Guidelines to prevent alcohol harm in pregnancy and fetal alcohol spectrum disorder (FASD)
1
Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Westmead, Australia
2
Child and Adolescent Health, Faculty of Medicine and Health, The University Of Sydney, Westmead, Australia
3
NHMRC Centre for Research Excellence in Fetal Alcohol Spectrum Disorder, The University Of Sydney, Westmead, Australia
4
CICADA Centre, Sydney Children's Hospital Network, The University Of Sydney, Westmead, Australia
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Clinical guidelines provide clinicians with a consistent, evidence-based approach to screen for and address prenatal alcohol exposure (PAE) in antenatal settings. The aim of this research was to identify and appraise the quality of globally relevant and Australian guidelines on the prevention of alcohol harms in pregnancy, including Fetal alcohol spectrum disorder (FASD).
METHODS:
A Google search was conducted for guidelines on the prevention of PAE and/or FASD published between 2014 and 2024. The guidelines were published by international bodies and professional associations, Australian national or state governments and Australian professional associations. A thematic analysis was performed to identify the inclusion of predetermined themes, and the quality of guidelines was appraised using the AGREE II tool.
RESULTS:
Fifteen guidelines on the prevention of alcohol harms in pregnancy were identified, including five global, eight Australian, and two from Australian jurisdictions (Queensland and New South Wales). Thirteen guidelines focused on pregnant women as the priority group, and three focused on the assessment for FASD (one focused on both). The most prevalent themes surrounding alcohol use in pregnancy or FASD were screening for PAE (93.3%), health promotion and/or literacy (93.3%), and drug and alcohol services (80%).
CONCLUSIONS:
Most guidelines on preventing harms from PAE and FASD focus on pregnant women, with limited attention to paternal alcohol use. There is a growing recognition of the need for cross-sectoral collaboration and ethical, non-stigmatising care. Evidence-based recommendations to guide health care professionals in the management of women during pregnancy should be updated to reflect emerging evidence on harms from paternal alcohol use, broaden screening practices to include holistic care to promote healthy pregnancy (including drug and alcohol use, contraception and supplements) and consider priority populations. Guideline development should integrate lived experience, be culturally responsive and provide practical tools that enable respectful dialogue to reduce stigma.
Clinical guidelines provide clinicians with a consistent, evidence-based approach to screen for and address prenatal alcohol exposure (PAE) in antenatal settings. The aim of this research was to identify and appraise the quality of globally relevant and Australian guidelines on the prevention of alcohol harms in pregnancy, including Fetal alcohol spectrum disorder (FASD).
METHODS:
A Google search was conducted for guidelines on the prevention of PAE and/or FASD published between 2014 and 2024. The guidelines were published by international bodies and professional associations, Australian national or state governments and Australian professional associations. A thematic analysis was performed to identify the inclusion of predetermined themes, and the quality of guidelines was appraised using the AGREE II tool.
RESULTS:
Fifteen guidelines on the prevention of alcohol harms in pregnancy were identified, including five global, eight Australian, and two from Australian jurisdictions (Queensland and New South Wales). Thirteen guidelines focused on pregnant women as the priority group, and three focused on the assessment for FASD (one focused on both). The most prevalent themes surrounding alcohol use in pregnancy or FASD were screening for PAE (93.3%), health promotion and/or literacy (93.3%), and drug and alcohol services (80%).
CONCLUSIONS:
Most guidelines on preventing harms from PAE and FASD focus on pregnant women, with limited attention to paternal alcohol use. There is a growing recognition of the need for cross-sectoral collaboration and ethical, non-stigmatising care. Evidence-based recommendations to guide health care professionals in the management of women during pregnancy should be updated to reflect emerging evidence on harms from paternal alcohol use, broaden screening practices to include holistic care to promote healthy pregnancy (including drug and alcohol use, contraception and supplements) and consider priority populations. Guideline development should integrate lived experience, be culturally responsive and provide practical tools that enable respectful dialogue to reduce stigma.
| eISSN: | 2654-1459 |
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