背景:怀孕期间饮酒是欧洲出生缺陷和儿童发育障碍的主要原因。怀孕期间饮酒的不利影响可能包括身体,行为和认知问题,统称为胎儿酒精谱系障碍(FASD)。需要在欧洲一级就如何实施预防和治疗政策以减少酒精暴露的怀孕提出循证综合建议。远洋,欧盟委员会授予的招标服务合同(编号20,187,106),旨在制定指导方针来应对这一知识差距。
方法:FARSEAS建议建立在(1)干预措施的两阶段审查,(2)国际专家咨询,和(3)在波兰马佐维亚地区进行的预防FASD的试点研究。对干预措施的审查包括19个电子开放访问数据库,几个灰色文献存储库和涵盖大多数欧盟(EU)国家的关键信息咨询,以及其他指南搜索。在三角测量源之后,收集了94条记录。专家对研究问题的设计做出了贡献,解决文献中的差距,并审查所提出的建议。波兰飞行员在制定的建议中增加了现实世界实践的细微差别,最终形成了一套传播准则。
结果:远海指南包括23项建议,分为不同主题的政策领域,沟通策略,筛选,简短的干预和转诊治疗,治疗和社会服务。这些建议强调必须尊重妇女的自主权,避免歧视和污名化;对育龄妇女进行普遍筛查,包括检测其他心理社会风险(如家庭暴力);和个性化,为需要的人提供全面和多学科的支持性干预措施,比如那些有酒精使用障碍的人,包括女性的合作伙伴。防止FASD的策略应该是多组件的,公共卫生传播应将有关风险的信息与自我效能信息结合起来,以促进变化。
结论:FARSEAS指南是支持政策制定者和服务管理人员实施有效计划以减少普通人群和高危人群的产前酒精暴露的工具。FASD的预防必须涉及全面和多层次的循证政策和实践,提供适合不同风险水平妇女需求的服务和活动,并适当注意减少污名。
BACKGROUND: Drinking during pregnancy is the leading cause of birth defects and child developmental disorders in Europe. The adverse effects of drinking during pregnancy may include physical, behavioural and cognitive problems, known collectively as fetal alcohol spectrum disorders (FASD). Evidence-based comprehensive recommendations at the European level on how to implement preventive and treatment policies to reduce alcohol-exposed pregnancies are needed. FAR SEAS, a tendered service contract (number 20,187,106) awarded by the European Commission, aimed at developing
guidelines to respond to this knowledge gap.
METHODS: FAR SEAS recommendations were built on (1) a two-phase review of interventions, (2) an international expert consultation, and (3) a pilot study on prevention of FASD conducted in the Mazovia region of Poland. The review of interventions included nineteen electronic open access databases, several repositories of grey literature and a key informant consultation covering most European Union (EU) countries and an additional
guidelines search. After triangulating sources, 94 records were collected. Experts contributed in the design of the research questions, addressing the gaps in the literature and reviewing the recommendations formulated. The Polish pilot added nuances from real world practice to the formulated recommendations, resulting in the final set of
guidelines for dissemination.
RESULTS: The FAR SEAS
Guidelines comprise 23 recommendations grouped into different topics areas of policies, communication strategies, screening, brief intervention and referral to treatment, treatment and social services. The recommendations highlight the need to respect women\'s autonomy and avoid discrimination and stigmatization; using universal screening for women of childbearing age, including detection of other psychosocial risks (such as domestic violence); and individualized, comprehensive and multidisciplinary supportive interventions for those who require it, such as those with alcohol use disorders, including women\'s partners. Policies to prevent FASD should be multicomponent, and public health communication should combine information about the risks together with self-efficacy messages to promote changes.
CONCLUSIONS: The FAR SEAS
guidelines are a tool to support policy-makers and service managers in implementing effective programmes to reduce prenatal alcohol exposure among general and at-risk population groups. FASD prevention has to involve comprehensive and multi-level evidence-based policies and practice, with services and activities tailored to the needs of women at differing levels of risk, and with due attention to reducing stigma.