Dépistage et prise en charge des conduites d'alcoolisation gravidique.

soon as pregnancy has been confirmed, the members of the health care team must question the patient about alcohol consumption (similarly for lifestyle, smoking, medication and use of illicit substances). In France, alcohol, tobacco and cannabis are the three substances which are most frequently used. If the patient is found to be taking one of them, then inquiries should be made about the others. Alcohol is teratogenic and is the most dangerous of the addictive agents for the foetus. Ante-partum exposure to alcohol has damaging effects ranging from foetal alcohol syndrome (FAS) to related problems resulting from the effects of alcohol on the foetus. FAS is the main nongenetic cause of avoidable mental retardation. The prevention of the range of disorders caused by foetal exposure to alcohol (FASD-foetal alcohol spectrum disorder) depends on abstinence from all alcoholic drinks during pregnancy. This information should be imparted by all health professionals. Methods which are likely to change alcohol intake include short interventions and motivational interviews. Questionnaires such as AUDIT (Alcohol Use Disorders Identification Test) and T-ACE (Tolerance, Annoyed, Cut-down, Eye-opener) are recommended for screening for alcohol consumption in pregnancy, while laboratory markers are complementary to the clinical history. The management of alcohol abuse in pregnancy (at-risk pregnancy) is multidisciplinary involving established systems of perinatal care and those for treatment of addiction. The mother-child bond must be taken into account and psychosocial support should be offered. [ABSTRACT FROM AUTHOR]