Despite two decades of consistent warnings from public health authorities that pregnant women should not drink alcoholic beverages, the vast majority of widely used medical textbooks fail to communicate this message unequivocally, a new study reveals. Many texts, including those published recently, contradict these public health guidelines, researchers report in the August issue of the American Journal of Preventive Medicine.
"Medical texts are used for training as well as for reference," observes senior author Mary D. Nettleman, M.D., M.S., from Virginia Commonwealth University. "In turn, training influences physician behavior. Therefore, it is concerning that many distinguished texts fail to provide clear and consistent recommendations about drinking in pregnancy."
Previous research has shown that alcohol consumption by pregnant women is one of the leading preventable causes of birth defects and developmental disabilities, Nettleman explains. Yet when she and her colleague, Karen Q. Loop, reviewed 81 clinical obstetric texts in current use, they found that only 14 contain a consistent recommendation that pregnant women should not drink alcohol. Among the 29 texts published since 1991, only seven consistently recommend abstinence.
More than half of the 81 texts, Nettleman and Loop found, contain at least one statement condoning drinking. Although none of the 29 texts published since 1991 contains a consistent message that drinking is permissible during pregnancy, 15 carry a mixed message, recommending abstinence in one place and stating elsewhere that some level of drinking is permissible.
"Although tolerance toward drinking during pregnancy may be expected in older texts, such tolerance in recent texts was very disturbing," Nettleman says.
Mixed messages, Nettleman added, "are not appropriate because they leave the reader with the impression that abstinence is the official line but a foolish rule made to be broken."
Statements that condone "minimal," "occasional" or "moderate" drinking without defining what these terms mean — found in 22 of the 81 texts — also raise concerns for the researchers. "Vague terms such as [these] are detrimental, not only because they provide no concrete guidance, but because they may have vastly different interpretations according to the social norms in the patients (and perhaps physicians) environments," Nettleman explains.
Some texts, the researchers found, skirt the issue by offering no guidance at all. Nineteen of the 81 texts discuss the topic of alcohol consumption during pregnancy without providing a recommendation, and five books dont address the topic at all.
Nettleman and Loop suspect that the disconnect between what authorities and textbooks recommend stems, at least in part, from the fact that no safe level of drinking during pregnancy has been established. "[M]any textbooks, even recent ones, seem to have interpreted the absence of a safe level to mean that lower levels of drinking are safe and may be permitted," Nettleman observes.
Joe Kuttenkuler | EurekAlert
How cancer metastasis happens: Researchers reveal a key mechanism
19.01.2018 | Weill Cornell Medicine
Researchers identify new way to unmask melanoma cells to the immune system
17.01.2018 | Duke University Medical Center
On the way to an intelligent laboratory, physicists from Innsbruck and Vienna present an artificial agent that autonomously designs quantum experiments. In initial experiments, the system has independently (re)discovered experimental techniques that are nowadays standard in modern quantum optical laboratories. This shows how machines could play a more creative role in research in the future.
We carry smartphones in our pockets, the streets are dotted with semi-autonomous cars, but in the research laboratory experiments are still being designed by...
What enables electrons to be transferred swiftly, for example during photosynthesis? An interdisciplinary team of researchers has worked out the details of how...
For the first time, scientists have precisely measured the effective electrical charge of a single molecule in solution. This fundamental insight of an SNSF Professor could also pave the way for future medical diagnostics.
Electrical charge is one of the key properties that allows molecules to interact. Life itself depends on this phenomenon: many biological processes involve...
At the JEC World Composite Show in Paris in March 2018, the Fraunhofer Institute for Laser Technology ILT will be focusing on the latest trends and innovations in laser machining of composites. Among other things, researchers at the booth shared with the Aachen Center for Integrative Lightweight Production (AZL) will demonstrate how lasers can be used for joining, structuring, cutting and drilling composite materials.
No other industry has attracted as much public attention to composite materials as the automotive industry, which along with the aerospace industry is a driver...
Scientists at Tokyo Institute of Technology (Tokyo Tech) and Tohoku University have developed high-quality GFO epitaxial films and systematically investigated their ferroelectric and ferromagnetic properties. They also demonstrated the room-temperature magnetocapacitance effects of these GFO thin films.
Multiferroic materials show magnetically driven ferroelectricity. They are attracting increasing attention because of their fascinating properties such as...
08.01.2018 | Event News
11.12.2017 | Event News
08.12.2017 | Event News
19.01.2018 | Materials Sciences
19.01.2018 | Health and Medicine
19.01.2018 | Physics and Astronomy