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
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)

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

Open Data