A survey of obstetrician-gynecologists on their patients' alcohol use during pregnancy

Objective: To examine knowledge, attitudes, current clinical practices, and educational needs of obstetrician-gynecologists regarding patients' alcoho l use during pregnancy. Methods: A 20-item, self-administered questionnaire on patients' prenatal a lcohol use was sent to 1000 active ACOG fellows. Responses were analyzed us ing univariate and multivariate statistical techniques. Results: Of the 60% of the obstetrician-gynecologists who responded to the survey, 97% reported asking their pregnant patients about alcohol use. When a patient reports alcohol use, most respondents reported that they always discuss adverse effects and always advise abstinence. One fifth of the resp ondents (20%) reported abstinence to be the safest way to avoid all four of the adverse pregnancy outcomes cited (ie, spontaneous abortion, central ne rvous system impairment, birth defects, and fetal alcohol syndrome); 13% we re unsure about levels associated with all of the adverse outcomes; and 4% reported that consumption of eight or more drinks per week did not pose a r isk for any of the four adverse outcomes. The two resources that respondent s said they needed most to improve alcohol-use assessment were information on thresholds for adverse reproductive outcomes (83%) and referral resource s for patients with alcohol problems (63%). Conclusion: Efforts should be made to provide practicing obstetrician-gynec ologists with updates on the adverse effects of alcohol use by pregnant wom en and with effective methods for screening and counseling women who report alcohol use during pregnancy. (C) 2000 by The American College of Obstetri cians and Gynecologists.