Identifying Patients at Risk For Alcohol-Exposed Pregnancies: the Importance of Addressing Multiple Risk Factors.

Details

• Alternative Title:
  Substance Use & Addiction Journal, 2025, v. 46, no. 2: Identifying Patients at Risk For Alcohol-Exposed Pregnancies: the Importance of Addressing Multiple Risk Factors.
• Journal Article:
  Substance Use & Addiction Journal
• Personal Author:
  McRee, Bonnie G. ; Hanson, Bridget L. ; Vendetti, Janice ; King, Diane K. ; Pawlukiewicz, Iwona ; Berry, Erin ; Johnson, Jessica ; Marshall, Deanna ; Rosato, Lauren ; Gallucci, Karen Steinberg ; Whitmore, Corrie
• Description:
  The increasing prevalence of fetal alcohol spectrum disorders is a critical public health issue. Two behaviors, consuming alcohol and using less effective pregnancy prevention, may result in alcohol-exposed pregnancies (AEPs) in individuals who can become pregnant. In the context of alcohol screening and brief intervention (SBI) services, cutoff scores on widely used alcohol risk assessments (eg, Alcohol Use Disorders Identification Test, U.S. version USAUDIT) may fail to identify individuals whose relatively low alcohol consumption may still put them at risk for an AEP due to their pregnancy prevention method.
  
  To identify this gap in alcohol SBI service delivery, we examined data from 2 reproductive healthcare systems implementing alcohol SBI, to explore the prevalence of individuals who met both of the following risk conditions: reported any alcohol use on the USAUDIT and a pregnancy prevention method less than 88% effective. Electronic health records for individuals aged 18 to 49 presenting for preventive care in 2021 were analyzed.
  
  Of 11 567 screened, 7638 reported some alcohol use, but screened at a lower-risk level and were not flagged to receive an alcohol-focused brief intervention (BI). Of these, 1477 were using a method of pregnancy prevention that was less than 88% effective. In addition, 118 of the 1676 who screened positive on the USAUDIT were using less effective contraception and did not receive a BI. In summary, the number of individuals at risk of an AEP who did not receive an alcohol BI was 1595 (13.8%) of the total patients screened for at-risk alcohol use.
  
  There is a need for system modifications to assess multiple behaviors simultaneously and alert providers when a combination of behaviors increases a specific health risk, such as an AEP. Tailored alcohol BIs that include the risks/benefits of various pregnancy prevention methods to reduce AEPs provide opportunities to enhance the reach of standard alcohol SBI services.
• Content Notes:
  Author manuscript
• Subjects:
  • Humans
  • Female
  • Pregnancy
  • Adult
  • Risk Factors
  • Young Adult
  • Alcohol Drinking
  • Fetal Alcohol Spectrum Disorders
  • Adolescent
  • Middle Aged
  More +
• Keywords:
  • Alcohol Screening and Brief Intervention
  • Brief Intervention and Referral to Treatment
  • Alcohol Use Disorders Identification Test
  • Alcohol-Exposed Pregnancy
  • Fetal Alcohol Spectrum Disorders
  • Contraception Effectiveness
  • Pregnancy Prevention
  • USAUDIT
  • SBI
  • SBIRT
  More +
• Source:
  Substance Use & Addiction Journal, 2025, v. 46, no. 2
• DOI:
  https://doi.org/10.1177/29767342241267086
• ISSN:
  2976-7342 ; 2976-7350
• Pubmed ID:
  39096200
• Pubmed Central ID:
  PMC11789002
• Document Type:
  Text
• Funding:
  NU84DD000004/DD/NCBDD CDC HHSUnited States/ ; NU84DD000005/DD/NCBDD CDC HHSUnited States/
• Genre:
  Journal Article
• Pages in Document:
  452-460 (15 pdf pages)
• Volume:
  46
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/262064/cdc_262064_DS1.pdf
• File Type:
  [PDF - 503.51 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:f670d80f3902d5db69fbb246b53b1905d647551c130548dac3fdcd5a9312edb1b10f88704282a159d583840813975df092deb65d2485fa85322d56c51ed3e355