SOGC临床实践指南第471号：酒精与妊娠。
完整摘要 · 中文译文
目的：建立孕妇和育龄个体饮酒及酒精使用障碍筛查和咨询的全国性医疗照护标准。 预期使用者：照护孕妇和育龄女性的医务人员。 目标人群：孕妇、育龄女性及其家庭。 证据：检索了Medline、EMBASE和CENTRAL数据库中关于“酒精使用与妊娠”的资料。检索结果按发表日期在2018年10月至2026年2月之间进行筛选。检索词采用MeSH词条和关键词制定，包括：孕前、妊娠、母乳喂养、哺乳期、女性、妇女、孕前保健、产前保健、胎儿酒精谱系障碍、产前酒精暴露、饮酒行为、戒酒、饮酒、狂饮、酒精相关障碍、酒精中毒、酒精消费、酒精滥用、苯二氮䓬类、双硫仑、纳曲酮、阿坎酸、昂丹司琼、托吡酯、氰胺、氰胺钙、戒酒药、疾病管理、脱毒、匿名戒酒会、酒精咨询、减少伤害、孕前保健、产前保健、发病率、患病率、流行病学监测、简短干预。纳入的文献类型包括临床试验、观察性研究、综述、系统评价和荟萃分析、指南及会议共识。支持本建议的检索证据表收录于附录B。 验证方法：作者采用推荐意见分级评估、制定与评价（GRADE）方法对证据质量和推荐强度进行评级。见在线附录A（表A1为定义，表A2为强推荐和条件推荐的解释）。 益处、危害和成本：实施这些指南中的推荐意见，可能会提高产科保健提供者使用经过验证的筛查工具和简短干预方法对育龄期或妊娠期女性饮酒及问题性饮酒的识别。妇产科医生应被优先提供为其患者接触具备戒酒专业知识的医疗保健专业人员的机会，以支持最佳健康和妊娠结局。由于他们已经负责妊娠相关并发症的紧急处理，他们必须能够依靠快速转诊途径以确保及时干预。 摘要陈述：推荐意见：（加粗的推荐意见是本版指南更新中新增的；所有推荐意见的更新支持文献概述见附录B）。
完整摘要 · 英文原文
OBJECTIVE: To establish national standards of care for screening and counselling pregnant women and individuals of reproductive age regarding alcohol consumption and alcohol use disorder. INTENDED USERS: Health care providers who care for pregnant women and women of childbearing age. TARGET POPULATION: Pregnant women and women of childbearing age and their families. EVIDENCE: Medline, EMBASE, and CENTRAL databases were searched for "alcohol use and pregnancy". The results were filtered for a publication date between October 2018 and February 2026. The search terms were developed using the MeSH terms and key words including: pre-pregnancy, pregnant, breast feeding, lactation, female, women, preconception care, prenatal care, Fetal Alcohol Spectrum Disorder, prenatal alcohol exposure, drinking behavior, alcohol abstinence, alcohol drinking, binge drinking, Alcohol-Related Disorders, alcoholism, alcohol consumption, alcohol abuse, benzodiazepines, disulfiram, naltrexone, acamprosate, ondansetron, topiramate, cyanamide, calcium carbimide, alcohol deterrents, disease management, detoxification, Alcoholics Anonymous, alcohol counselling, harm reduction, pre-pregnancy care, prenatal care, incidence, prevalence, epidemiological monitoring, brief intervention. Clinical trials, observational studies, reviews, systematic reviews and meta-analysis, guidelines, and conference consensus were included. The table of evidence from the search that supports the recommendations is included as Appendix B. VALIDATION METHODS: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional recommendations). BENEFITS, HARMS, AND COSTS: Implementation of the recommendations in these guidelines may increase obstetrical care provider recognition of alcohol consumption and problematic alcohol use among women of childbearing age or who are pregnant using validated screening tools and brief intervention approaches. Obstetrician-gynecologists should be given priority access to healthcare professionals with expertise in alcohol cessation for their patients in order to support optimal health and pregnancy outcomes. As they are already responsible for the urgent management of pregnancy-related complications, they must be able to rely on expedited referral pathways to ensure timely interventions. SUMMARY STATEMENTS: RECOMMENDATIONS: (Recommendations IN BOLD are new to this guideline update; an overview of the updated supporting literature for all recommendations is provided in Appendix B).