All women of childbearing age, and not just pregnant women, should be screened about how much alcohol they drink, new Canadian guidelines recommend.
Women's health experts from the Society of Obstetricians and Gynaecologists of Canada (SOGC) developed the guidelines based on a two-year review of scientific evidence regarding possible harm to a fetus.
The guidelines, released on Thursday, aim to make alcohol screening and support for women at risk a routine part of medical visits to prevent fetal alcohol spectrum disorder (FASD).
Health Canada reports more than 3,000 babies are born with fetal alcohol syndrome every year. About 14 per cent of pregnant women reported drinking pregnancy, according to the 2005 Report on Maternal and Child Health in Canada.
"The prevention has to be instituted with the mother preferably prior to her becoming pregnant," said Dr. Vyta Senikas, vice-president of the SOGC in Ottawa.
The guidelines states there is no known safe time, amount or type of alcohol to consume during pregnancy, noted Dr. Ahmed Ezzat, the society's president and a professor of obstetrics and gynecology at the University of Saskatchewan.
Recording alcohol use recommended
Abstinence is the best choice for a woman who is or might become pregnant, but the guidelines recognize it is not always feasible, said Dr. Gideon Koren, director of the Motherisk program at Toronto's Hospital for Sick Children.
Women who have become dependent on alcohol and other substances should be offered harm reduction and treatment, such as priority access to withdrawal management programs, the guidelines recommend.
Screening and recording use of alcohol before and during pregnancy was considered a practical way to improve the health of mothers and children by:
- Early identification and reduction of problem maternal drinking.
- Early identification of exposed infants.
- Earlier diagnosis of FASD.
To that end, it is important to record alcohol use in pregnancy on the chart of a newborn and developing child, the guidelines say.
"We're not talking mom had one glass of wine in Bermuda before she knew she's pregnant," Koren said. "But if there's evidence mom had a problem with drinking in the past, it's very important. And we find out very often it's not there [on the chart]."
The guidelines should standardize advice on alcohol use and pregnancy across provinces, territories, hospitals and health-care professionals, said Dr. Pascal Croteau, vice-president of the Quebec section of the Society of Rural Physicians of Canada, one of the medical groups that endorsed the guidelines.
The Canadian Association of Midwives, the Canadian Association of Perinatal and Women's Health Nurses, the College of Family Physicians of Canada and Motherisk also endorsed the document.
The Public Health Agency of Canada funded it.