Alcohol Use Screening in Pregnant and Childbearing Aged Women: Practices and Implications

Dozet, Danijela; Burd, Larry; Popova, Svetlana

doi:10.1007/978-1-0716-2613-9_11

Cited by 2 publications

(1 citation statement)

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“…The diagnostic criteria and the methodology for diagnosis has been presented in detail in [ 14 ]. In brief, each child with a diagnosis of FASD had an exposure assessment which consisted of the One-Question Screen “When was your last drink?”, and a Maternal Risk Score and a dosimetry assessment [ 14 – 16 ]. This data is then reviewed and a five item Likert scale is used to assess clinician confidence in exposure.…”

Section: Methodsmentioning

confidence: 99%

Screening for fetal alcohol spectrum disorder in infants and young children

Fleming

Sheridan

Waite

et al. 2023

Adv. Drug Alcohol Res.

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Introduction: With an estimated prevalence of up to five percent in the general population, fetal alcohol spectrum disorders (FASD) are the most common neurodevelopmental disorder and more prevalent than autism. Early identification and subsequent early intervention have the potential to improve developmental trajectory of children with FASD. In addition, new research suggests supplementation with choline may ameliorate the developmental impairments associated with prenatal alcohol exposure. Availability of a screening tool with acceptable epidemiologic performance criteria may be clinical useful in identification of young children at increased risk for FASD. In this paper we describe the Early Fetal Alcohol Spectrum Disorder Screening Test (E-FAST) to identify young children at increased risk for an FASD.Methods: We developed the E-FAST dataset from previously published studies, comprised of 281 children under 5 years of age, 180 (64.1%) were diagnosed with FASD and 101 (35.9%) were non-FASD.Analysis: The analysis identified seven useful variables (prenatal alcohol exposure, ADHD (Attention Deficit Hyperactivity Disorder), foster care or adopted, small OFC (occipital frontal circumference), communication impairments, impaired social skills, and cognitive deficits. All variables were categorized as yes/no for ease of use in a screening tool. Risk ratios for each of the seven indicators were estimated using two-way table analyses. Weights for each variable were estimated based on the relative strength of their odds ratios.Results: The average age was 2.7 years of age (S.D. 1.29) and ranged from infant (6.4%) to 4 years old (35.9%). Maternal alcohol use alone had a sensitivity of 0.97, specificity 0.65, and accuracy 0.86. For the combined seven variables, sensitivity was 0.94, specificity 0.74, and accuracy 0.87. Thus, the seven-item E-FAST screen had acceptable epidemiologic screening characteristics.Discussion: In the United States, up to 547 infants with FASD are born each day which far exceeds the capacity of multidisciplinary diagnostic clinics. During routine clinical management of infants and young children the use of an evidence-based screening tool provides a time efficient means to exclude large numbers of young children from further follow-up for FASD. Conversely, a positive screen identifies a smaller number of children at increased risk for FASD requiring more intensive evaluation and follow-up.

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Section: Methodsmentioning

confidence: 99%