Skip to main content
Top
Published in: BMC Pediatrics 1/2011

Open Access 01-12-2011 | Research article

A survey of Italian and Spanish neonatologists and paediatricians regarding awareness of the diagnosis of FAS and FASD and maternal ethanol use during pregnancy

Authors: F Vagnarelli, I Palmi, O García-Algar, M Falcon, L Memo, L Tarani, R Spoletini, R Pacifici, C Mortali, A Pierantozzi, S Pichini

Published in: BMC Pediatrics | Issue 1/2011

Login to get access

Abstract

Background

Ethanol is the most widely used drug in the world and a human teratogen whose consumption among women of childbearing age has been steadily increasing. There are no Italian or Spanish statistics on ethanol consumption during pregnancy nor any information regarding prevalence of fetal alcohol syndrome (FAS) and fetal alcohol spectrum disorders (FASD). There is also a reasonable suspicion that these two diseases are underdiagnosed by professionals from the above-reported countries. The objectives of this study were: 1) to evaluate the experience, knowledge and confidence of Italian and Spanish neonatologists and paediatricians with respect to the diagnosis of FAS and FASD, and 2) to evaluate professionals awareness of maternal drinking patterns during pregnancy.

Methods

A multiple-choice anonymous questionnaire was e-mailed to Italian neonatologists registered in the mailing list of the corresponding Society and administered to Italian and Spanish paediatricians during their National Congress.

Results

The response rate was 16% (63/400) for the Italian neonatologists of the National Society while a total of 152 Spanish and 41 Italian paediatricians agreed to complete the questionnaire during National Congress. Over 90% of the surveyed physicians declared that FAS is an identifiable syndrome and over 60% of them identified at least one of the most important features of FAS. Although over 60% Italian responders and around 80% Spanish responders were aware that ethanol use in pregnancy is dangerous, approximately 50% Italian responders and 40% Spanish ones allowed women to drink sometimes a glass of wine or beer during pregnancy.
Neonatologists and paediatricians rated confidence in the ability to diagnosis FAS and FASD as low, with over 50% responders feeling they needed more information regarding FAS and FASD identification in newborn and child.

Conclusions

Italian and Spanish neonatologists and paediatricians do not feel confident about diagnosing FAS and FASD. More training is needed in order to accurately diagnose ethanol use during pregnancy and correctly inform pregnant women on the consequences on the newborn.
Appendix
Available only for authorised users
Literature
2.
go back to reference Scafato E, Gandin C, Ghirini S, Galluzzo L, Rossi A: Epidemiology and alcohol-related monitoring in Italy. Evaluation of the National Observatory on Alcohol-CNESPS on the impact of the use and abuse of alcohol in support for the implementation of the activities of the National Alcohol and Health Plan. Report 2010. 2010, VIII: 50-Rapporti ISTISAN 10/5, [http://www.iss.it/binary/publ/cont/10cinqueWEB.pdf] Scafato E, Gandin C, Ghirini S, Galluzzo L, Rossi A: Epidemiology and alcohol-related monitoring in Italy. Evaluation of the National Observatory on Alcohol-CNESPS on the impact of the use and abuse of alcohol in support for the implementation of the activities of the National Alcohol and Health Plan. Report 2010. 2010, VIII: 50-Rapporti ISTISAN 10/5, [http://​www.​iss.​it/​binary/​publ/​cont/​10cinqueWEB.​pdf]
5.
go back to reference Lemoine P, Harousseau H, Borteyru JP, Menuet JC: Children of alcoholic parents-observed anomalies: discussion of 127 cases. Ther Drug Monit. 2003, 25: 132-6. 10.1097/00007691-200304000-00002.CrossRefPubMed Lemoine P, Harousseau H, Borteyru JP, Menuet JC: Children of alcoholic parents-observed anomalies: discussion of 127 cases. Ther Drug Monit. 2003, 25: 132-6. 10.1097/00007691-200304000-00002.CrossRefPubMed
6.
go back to reference Koren G, Nulman I, Chudley AE, Loocke C: Fetal alcohol spectrum disorder. CMAJ. 2003, 25 (169): 1181-1185. Koren G, Nulman I, Chudley AE, Loocke C: Fetal alcohol spectrum disorder. CMAJ. 2003, 25 (169): 1181-1185.
7.
go back to reference Pichini S, Marchei E, Vagnarelli F, Tarani L, Raimondi F, Maffucci R, Sacher B, Bisceglia M, Rapisardi G, Elicio MR, Biban P, Zuccaro P, Pacifici R, Pierantozzi A, Morini L: Assessment of prenatal exposure to ethanol by meconium analysis: results of an Italian multicentric study. ACER. 2011 Pichini S, Marchei E, Vagnarelli F, Tarani L, Raimondi F, Maffucci R, Sacher B, Bisceglia M, Rapisardi G, Elicio MR, Biban P, Zuccaro P, Pacifici R, Pierantozzi A, Morini L: Assessment of prenatal exposure to ethanol by meconium analysis: results of an Italian multicentric study. ACER. 2011
8.
go back to reference Fiorentino D, Coriale G, Spagnolo PA, Prastaro A, Attilia ML, Mancinelli R, Ceccanti M: Fetal alcohol syndrome disorders: experience on the field. The Lazio study preliminary report. Ann Ist Super Sanita. 2006, 42: 53-57.PubMed Fiorentino D, Coriale G, Spagnolo PA, Prastaro A, Attilia ML, Mancinelli R, Ceccanti M: Fetal alcohol syndrome disorders: experience on the field. The Lazio study preliminary report. Ann Ist Super Sanita. 2006, 42: 53-57.PubMed
9.
go back to reference Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N: Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ. 2004, 172: S1-S21.CrossRef Chudley AE, Conry J, Cook JL, Loock C, Rosales T, LeBlanc N: Fetal alcohol spectrum disorder: Canadian guidelines for diagnosis. CMAJ. 2004, 172: S1-S21.CrossRef
10.
go back to reference May PA, Gossage JP: Estimating the prevalence of fetal alcohol syndrome. A summary. Alcohol Res Health. 2001, 25 (3): 159-67.PubMed May PA, Gossage JP: Estimating the prevalence of fetal alcohol syndrome. A summary. Alcohol Res Health. 2001, 25 (3): 159-67.PubMed
11.
go back to reference Nevin AC, Parshuram C, Nulman I, Koren G, Einarson A: A survey of physicians knowledge regarding awareness of maternal alcohol use and the diagnosis of FAS. BMC Fam Pract. 2002, 3: 2-10.1186/1471-2296-3-2.CrossRefPubMedPubMedCentral Nevin AC, Parshuram C, Nulman I, Koren G, Einarson A: A survey of physicians knowledge regarding awareness of maternal alcohol use and the diagnosis of FAS. BMC Fam Pract. 2002, 3: 2-10.1186/1471-2296-3-2.CrossRefPubMedPubMedCentral
12.
go back to reference Gahagan S, Sharpe TT, Brimacombe M, Fry-Johnson Y, Levine R, Mengel M, O'Connor M, Paley B, Adubato S, Brenneman G: Pediatricians' knowledge, training and experience in the care of children with fetal alcohol syndrome. Pediatrics. 2006, 118 (3): e657-e668. 10.1542/peds.2005-0516.CrossRefPubMed Gahagan S, Sharpe TT, Brimacombe M, Fry-Johnson Y, Levine R, Mengel M, O'Connor M, Paley B, Adubato S, Brenneman G: Pediatricians' knowledge, training and experience in the care of children with fetal alcohol syndrome. Pediatrics. 2006, 118 (3): e657-e668. 10.1542/peds.2005-0516.CrossRefPubMed
13.
go back to reference Senecky Y, Inbar D, Diamond G, Basel-Vanagaite L, Rigler S, Chodick G: Fetal alcohol spectrum disorder in Israel. Israel Medical Association Journal. Imaj. 2009, 11 (10): 619-622.PubMed Senecky Y, Inbar D, Diamond G, Basel-Vanagaite L, Rigler S, Chodick G: Fetal alcohol spectrum disorder in Israel. Israel Medical Association Journal. Imaj. 2009, 11 (10): 619-622.PubMed
14.
go back to reference Payne J, Elliott E, D'Antoine H, O'Leary C, Mahony A, Haan E, Bower C: Health professionals' knowledge, practice and opinions about Fetal Alcohol Syndrome and alcohol consumption in pregnancy. Australian and New Zealand Journal of Public Health. 2005, 29 (6): 558-564. 10.1111/j.1467-842X.2005.tb00251.x.CrossRefPubMed Payne J, Elliott E, D'Antoine H, O'Leary C, Mahony A, Haan E, Bower C: Health professionals' knowledge, practice and opinions about Fetal Alcohol Syndrome and alcohol consumption in pregnancy. Australian and New Zealand Journal of Public Health. 2005, 29 (6): 558-564. 10.1111/j.1467-842X.2005.tb00251.x.CrossRefPubMed
15.
go back to reference Elliott EJ, Payne J, Haan E, Bower C: Diagnosis of foetal alcohol syndrome and alcohol use in pregnancy: a survey of paediatricians' knowledge, attitudes and practice. Journal of Paediatrics & Child Health. 2006, 42 (11): 698-703. 10.1111/j.1440-1754.2006.00954.x.CrossRef Elliott EJ, Payne J, Haan E, Bower C: Diagnosis of foetal alcohol syndrome and alcohol use in pregnancy: a survey of paediatricians' knowledge, attitudes and practice. Journal of Paediatrics & Child Health. 2006, 42 (11): 698-703. 10.1111/j.1440-1754.2006.00954.x.CrossRef
16.
go back to reference Garcia-Algar O, Kulaga V, Gareri J, Koren G, Vall O, Zuccaro P, Pacifici R, Pichini S: Alarming prevalence of fetal alcohol exposure in a Mediterranean city. Ther Drug Monit. 2008, 30: 249-54. 10.1097/FTD.0b013e31816a8657.CrossRefPubMed Garcia-Algar O, Kulaga V, Gareri J, Koren G, Vall O, Zuccaro P, Pacifici R, Pichini S: Alarming prevalence of fetal alcohol exposure in a Mediterranean city. Ther Drug Monit. 2008, 30: 249-54. 10.1097/FTD.0b013e31816a8657.CrossRefPubMed
17.
go back to reference Morini L, Marchei E, Pellegrini M, Groppi A, Stramesi C, Vagnarelli F, Garcia-Algar O, Pacifici R, Pichini S: Liquid chromatography with tandem mass spectrometric detection for the measurement of ethyl glucuronide and ethyl sulfate in meconium: new biomarkers of gestational ethanol exposure?. Ther Drug Monit. 2008, 30: 725-32. 10.1097/FTD.0b013e31818b2fd9.CrossRefPubMed Morini L, Marchei E, Pellegrini M, Groppi A, Stramesi C, Vagnarelli F, Garcia-Algar O, Pacifici R, Pichini S: Liquid chromatography with tandem mass spectrometric detection for the measurement of ethyl glucuronide and ethyl sulfate in meconium: new biomarkers of gestational ethanol exposure?. Ther Drug Monit. 2008, 30: 725-32. 10.1097/FTD.0b013e31818b2fd9.CrossRefPubMed
18.
go back to reference Pichini S, Pellegrini M, Gareri J, Koren G, Garcia-Algar O, Vall O, Vagnarelli F, Zuccaro P, Marchei E: Liquid chromatography-tandem mass spectrometry for fatty acid ethyl esters in meconium: assessment of prenatal exposure to alcohol in two European cohorts. J Pharm Biomed Anal. 2008, 48: 927-33. 10.1016/j.jpba.2008.07.026.CrossRefPubMed Pichini S, Pellegrini M, Gareri J, Koren G, Garcia-Algar O, Vall O, Vagnarelli F, Zuccaro P, Marchei E: Liquid chromatography-tandem mass spectrometry for fatty acid ethyl esters in meconium: assessment of prenatal exposure to alcohol in two European cohorts. J Pharm Biomed Anal. 2008, 48: 927-33. 10.1016/j.jpba.2008.07.026.CrossRefPubMed
19.
go back to reference Pichini S, Morini L, Marchei E, Palmi I, Rotolo MC, Vagnarelli F, Garcia-Algar O, Vall O, Zuccaro P: Ethylglucuronide and ethylsulfate in meconium to assess gestational ethanol exposure: preliminary results in two Mediterranean cohorts. Can J Clin Pharmacol. 2009, 16: e370-375.PubMed Pichini S, Morini L, Marchei E, Palmi I, Rotolo MC, Vagnarelli F, Garcia-Algar O, Vall O, Zuccaro P: Ethylglucuronide and ethylsulfate in meconium to assess gestational ethanol exposure: preliminary results in two Mediterranean cohorts. Can J Clin Pharmacol. 2009, 16: e370-375.PubMed
20.
go back to reference Morini L, Groppi A, Marchei E, Vagnarelli F, Garcia Algar O, Zuccaro P, Pichini S: Population Baseline of Meconium Ethyl Glucuronide and Ethyl Sulfate Concentrations in Newborns of Nondrinking Women in 2 Mediterranean Cohorts. Ther Drug Monit. 2010, 32: 359-363. 10.1097/FTD.0b013e3181d5f14a. Jun 2010CrossRefPubMed Morini L, Groppi A, Marchei E, Vagnarelli F, Garcia Algar O, Zuccaro P, Pichini S: Population Baseline of Meconium Ethyl Glucuronide and Ethyl Sulfate Concentrations in Newborns of Nondrinking Women in 2 Mediterranean Cohorts. Ther Drug Monit. 2010, 32: 359-363. 10.1097/FTD.0b013e3181d5f14a. Jun 2010CrossRefPubMed
21.
go back to reference Morini L, Marchei E, Vagnarelli F, Garcia Algar O, Groppi A, Mastrobattista L, Pichini S: Ethyl glucuronide and ethyl sulfate in meconium and hair-potential biomarkers of intrauterine exposure to ethanol. Forensic Sci Int. 2010, 196: 74-7. 10.1016/j.forsciint.2009.12.035.CrossRefPubMed Morini L, Marchei E, Vagnarelli F, Garcia Algar O, Groppi A, Mastrobattista L, Pichini S: Ethyl glucuronide and ethyl sulfate in meconium and hair-potential biomarkers of intrauterine exposure to ethanol. Forensic Sci Int. 2010, 196: 74-7. 10.1016/j.forsciint.2009.12.035.CrossRefPubMed
22.
go back to reference Bradley KA, Boyd-Wickizer J, Powell SH, Burman ML: Alcohol screening questionnaires in women. A critical review. JAMA. 1998, 280: 166-171. 10.1001/jama.280.2.166.CrossRefPubMed Bradley KA, Boyd-Wickizer J, Powell SH, Burman ML: Alcohol screening questionnaires in women. A critical review. JAMA. 1998, 280: 166-171. 10.1001/jama.280.2.166.CrossRefPubMed
Metadata
Title
A survey of Italian and Spanish neonatologists and paediatricians regarding awareness of the diagnosis of FAS and FASD and maternal ethanol use during pregnancy
Authors
F Vagnarelli
I Palmi
O García-Algar
M Falcon
L Memo
L Tarani
R Spoletini
R Pacifici
C Mortali
A Pierantozzi
S Pichini
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Pediatrics / Issue 1/2011
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/1471-2431-11-51

Other articles of this Issue 1/2011

BMC Pediatrics 1/2011 Go to the issue