Abstract
The purpose of the study was to validate the Prenatal Risk Overview (PRO) Alcohol use domain against a structured diagnostic
interview. The PRO was developed to screen for 13 psychosocial risk factors associated with poor birth outcomes. After clinic
staff administered the PRO to prenatal patients, they asked for consent to administration of selected modules of the structured
clinical interview for DSM-IV (SCID) by a research assistant. To assess the criterion validity of the PRO, low and moderate/high
risk classifications from the alcohol use domain were cross-tabulated with SCID Alcohol Use Disorder variables. The study
sample included 744 women. Based on PRO responses, 48.7% reported alcohol use during the 12 months before they learned they
were pregnant; 5.4% reported use post pregnancy awareness. The typical quantity consumed pre-pregnancy was four or more drinks
per occasion. Based on the SCID, 7.4% met DSM-IV criteria for either Alcohol Abuse or Dependence. Sensitivity and specificity
of the PRO for Alcohol Use Disorders were 83.6 and 80.3%, respectively. Negative predictive value was 98.4% and positive predictive
value was 25.3%. The results indicate the PRO effectively identified pregnant women with Alcohol Use Disorders. However, prenatal
screening must also detect consumption patterns that do not meet diagnostic thresholds but may endanger fetal development.
The PRO also identified women who continued to drink after they knew they were pregnant, as well as those whose previous drinking
habits put them at risk for resumption of hazardous use.
interview. The PRO was developed to screen for 13 psychosocial risk factors associated with poor birth outcomes. After clinic
staff administered the PRO to prenatal patients, they asked for consent to administration of selected modules of the structured
clinical interview for DSM-IV (SCID) by a research assistant. To assess the criterion validity of the PRO, low and moderate/high
risk classifications from the alcohol use domain were cross-tabulated with SCID Alcohol Use Disorder variables. The study
sample included 744 women. Based on PRO responses, 48.7% reported alcohol use during the 12 months before they learned they
were pregnant; 5.4% reported use post pregnancy awareness. The typical quantity consumed pre-pregnancy was four or more drinks
per occasion. Based on the SCID, 7.4% met DSM-IV criteria for either Alcohol Abuse or Dependence. Sensitivity and specificity
of the PRO for Alcohol Use Disorders were 83.6 and 80.3%, respectively. Negative predictive value was 98.4% and positive predictive
value was 25.3%. The results indicate the PRO effectively identified pregnant women with Alcohol Use Disorders. However, prenatal
screening must also detect consumption patterns that do not meet diagnostic thresholds but may endanger fetal development.
The PRO also identified women who continued to drink after they knew they were pregnant, as well as those whose previous drinking
habits put them at risk for resumption of hazardous use.
- Content Type Journal Article
- Pages 1-10
- DOI 10.1007/s10995-011-0926-2
- Authors
- Patricia A. Harrison, Minneapolis Department of Health and Family Support, 250 Fourth St. South, Minneapolis, MN 55415-1384, USA
- Amy Godecker, Minneapolis Department of Health and Family Support, 250 Fourth St. South, Minneapolis, MN 55415-1384, USA
- Abbey C. Sidebottom, Allina Hospitals and Clinics, 2925 Chicago Avenue, Mail Route 10105, Minneapolis, MN 55407-1321, USA
- Journal Maternal and Child Health Journal
- Online ISSN 1573-6628
- Print ISSN 1092-7875