Under-recognition of prenatal alcohol effects in infants of known alcohol abusing women

Medical records of 124 women and their infants were analyzed for: (1) docum entation of maternal alcohol and other substance abuse and (2) evaluation o f exposed infants. These results were compared with the study interview and infant examination. More obstetric nurses documented the presence or absen ce of alcohol and substance abuse than did pediatricians. More women report ed using alcohol in the study interview than documented in the medical reco rds. There was slightly better documentation for cocaine use than for alcoh ol use in the medical records. One of the 19 infants with documentation of maternal alcohol use was noted to have possible alcohol-related features by the pediatrician, in contrast to 7 infants identified by the study examine r. In addition, 2 of these 19 infants were determined by the study examiner to have fetal alcohol syndrome; neither case was diagnosed by the pediatri cians. Continued efforts at education regarding the importance of asking ab out prenatal alcohol exposure and the spectrum of fetal alcohol effects are needed for early diagnosis.