What do physicians know and say about fetal alcohol syndrome: a survey of obstetricians, pediatricians, and family medicine physicians.

Pediatricians, obstetricians, and family practice physicians in Michigan were surveyed by mail for their knowledge and opinions about Fetal Alcohol Syndrome (FAS) and Fetal Alcohol Effects (FAE). Physicians said that about 67% of their patients raised questions about drinking during pregnancy but only 2% specifically referred to FAS or FAE. Most physicians were uncertain about whether their colleagues were sufficiently aware of FAS, whether FAS could be diagnosed at birth, or if physicians were acquainted with the syndrome's major criteria. However, most believed FAS was not being overdiagnosed and believed that making a diagnosis of FAS at birth could lead to improved treatment of an affected child. Physicians also believed that physician counseling was a more effective way of reducing the incidence of FAS/FAE than warning labels. Forty-one percent of the physicians placed the threshold for FAS at one to three drinks per day and 38% placed the threshold at one or fewer drinks a day. Thirty-five percent placed the estimated incidence of FAS at 1 to 2 per 1000 in the United States. We conclude that physicians are in relative agreement about the effects of drinking during pregnancy and the value of physician counseling but are misguided as to what constitutes a true risk level of drinking as far as the etiology of FAS is concerned.