Using a single binge drinking question to identify Russian women at risk for an alcohol-exposed pregnancy

Abstract

Introduction Low rates of contraception and at-risk drinking place many Russian women at risk of an alcohol-exposed pregnancy (AEP). The only realistic way to determine when women are at risk of AEP is by self-reports. A U.S. study found that a single binge-drinking question (SBD) effectively identified nearly all women whose drinking placed them at risk of AEP. Methods The present study replicated the U.S. study. Participants were 689 non-pregnant Russian women of childbearing age who were at AEP risk. Their answers to SBD, “During the previous three months, how often did you have four or more drinks on one occasion”, were compared with their reports of binge drinking on a 90-day Timeline Followback (TLFB) calendar. Results The SBD identified 99% of at-risk Russian women as binge drinkers, replicating U.S. findings. Only 8% of the women were identified at-risk using a second AEP criterion of ≥ 8 drinks on average per week. Although Russian women did not report heavy weekly drinking and two-thirds did not meet AUDIT criteria for problem drinking, when they did drink, 40% of the time it was binge drinking. Conclusions Almost all Russian women who were at risk of an AEP were identified by a single binge-drinking question. Results from this study suggest that Russian health care practitioners can use SBD to successfully screen women for AEP risk. SBD identified 99% of Russian women who were at AEP risk. Consequently, it is recommended that SBD be incorporated into routine health care screenings at OB/GYN clinic visits.

Neurobehavioral Disorder Associated With Prenatal Alcohol Exposure

“…Furthermore, single binge drinking questions have been shown to be effective at identifying women at risk for alcohol use during pregnancy and are consistent with current CDC and National Institute on Alcohol Abuse and Alcoholism recommendations. 89–91 Based on international work that involved minimal questioning and clinical experience, the ND-PAE workgroup suggests beginning screening with an introductory statement, such as “I ask all patients standard health questions to understand factors that may affect health of their child and their health.” 89,92 To approach the topic of alcohol and quickly determine whether prenatal exposure occurred, the following sets of questions are suggested in the newest edition of Bright Futures 16 : “How often do you drink beer, wine or liquor in your household?” (Continue for any response other than “never”) “In the 3 months before you knew you were pregnant, how many times did you have 4 or more drinks in a day?” “During the pregnancy, how many times did you have 4 or more drinks in a day?” If positive responses are given to any of the above questions, the clinician can follow up to determine frequency and extent of consumption by asking, “During the pregnancy, on average, how many days per week did you have a drink?” “During the pregnancy, on a typical day when you had an alcoholic beverage, how many drinks did you have?” Any affirmative answer indicates maternal at-risk drinking; a brief intervention or referral is indicated. The Bright Futures Guidelines (4th ed) suggests that these questions be asked at the prenatal visit, at an initial postnatal well visit, for all new patients, based on clinical suspicion, and if a caregiver describes cognitive or behavioral concerns consistent with ND-PAE criteria.…”

Improving Recognition of Children Affected by Prenatal Alcohol Exposure: Detection of Exposure in Pediatric Care

“…The National Institute on Alcohol Abuse and Alcoholism recommended the Single “Binge” Drinking Question (SBDQ) (“How often did you have ≥ 4 drinks on one occasion?”) to screen people whose drinking puts them at risk of an alcohol use disorder [13]. Recent studies found that the SBDQ accurately identified patients with at-risk drinking in primary care [61] and also identified women whose drinking placed them at risk of PAE [62-64]. These findings support the use of SBDQ to identify prenatal alcohol use.…”

Alcohol and HIV Risk Among Russian Women of Childbearing Age

“…At risk drinking for a woman was defined as drinking ≥8 drinks per week on average, or ≥4 drinks on at least one occasion within 90 days prior to the study visit. 23,24 Because details of the parent study are described in detail elsewhere, 21,25 only procedures relevant to the HIV study are included here.…”

“…30–32 The National Institute on Alcohol Abuse and Alcoholism recommends utilizing a binge drinking question to screen for at-risk alcohol use, including at-risk drinking among women. 33,34 …”