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Do Canadian Prenatal Record Forms Integrate Evidence-based Guidelines for the Diagnosis of a FASD?

  • Qualitative Research
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Canadian Journal of Public Health Aims and scope Submit manuscript

Abstract

Objectives: Prenatal alcohol exposure is a significant public health issue with lifelong psychological, emotional and financial costs associated with caring for an affected individual. In 2005, the Public Health Agency of Canada and Health Canada’s First Nations and Inuit Health Branch developed evidence-based guidelines for the diagnosis of a Fetal Alcohol Spectrum Disorder (FASD). We examined the extent to which prenatal records across Canadian provinces and territories currently integrate key recommendations from these guidelines.

Methods: A content analysis of prenatal record forms retrieved from each Canadian province and territory (N=12) was conducted to identify all questions or intervention prompts related to prenatal screening, exposure assessment, counseling or referral for maternal alcohol use during pregnancy. Findings were reviewed in relation to recommendations extrapolated from the Canadian guidelines and the FASD literature.

Results: All the prenatal record forms contained questions to assess maternal alcohol use during pregnancy. However, the dimensions of alcohol consumption assessed and the format, wording and number of items related to each dimension varied markedly across provinces/territories. Only five prenatal record forms included a validated screening tool to identify risky alcohol drinking behaviour. Most of the forms lacked prompts to encourage providers to intervene or refer pregnant clients with high-risk drinking behaviour.

Conclusion: Integration of the Canadian recommendations into Canadian prenatal record forms may be an effective public health strategy for helping identify pregnancies at high risk for alcohol exposure, reducing the incidence of a FASD through appropriate prenatal intervention and referral, and facilitating early diagnosis of a FASD.

Résumé

Objectifs: L’exposition prénatale à l’alcool est une importante question de santé publique, entraînant des coûts financiers, émotionnels et psychologiques associés aux soins à donner à une personne affectée, et ce, pendant toute une vie. En 2005, l’Agence canadienne de la santé publique et la Direction générale de la santé des Premières nations et des Inuits (DGSPNI) ont élaboré des lignes directrices fondées sur des données probantes pour le diagnostic de l’ensemble des troubles causés par l’alcoolisation fœtale (ETCAF). Nous avons examiné la mesure dans laquelle les dossiers prénataux des provinces et des territoires canadiens intègrent actuellement les recommandations clés de ces lignes directrices.

Méthodes: Nous avons mené une analyse du contenu des formulaires prénataux récupérés dans chaque province et territoire du Canada (N=12) afin de déterminer toutes les questions ou les moteurs d’intervention liés au dépistage prénatal, à l’évaluation de l’exposition, à la consultation ou à la recommandation en ce qui a trait à la consommation d’alcool pendant la grossesse. Nous avons examiné les résultats en relation avec les recommandations extrapolées des lignes directrices canadiennes et de la documentation sur l’ETCAF.

Résultats: Tous les formulaires prénataux contenaient des questions visant à évaluer la consommation d’alcool par la mère pendant la grossesse. Toutefois, l’ampleur et la forme consommation d’alcool évaluée, le vocabulaire et le nombre d’articles associé à chaque forme, variaient considérablement entre les provinces et les territoires. Seulement cinq formulaires prénataux comprenaient un outil de dépistage validé permettant de déterminer la présence d’un comportement associé à une consommation d’alcool à risque. Nous avons pu noter l’absence de messages-guides dans les formulaires pour encourager les fournisseurs de soins à intervenir ou à diriger les clientes enceintes présentant une consommation d’alcool à risque élevé.

Conclusion: L’intégration des recommandations canadiennes dans les formulaires prénataux serait une stratégie de santé publique efficace pour aider à déceler les grossesses présentant un risque élevé d’exposition à l’alcool, à réduire l’incidence d’ETCAF grâce à une intervention prénatale et à des recommandations, et à faciliter le diagnostic précoce de l’ETCAF.

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Authors and Affiliations

  1. Faculty of Nursing, University of Calgary, Calgary, AB, Canada

    Shahirose S. Premji RN, NP (Neonatal), PhD (Associate Professor, Neonatal Nurse Practitioner)

  2. School of Nursing, McGill University, 3506 University St., H3A 2A7, Montreal, QC, Canada

    Sonia Semenic RN, PhD (Assistant Professor, Nurse Scientist)

  3. Department of Pediatrics (Neonatology), Calgary Health Region, Calgary, AB, Canada

    Shahirose S. Premji RN, NP (Neonatal), PhD (Associate Professor, Neonatal Nurse Practitioner)

  4. McGill University Health Centre, Montreal, QC, Canada

    Sonia Semenic RN, PhD (Assistant Professor, Nurse Scientist)

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  1. Shahirose S. Premji RN, NP (Neonatal), PhD
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  2. Sonia Semenic RN, PhD
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Correspondence to Sonia Semenic RN, PhD.

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Premji, S.S., Semenic, S. Do Canadian Prenatal Record Forms Integrate Evidence-based Guidelines for the Diagnosis of a FASD?. Can J Public Health 100, 274–280 (2009). https://doi.org/10.1007/BF03403946

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