A survey of health care professionals' knowledge and experience of Fetal Alcohol Spectrum Disorder (FASD) and alcohol use in pregnancy

First published: 09/05/2019 | Last updated: May 20th, 2019

Background: Fetal Alcohol Spectrum Disorder (FASD) is the leading known cause of preventable learning disability in developed countries. Screening for alcohol use early in pregnancy can facilitate the identification of women who are in need of support. However, only a small percentage of UK children with FASD are identified. This may be partly attributed to a lack of awareness of the condition by NHS health professionals.

Methods: We developed an online survey to determine healthcare professionals’ (midwives, health visitors, obstetricians, paediatricians and general practitioners) knowledge and opinions. A profession-specific survey link was sent to each professional group, as some questions were adapted accordingly. Questions were predominantly multiple-choice with free text options where appropriate.

Results: There were a total of 250 responses to the survey’s (78 midwives, 60 health visitors, 55 obstetricians, 31 paediatricians and 26 general practitioners). 58.1% of paediatricians had diagnosed a patient with Fetal Alcohol Disorder (FAS) or FASD and 36.7% worried about stigmatisation with diagnosis. Paediatricians reported the highest levels of FASD training (54.8%), with much lower levels in midwives (21.3%). This was reflected in knowledge levels; overall, only 22.1% of respondents knew the estimated UK prevalence of fetal alcohol syndrome and only 19.8% the estimated prevalence of FASD.

Conclusions: We identified a need for training in FASD and alcohol screening in pregnancy to improve awareness and recognition by professionals. Clear referral routes and care pathways need to be developed in the UK and their use promoted to optimise outcomes.

Co-Authors

Helen Howlett, Research Midwife, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK. Shonag Mackenzie, Consultant Obstetrician and Gynaecologist, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK. Eugen-Matthias Strehle, Consultant Paediatrician, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK. Judith Rankin, Prof Maternal & Perinatal Epidemiology, Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK William K. Gray, Senior Research Associate, Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, UK.


Awarded: First prize


Conflicts of interest:

There were no conflicts of interest.

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Mrs Helen Howlett