Psychometric Properties of Brief Screening Tests for Alcohol Use Disorders during Pregnancy in Argentina

Abstract

Background Considering the physical, mental and behavioral problems related to fetal alcohol exposure, prenatal clinical guides suggest a brief evaluation of alcohol consumption during pregnancy to detect alcohol intake and to adjust interventions, if required. Even if any alcohol use should be considered risky during pregnancy, identifying women with alcohol use disorders is important because they could need a more specific intervention than simple advice to abstain. Most screening tests have been developed and validated in male populations and focused on the long-term consequences of heavy alcohol use, so they might be inappropriate to assess consumption in pregnant women. Objective To analyze the internal reliability and validity of the alcohol screening instruments Alcohol Use Disorders Identification Test (AUDIT), Alcohol Use Disorders Identification Test -Consumption (AUDIT-C), Tolerance, Worried, Eye-Opener, Amnesia and Cut-Down (TWEAK), Rapid Alcohol Problems Screen -Quantity Frequency (RAPS-QF) and Tolerance, Annoyed, Cut-Down and Eye-Opener (T-ACE) to identify alcohol use disorders in pregnant women. Methods A total of 641 puerperal women were personally interviewed during the 48 hours after delivery. The receiver operating characteristics (ROC) curves and the sensitivity and specificity of each instrument using different cut-off points were analyzed. Results All instruments showed areas under the ROC curves above 0.80. Larger areas were found for the TWEAK and the AUDIT. The TWEAK, the T-ACE and the AUDIT-C showed higher sensitivity, while the AUDIT and the RAPS-QF showed higher specificity.

Alcohol use and associated factors among women attending antenatal care in Southern Ethiopia: a facility based cross sectional study

“…Alcohol use was measured using AUDIT-C [22, 23] derived from the 10-item alcohol use disorder identification test which is cross culturally validated and preferred tool to measure alcohol consumption [24, 25]. AUDIT-C has been used in different studies to measure alcohol use among pregnant women [9, 26, 27].…”

Prenatal alcohol exposure prevalence as measured by direct ethanol metabolites in meconium in a Native American tribe of the southwest

“…AUDIT-C has been demonstrated to perform with approximately equal accuracy to the full 10-item AUDIT and with superior accuracy compared to other alcohol self-assessment tools (Burns et al, 2010). It has been used in research to screen pregnant women for risky alcohol use and demonstrated high accuracy (Lopez et al, 2017;May, Hasken, et al, 2018). More in-depth measures (e.g., Timeline Follow-Back interview) were deemed inappropriate for this population due to high sensitivity related to alcohol use in the community, and a reluctance of participants to discuss alcohol use observed in previous studies.…”

Alcohol drinking in pregnant women from an Argentinian city

“…The AUDIT has shown adequate psychometric properties in Argentine pregnant women (α = .93, Se = 87%, Sp = 86%) (López, Lichtenberger, Conde, & Cremonte, 2017). Risky consumption was considered when the BPR score was equal to or greater than eight, and when the APR score was equal to or greater than one (López et al, 2017).…”

“…Possible dependence was considered when the BPR scores were equal to or greater than 16 (Babor et al, 1992), and when the APR scores were equal to or greater than four (López et al, 2017). (Table 3).…”