Assessing Prenatal Alcohol Exposure in a Study of Foetal Alcohol Spectrum Disorder

Foetal Alcohol Spectrum Disorder (FASD) is a diagnostic term used to describe physical, neurodevelopmental, and cognitive impairments that have occurred following exposure to alcohol during pregnancy. The diagnosis of FASD requires a complex assessment and confirmation of maternal alcohol consumption during pregnancy. Obtaining accurate and reliable assessment results can be difficult.

Researchers from the University of Western Australia have conducted a study to assess the challenges practitioners face when trying to gain information about prenatal alcohol exposure as part of a broader FASD assessment.

Interviews were carried out with the birth mother or responsible adult for 88 young people sentenced to detention in Western Australia.

Results found that:

• The birth mother provided information on prenatal alcohol exposure for 55 (63%) of the 88 young people. The other remaining accounts of prenatal alcohol exposure were mostly from relatives.
• Of the 88 young people with information on prenatal alcohol exposure, 41 (47%) had no reported prenatal alcohol exposure, 19 (22%) had either unknown or moderate‐quantity prenatal alcohol exposure, and 28 (32%) reported prenatal alcohol exposure at high‐risk levels
• 54% consumed a drink containing alcohol during pregnancy.
• The most common reported number of standard drinks containing alcohol consumed on a typical day during pregnancy was 7 to 9 drinks (26%)
• Only 29 of the 47 sources that confirmed prenatal alcohol exposure provided enough information to complete the questionnaire.

Obtaining a reliable measure of prenatal alcohol exposure using maternal recall and self‐report is likely to be limited due to suspected underreporting and lack of clarity as to what constitutes a standard drink. It is likely this is influenced by social stigma and recall bias. The authors suggest standardized recording on all antenatal birth records would aid later assessment for FASD and provide opportunities for advice and support for women who continue to drink.