Increased Cut‐Point of the TACER‐3 Screen Reduces False Positives Without Losing Sensitivity in Predicting Risk Alcohol Drinking in Pregnancy

Chiodo, Lisa M.; Delaney‐Black, Virginia; Sokol, Robert J.; Janisse, James; Pardo, Yobany; Hannigan, John H.

doi:10.1111/acer.12368

Cited by 18 publications

(15 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Increasing the cut-off to 3 points resulted in greater specificity (decreased false positives, which can be time consuming for the clinician to further investigate) while maintaining sensitivity, and was also more effective in identifying women whose children had FASD. 44 …”

Section: Screening For Auds During Pregnancymentioning

confidence: 99%

Alcohol Use Disorders in Pregnancy

DeVido

Bogunovic

Weiss

2015

Harvard Review of Psychiatry

View full text Add to dashboard Cite

Alcohol use disorders (AUD) during pregnancy are less prevalent than in non-pregnant women, but they can create a host of clinical challenges when encountered. Unfortunately, there is little research information available to guide clinical decision-making in this population. Drinking alcohol during pregnancy can have negative consequences on both fetus and mother, but there is controversy regarding the volume of alcohol consumption that correlates with these consequences. There is little evidence to support the use of pharmacologic interventions for AUD during pregnancy. Similarly, there are few data to guide management of alcohol detoxification in pregnant women, and the use of benzodiazepines (the mainstay of most alcohol detoxification protocols) in pregnant women is controversial. Despite a lack of robust data to guide management of AUDs in pregnancy, clinicians must nonetheless make management decisions when confronted with these challenging situations. Therefore, this paper reviews the epidemiology of AUDs in pregnancy, and the pharmacologic management of both AUDs and alcohol withdrawal in pregnant women, to better inform clinicians about what is known about managing these co-occurring conditions.

show abstract

Section: Screening For Auds During Pregnancymentioning

confidence: 99%

Alcohol Use Disorders in Pregnancy

DeVido

Bogunovic

Weiss

2015

Harvard Review of Psychiatry

View full text Add to dashboard Cite

show abstract

“…The shortness of the test (takes less than 1 min to ask) and the fact that any score than 0 is considered positive (0/1 easy scoring) make it an attractive instrument to identify potential pregnant risk drinkers. More recently, an updated version of the test (TACER‐3) has been proposed and validated . Questions and scoring of the test are shown in Table ; further information about the test is available at the following address: https://pubs.niaaa.nih.gov/publications/arh25-3/204-209.htm.…”

Section: Methodsmentioning

confidence: 99%

“…Assessing the mother's alcohol consumption habits during gestation could be complicated as the admission of alcohol drinking during gestation may be accompanied by heavy guilt feelings. To overcome these difficulties, specific screening instruments for pregnant women have been developed: Indeed, the Tolerance‐Worried‐Eye opener‐Amnesia‐(K)Cut down (TWEAK), the Alcohol Use Disorders Identification Test–Consumption (AUDIT‐C), the T‐ACE/TACER‐3, and the examination of food habits in the diet are commonly used by FASD experts.…”

Section: Introductionmentioning

confidence: 99%

Fetus morphology changes by second‐trimester ultrasound in pregnant women drinking alcohol

et al. 2019

View full text Add to dashboard Cite

Fetal alcohol spectrum disorders (FASDs) are a group of negative conditions occurring in children exposed to alcohol during gestation. The early discovery of FASD is crucial for mother and infant follow-ups. In this study, we investigated in pregnant women the association between urine ethylglucuronide (EtG-a biomarker of alcohol drinking) and indicators of the physical characteristics of FASD by prenatal ultrasound in the second trimester of gestation. We also correlated these data with the AUDIT-C, T-ACE/TACER-3, TWEAK, and food habit diary, screening questionnaires used to disclose alcohol drinking during pregnancy. Forty-four pregnant women were randomly enrolled and examined for ultrasound investigation during the second trimester of gestation. Urine samples were provided by pregnant women immediately after the routine interviews. EtG determinations were performed with a cutoff established at 100 ng/mL, a value indicating occasional alcohol drinking. Fifteen of the enrolled pregnant women overcame the EtG cutoff (34.09%). Analysis of variance (ANOVA) revealed that the fetuses of the positive EtG pregnant women had significantly longer interorbital distance and also significantly increased frontothalamic distance (P's < 0.02). Quite interestingly, no direct correlation was found between EtG data and both food diary and AUDIT-C. However, a significant correlation was observed between urinary EtG and T-ACE (r = 0.375; P = 0.012) and between urinary EtG and TWEAK (r = 0.512; P < 0.001) and a concordance with all questionnaire for EtG values higher than 500 ng/mL. This study provides clinical evidence that the diagnosis of maternal alcohol consumption during pregnancy by urine EtG may disclose FASD-related damage in the fetus.

show abstract

“…The American College of Obstetrics & Gynecology (2006) currently recommends a cut-point of 2 for the total T-ACE score which maximizes sensitivity in identifying women drinking at any level (Sokol et al, 2003). We had demonstrated previously that a total score cut-point of 3 or more rather than 2 or more on the T-ACE (i.e., the “TACER-3” screen), improved prediction of which pregnant women were consuming higher levels of alcohol, reduced “false positives” in detecting at-risk drinking, and improved prediction of alcohol-related neurobehavioral outcomes in children (Chiodo et al, 2009; 2010; 2014). …”

Section: Methodsmentioning

confidence: 99%

Prenatal alcohol exposure selectively enhances young adult perceived pleasantness of alcohol odors

Hannigan

Chiodo

Sokol

et al. 2015

Physiology & Behavior

Self Cite

View full text Add to dashboard Cite

Prenatal Alcohol Exposure (PAE) can lead to life-long neurobehavioral and social problems that can include a greater likelihood of early use and/or abuse of alcohol compared to older teens and young adults without PAE. Basic research in animals demonstrates that PAE influences later postnatal responses to chemosensory cues (i.e., odor & taste) associated with alcohol. We hypothesized that PAE would be related to poorer abilities to identify odors of alcohol-containing beverages, and would alter perceived alcohol odor intensity and pleasantness. To address this hypothesis we examined responses to alcohol and other odors in a small sample of young adults with detailed prenatal histories of exposure to alcohol and other drugs. The key finding from our controlled analyses is that higher levels of PAE were related to higher relative ratings of pleasantness for alcohol odors. As far as we are aware, this is the first published study to report the influence of PAE on responses to alcohol beverage odors in young adults. These findings are consistent with the hypothesis that positive associations (i.e., “pleasantness”) to the chemosensory properties of alcohol (i.e., odor) are acquired prenatally and are retained for many years despite myriad interceding postnatal experiences. Alternate hypotheses may also be supported by the results. There are potential implications of altered alcohol odor responses for understanding individual differences in initiation of drinking, and alcohol seeking and high-risk alcohol-related behaviors in young adults.

show abstract

Increased Cut‐Point of the TACER‐3 Screen Reduces False Positives Without Losing Sensitivity in Predicting Risk Alcohol Drinking in Pregnancy

Cited by 18 publications

References 41 publications

Alcohol Use Disorders in Pregnancy

Alcohol Use Disorders in Pregnancy

Fetus morphology changes by second‐trimester ultrasound in pregnant women drinking alcohol

Prenatal alcohol exposure selectively enhances young adult perceived pleasantness of alcohol odors

Contact Info

Product

Resources

About