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

Research output: Contribution to journalArticleResearchpeer-review

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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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.

KW - Alcohol consumption

KW - Antenatal care

KW - Evidence-based practice

KW - Implementation

KW - Maternal

KW - Pregnancy

KW - Quantitative methods

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