Screening for Alcohol Use in Pregnant Women

NHMRC advice in 2020 is that it is safest to consume no alcohol during pregnancy, and in line with international guidelines. The low levels of consumption highlighted as a concern in recent guidelines cannot be identified using current questionnaires. A clinical history to estimate the quantity and frequency of alcohol use is the preferred method. 

In light of the potential for adverse effects on the foetus, screening for alcohol use should be included in the usual antenatal history. All pregnant women should be asked about their level of alcohol consumption in the context of a clinical assessment. 

All pregnant women should be made aware of the current recommendations relating to alcohol use during pregnancy. If alcohol use continues, a full assessment of alcohol intake and any adverse effects should be sensitively undertaken and appropriate referrals should be made. It is appropriate to reassure pregnant women drinking minimal amounts of alcohol (for example, 1–2 standard drinks per week without escalation to higher amounts) that there remains no evidence that this is harmful. 

The ASSIST questionnaire that screens for alcohol and other substances has been shortened to screen for use in this population, but is not recommended due to low sensitivity in detecting alcohol use in pregnant women. 

See Chapter 14 Pregnant and Breastfeeding Women for more information.