Antenatal care for alcohol consumption during pregnancy

Pregnant women's reported receipt of care and associated characteristics

Emma Doherty, John Wiggers, Luke Wolfenden, Amy E. Anderson, Kristy Crooks, Tracey W. Tsang, Elizabeth J. Elliott, Adrian J. Dunlop, John Attia, Julia Dray, Belinda Tully, Nicole Bennett, Henry Murray, Carol Azzopardi, Melanie Kingsland

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    Abstract

    Background: Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women's reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women's acceptability of care.

    Methods: From July 2017 - February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses.

    Results: At the initial antenatal visit, less than two thirds (64.3%) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9%) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10% of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95% CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95% CI:1.17, 3.79), first pregnancy (OR = 1.91; 95% CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95% CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95% CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95% CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3-99.4%).

    Conclusions: Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.

    Original languageEnglish
    Article number299
    Pages (from-to)1-17
    Number of pages17
    JournalBMC Pregnancy and Childbirth
    Volume19
    Issue number1
    DOIs
    Publication statusPublished - 16 Aug 2019

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    Prenatal Care
    Alcohol Drinking
    Pregnant Women
    Pregnancy
    Guidelines
    Referral and Consultation
    Telephone
    Logistic Models
    Regression Analysis
    Alcohols
    Health

    Cite this

    Doherty, E., Wiggers, J., Wolfenden, L., Anderson, A. E., Crooks, K., Tsang, T. W., ... Kingsland, M. (2019). Antenatal care for alcohol consumption during pregnancy: Pregnant women's reported receipt of care and associated characteristics. BMC Pregnancy and Childbirth, 19(1), 1-17. [299]. https://doi.org/10.1186/s12884-019-2436-y
    Doherty, Emma ; Wiggers, John ; Wolfenden, Luke ; Anderson, Amy E. ; Crooks, Kristy ; Tsang, Tracey W. ; Elliott, Elizabeth J. ; Dunlop, Adrian J. ; Attia, John ; Dray, Julia ; Tully, Belinda ; Bennett, Nicole ; Murray, Henry ; Azzopardi, Carol ; Kingsland, Melanie. / Antenatal care for alcohol consumption during pregnancy : Pregnant women's reported receipt of care and associated characteristics. In: BMC Pregnancy and Childbirth. 2019 ; Vol. 19, No. 1. pp. 1-17.
    @article{f8f10ee6881740009d2153930c0d45e3,
    title = "Antenatal care for alcohol consumption during pregnancy: Pregnant women's reported receipt of care and associated characteristics",
    abstract = "Background: Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women's reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women's acceptability of care. Methods: From July 2017 - February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses. Results: At the initial antenatal visit, less than two thirds (64.3{\%}) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9{\%}) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10{\%} of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95{\%} CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95{\%} CI:1.17, 3.79), first pregnancy (OR = 1.91; 95{\%} CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95{\%} CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95{\%} CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95{\%} CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3-99.4{\%}). Conclusions: Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.",
    keywords = "Alcohol consumption, Antenatal care, Evidence-based practice, Implementation, Maternal, Pregnancy, Quantitative methods",
    author = "Emma Doherty and John Wiggers and Luke Wolfenden and Anderson, {Amy E.} and Kristy Crooks and Tsang, {Tracey W.} and Elliott, {Elizabeth J.} and Dunlop, {Adrian J.} and John Attia and Julia Dray and Belinda Tully and Nicole Bennett and Henry Murray and Carol Azzopardi and Melanie Kingsland",
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    language = "English",
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    Doherty, E, Wiggers, J, Wolfenden, L, Anderson, AE, Crooks, K, Tsang, TW, Elliott, EJ, Dunlop, AJ, Attia, J, Dray, J, Tully, B, Bennett, N, Murray, H, Azzopardi, C & Kingsland, M 2019, 'Antenatal care for alcohol consumption during pregnancy: Pregnant women's reported receipt of care and associated characteristics', BMC Pregnancy and Childbirth, vol. 19, no. 1, 299, pp. 1-17. https://doi.org/10.1186/s12884-019-2436-y

    Antenatal care for alcohol consumption during pregnancy : Pregnant women's reported receipt of care and associated characteristics. / Doherty, Emma; Wiggers, John; Wolfenden, Luke; Anderson, Amy E.; Crooks, Kristy; Tsang, Tracey W.; Elliott, Elizabeth J.; Dunlop, Adrian J.; Attia, John; Dray, Julia; Tully, Belinda; Bennett, Nicole; Murray, Henry; Azzopardi, Carol; Kingsland, Melanie.

    In: BMC Pregnancy and Childbirth, Vol. 19, No. 1, 299, 16.08.2019, p. 1-17.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Antenatal care for alcohol consumption during pregnancy

    T2 - Pregnant women's reported receipt of care and associated characteristics

    AU - Doherty, Emma

    AU - Wiggers, John

    AU - Wolfenden, Luke

    AU - Anderson, Amy E.

    AU - Crooks, Kristy

    AU - Tsang, Tracey W.

    AU - Elliott, Elizabeth J.

    AU - Dunlop, Adrian J.

    AU - Attia, John

    AU - Dray, Julia

    AU - Tully, Belinda

    AU - Bennett, Nicole

    AU - Murray, Henry

    AU - Azzopardi, Carol

    AU - Kingsland, Melanie

    PY - 2019/8/16

    Y1 - 2019/8/16

    N2 - Background: Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women's reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women's acceptability of care. Methods: From July 2017 - February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses. Results: At the initial antenatal visit, less than two thirds (64.3%) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9%) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10% of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95% CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95% CI:1.17, 3.79), first pregnancy (OR = 1.91; 95% CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95% CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95% CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95% CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3-99.4%). Conclusions: Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.

    AB - Background: Antenatal clinical guidelines recommend that during initial and subsequent antenatal visits all pregnant women: have their alcohol consumption assessed; be advised that it is safest not to consume alcohol during pregnancy and of the potential risks of consumption; and be offered referrals for further support if required. However, the extent to which pregnant women attending public antenatal services receive guideline recommended care at these visits, and the characteristics associated with its receipt, is unknown. The purpose of this study was to examine: 1) pregnant women's reported receipt of guideline recommended care addressing alcohol consumption during pregnancy; 2) characteristics associated with the receipt of care; and 3) pregnant women's acceptability of care. Methods: From July 2017 - February 2018 a survey (telephone or online) was undertaken with 1363 pregnant women who had recently visited a public antenatal service in one health district in Australia. Receipt and acceptability of recommended care were assessed via descriptive statistics and associations via logistic regression analyses. Results: At the initial antenatal visit, less than two thirds (64.3%) of pregnant women reported that they received an assessment of their alcohol consumption and just over one third (34.9%) received advice and referral appropriate to their self-reported level of alcohol consumption since pregnancy recognition. Less than 10% of women received such care at subsequent antenatal visits. Characteristics that significantly increased the odds of receiving all guideline elements at the initial antenatal visit included: less than university attainment (OR = 1.93; 95% CI:1.12, 3.34), not residing in an advantaged area (OR = 2.11; 95% CI:1.17, 3.79), first pregnancy (OR = 1.91; 95% CI:1.22, 2.99) and regional/rural service location (OR = 2.38; 95% CI:1.26, 4.48); and at subsequent visits: younger age (OR = 0.91; 95% CI:0.84, 0.99) and Aboriginal origin (OR = 3.17; 95% CI:1.22, 8.24). Each of the recommended care elements were highly acceptable to pregnant women (88.3-99.4%). Conclusions: Although care for alcohol consumption is both recommended by clinical guidelines and highly acceptable to pregnant women, its receipt in public antenatal services is suboptimal. There is a need and an opportunity for interventions to support antenatal care providers to routinely and consistently provide such care to all pregnant women.

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    KW - Antenatal care

    KW - Evidence-based practice

    KW - Implementation

    KW - Maternal

    KW - Pregnancy

    KW - Quantitative methods

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    JO - BMC Pregnancy and Childbirth

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    SN - 1471-2393

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