcool durante a gravidez. Sua utilização é recomendável nas rotinas e práticas dos serviços obstétricos devido à tendência de aumento do consumo alcoólico feminino, dificuldades para identificação do abuso de álcool pela gestante e riscos de problemas de desenvolvimento nos filhos.

Prevalence and factors associated with alcohol consumption during pregnancy

“…Furthermore, alcohol causes rapid placental vasoconstriction, due to oxidative stress, which causes a decrease in nitric oxide, and due to dysregulation of the balance of thromboxane (vasoconstrictor) and prostacyclin (vasodilator), still feel guilty and ashamed, and especially in those situations where newborns have unfavorable perinatal outcomes (malformed or premature children), it can be considered that there is bias in maternal memory and fewer women admit to drinking while pregnant. 22 All these aspects can undersize the alcohol consumption statistics in pregnancy and explain even the great variability in prevalence that occurred in different studies using the same screening tool. This research identified two variables whose results showed statistically significant differences between women who used alcohol or not during pregnancy: lower birth weight and no steady partner.…”

“…Furthermore, the Brazilian version of the T-ACE questionnaire was carried out. 22 Regarding sociodemographic information, the age of women was expressed in years. The color of the skin was categorized according to the IBGE (Brazilian Institute of Geography and Statistics) considering the following options: white, black, yellow, brown or indigenous.…”

“…22 When answering the questionnaire, whoever reaches a score of ≥ 2 is considered a positive case, i.e., is identified as an alcohol consumer. 20,22 The results were analyzed by distinguishing two groups of participants according to the T-ACE score: T-ACE negative (T-ACE score <2) and T-ACE positive (T-ACE score ≥ 2).…”

“…[14][15][16][17][18][19] T-ACE (Tolerance, Annoyed, Cut Down, and Eye-opener) was the first validated alcohol consumption screening questionnaire for use in obstetrical and gynecological practices, 20 and is routinely used in various services proving to be efficient in detecting pregnant women who consume alcohol. 1,21,22 A Brazilian Portuguese version of T-ACE, translated and adapted from the original questionnaire of Sokol et al, 20 was validated by Fabbri et al 22 in 2001. . When compared to ICD-10 criteria for alcohol abuse identification and alcohol dependence syndrome, the Brazilian version of the T-ACE questionnaire showed sensitivity and specificity coefficients of 100% and 85.6% respectively, indicating good performance as a screening tool for problems related to alcohol consumption during pregnancy.…”

“…When compared to ICD-10 criteria for alcohol abuse identification and alcohol dependence syndrome, the Brazilian version of the T-ACE questionnaire showed sensitivity and specificity coefficients of 100% and 85.6% respectively, indicating good performance as a screening tool for problems related to alcohol consumption during pregnancy. 22 This study aimed to investigate the prevalence of alcohol consumption during pregnancy among postpartum women, using the Brazilian version of the T-ACE questionnaire, and sociodemographic, reproductive and newborn factors associated with alcohol consumption during pregnancy.…”