Table 4 Agreement with statements on screening assessment methods for prenatal alcohol exposure, growth deficit and characteristic fetal alcohol syndrome facial anomalies in rounds 1 and 2
From: A modified Delphi study of screening for fetal alcohol spectrum disorders in Australia
Statement | R1 N | R1 % Agree†(IQD) | R2 % Agree†(IQD) |
|---|---|---|---|
Prenatal alcohol exposure | |||
Assessment of prenatal alcohol exposure should identify and record the: | |||
1. … number of standard drinks consumed during a typical drinking occasion | 85 | 98 (1) | - |
2. … frequency of drinking occasions | 86 | 98 (1) | - |
3. … frequency of excessive (binge) drinking (5+ standard drinks per occasion) | 86 | 95 (1) | - |
4. … timing of alcohol intake during pregnancy | 86 | 97 (1) | - |
5. Alcohol exposure should be assessed alongside other lifestyle factors (e.g. diet) | 85 | 92 (1) | - |
6. Prenatal alcohol exposure can be effectively assessed using an informal approach (e.g. inquiring during a consultation) | 82 | 52 (2) | 41 (2) |
7. Prenatal alcohol exposure should be assessed using a formal tool | 69 | 71 (2) | - |
8. The use of formal tools for the assessment of prenatal alcohol exposure should be combined with a clinical interview to obtain more detailed information about alcohol consumption patterns, potential indicators of addiction and other relevant contextual information | 80 | - | 88 (1) |
9. Information on alcohol use from family members, other health professionals or community members (if appropriate) should be sought if indicated | 78 | - | 77 (0) |
10. The AUDIT-C would be a useful tool for the formal assessment of prenatal alcohol exposure | 74 | - | 89 (0) |
Growth deficit | |||
11. Growth should be assessed by comparing height and weight with population standards | 70 | 93 (1) 1 | - |
12. Growth should be assessed by comparing weight to height ratio with population standards | 66 | 68 (2) 1 | - |
13. Growth should be assessed by comparing weights over time (to identify decelerating weight over time) | 68 | 90 (1) 1 | - |
14. Assessment of growth deficit should consider other factors that may affect growth (e.g. gestational age parental size, gestational diabetes, nutritional status, illness) | 78 | 100 (1) | - |
Characteristic fetal alcohol syndrome (FAS) facial anomalies | |||
15. The presence of the following characteristic FAS facial anomalies should be assessed: smooth philtrum, thin upper lip, and small palpebral fissures | 81 | 100 (1) | - |
16. Assessment of characteristic FAS facial anomalies should use appropriate anthropometric population standards for race and age where available | 77 | 95 (1) | - |
At the screening stage, characteristic FAS facial anomalies can be effectively assessed using: | |||
17. … clinical observation(R1) /Facial anomalies can be assessed using clinical observation for evidence of the characteristic FAS facial anomalies, with formal physical measurement of these features not essential at the screening stage (R2) | 69 | 73 (1) | 77 (0) |
18. … physical measurement of palpebral fissures | 50 | 76 (0) | - |
19. … the University of Washington Lip-Philtrum Guide | 49 | 86 (1) | - |
20. … the facial photographic screening tool | 45 | 76 (1.5) | - |
21. Palpebral fissure length must be assessed using formal physical measurement and comparison with population references at the screening stage | 62 | - | 39 (2) |
22. Thin upper lip and smooth philtrum must be assessed using formal tools such as the University of Washington Lip-Philtrum Guide at the screening stage | 61 | - | 46 (2) |