|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|
|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)|
|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)|
R1-Round 1; R2-Round 2; IQD-inter-quartile deviation.
†Includes responses ‘agree’ and ‘strongly agree’.
Results for statements that reached 70% agreement (consensus) are presented in bold.
1Friedman test indicated a significant difference in agreement with the 3 statements that described different methods to assess growth (statements 11-13: Friedman chi-square=19.3, p<0.001). Post-hoc testing found a significant difference between ratings for statements 11 and 12 (Wilcoxon Z=-3.5, p<0.001) and 12 and 13 (Wilcoxon Z=-3.1, p=0.002).
Watkins et al.
Watkins et al. BMC Pediatrics 2013 13:13 doi:10.1186/1471-2431-13-13