Medical texts lack direct messages on alcohol’s threat to pregnancy
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.
All latest news from the category: Health and Medicine
This subject area encompasses research and studies in the field of human medicine.
Among the wide-ranging list of topics covered here are anesthesiology, anatomy, surgery, human genetics, hygiene and environmental medicine, internal medicine, neurology, pharmacology, physiology, urology and dental medicine.
Researchers shrink camera to the size of a salt grain
Micro-sized cameras have great potential to spot problems in the human body and enable sensing for super-small robots, but past approaches captured fuzzy, distorted images with limited fields of view….
World-first product will be a lifesaving traffic stopper
Game-changing technology to design traffic lights that absorb kinetic energy, stopping them from crumpling when hit by a vehicle, will prevent thousands of fatalities and injuries each year and make…
Scientists capture electron transfer image in electrocatalysis process
The involvement between electron transfer (ET) and catalytic reaction at electrocatalyst surface makes electrochemical process challenging to understand and control. How to experimentally determine ET process occurring at nanoscale is…