Mini Oral Australian Epidemiology Association ASM 2018

Preventing alcohol consumption during pregnancy in Fitzroy Valley: AUDIT-C update (#86)

Martyn Symons 1 2 , James P Fitzpatrick 2 , Kaashifah Bruce 2
  1. NHMRC FASD Research Australia Centre of Research Excellence, Perth, WA, Australia
  2. Telethon Kids Institute, University of Western Australia, Perth, WA, Australia

Background

Fetal Alcohol Spectrum Disorder (FASD) encompasses lifelong neurodevelopmental disability caused by prenatal alcohol exposure (PAE). Aboriginal community leaders in the remote Fitzroy Valley, Western Australia, requested evaluation of the community-led FASD Prevention Strategy (2010-2016).

Aim

  1. Evaluate PAE prevention using self-reported Alcohol Use Disorders Identification Test–Consumption (AUDIT-C) data during pregnancy
  2. Compare AUDIT-C data collection, as an automated computerised alert, with standard practice

Methods

Midwives recorded first and third trimester alcohol consumption risk level in pregnant women from 2009-2016. From 2009-2014 standard practice was for midwives to enter PAE data in clinical notes. AUDIT-C responses were recorded in 2015/16 for the periods before and after pregnancy recognition. The proportion of women consuming alcohol by year were examined.

Results

Alcohol consumption was recorded for 524 pregnancies. The proportion of women reporting first trimester alcohol consumption decreased from 60% in 2011 to 16% in 2016. Third trimester consumption decreased from 28% in 2011 to <10% in 2016. The greatest decrease was in the proportion of women reporting low-risk consumption. In 2015/2016 the mean proportion of high-risk consumption was 6-7%. Consumption recorded using AUDIT-C before pregnancy recognition (n=101, 22%-92%) was higher than after recognition (n=204, 9%-40%) with less missing data. There were no significant differences between proportions by data collection method.

Conclusion

Community-led FASD prevention efforts appear to have reduced PAE and could be translated to other community settings. Future prevention could focus on high-risk alcohol consumption and investigate risk reduction before pregnancy. Automated computer-based questionnaires may help decrease missing data.