Rates and correlates of alcohol use among pregnant women in obstetrics clinics
Rates and correlates of alcohol use among pregnant women in obstetrics clinics
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DOI：
10.1097/01.alc.0000046595.47491.37
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发表时间：
2003-01-01
影响因子：
3.2
通讯作者：
Blow, FC
中科院分区：
文献类型：
--
作者：
Flynn, HA;Marcus, SM;Blow, FC
背景：本研究的目的是证明筛查的可行性，并在多个产科诊所的大量具有人口统计学代表性的孕妇样本中确定酒精使用的比率和相关因素，扩展先前对单一或高风险环境的研究。确定怀孕期间有害使用酒精及其相关因素对于设计和实施二级预防战略至关重要。方法：采用简短（10分钟）的筛查问卷，对密歇根州东南部8家产科诊所候诊区1131名18岁及以上的孕妇进行筛查。该调查包括酒精使用的直接和间接（TWEAK）测量，以及评估人口统计学特征、烟草使用以及参与者的医生是否与他们讨论了酒精使用行为的项目。女性年龄从18岁到46岁，平均年龄28.7岁（SD = 5.3）。我们样本的种族/民族分布适当地反映了密歇根人口的各个种族部分。结果：我们发现，15.1%的总样本（n = 169）报告怀孕期间饮酒，其中大多数妇女报告饮酒水平相对较低。147名女性（13%）在TWEAK上的得分高于临界值（即高于2分）。基于多变量分析，吸烟和怀孕早期可以预测怀孕期间饮酒风险较高（定义为酗酒或每周超过一次标准饮酒）。高加索人种、吸烟、心理困扰和怀孕期间饮酒过多都预示着在TWEAK上的得分高于2分。结论：本研究表明，在繁忙的产科诊所进行筛查对妇女来说是可行和可接受的，同时使用间接和直接的酒精使用措施可能是最佳的。此外，应在整个怀孕期间进行简短的评估，并可针对吸烟者和怀孕早期的妇女进行或加强评估。
Background: The purpose of this study was to demonstrate feasibility of screening and to identify rates and correlates of alcohol use in a large, demographically representative sample of pregnant women across a number of obstetrics clinics, extending previous studies of single or high-risk settings. Identification of harmful alcohol use during pregnancy and of associated factors is critical for the design and implementation of secondary prevention strategies.Methods: A total of 1131 pregnant women age 18 and older were screened in the waiting areas of eight obstetrics clinics in Southeastern Michigan using a brief (10 min) screening questionnaire. This survey consisted of direct and indirect (TWEAK) measures of alcohol use, as well items assessing demographic characteristics, use of tobacco, and whether participants' physicians discussed alcohol use behavior with them. Women ranged in age from 18 to 46, with a mean age of 28.7 (SD = 5.3). The racial/ethnic distribution of our sample suitably reflects the various racial segments of the Michigan population.Results: We found that 15.1% of the total sample (n = 169) reported any alcohol use during pregnancy, with the majority of those women reporting relatively low levels of alcohol use. One hundred and forty-seven women (13%) scored above the cutoff on the TWEAK (i.e., above a score of 2). Based on multivariate analyses, higher risk alcohol use (defined as binge drinking or greater than one standard drink per week) during pregnancy was predicted by smoking and earlier stage of pregnancy. Caucasian race, smoking, psychological distress, and greater number of drinks during pregnancy predicted scores above a cutoff of 2 on the TWEAK.Conclusion: This study demonstrated that screening in busy obstetrics clinics is feasible and acceptable to women and that it may be optimal to use both indirect and direct measures of alcohol use. In addition, brief assessments should be conducted throughout pregnancy and may be targeted or intensified for smokers and for women earlier in their pregnancy.