Identifying risk drinking in expectant fathers

Background: Identification of risk drinking in expectant fathers may be helpful as an important part of efforts to minimize maternal alcohol use, and as an opportunity to inform them about a problematic practice during a critical developmental stage for the couple. The purpose of this study was to evaluate the T-ACE screening questionnaire, which asks abouttolerance to alcohol, beingannoyed by other's comments about drinking, attempts tocut down, and having a drink first thing in the morning ("eye-opener"), in the male partners of pregnant women who themselves were T-ACE positive. Methods: Two hundred fifty-four male partners were asked to complete the T-ACE embedded in a health survey, the Alcohol Use Disorders Identification Test (AUDIT), and other questions about their alcohol use in the past 30 days when their pregnant partners had a median gestation of 11.5 weeks (T-1). After delivery, male partners again completed the T-ACE and quantity-frequency questions (T-2). The predictive ability of the T-ACE and AUDIT was compared, using risk drinking (> 4 drinks/day or > 14 drinks/week) as the criterion standard. Results: A substantial minority of male partners had risk drinking, 31 percent at T-1 and 25 percent at T-2. Although the AUDIT was better than the T-ACE as an independent predictor of risk drinking, the latter was most accurate when the tolerance threshold exceeded 2 drinks, the same established for pregnant women. The sensitivity (T-1 = 84.6%, T-2 = 82.8%) and specificity (T-1 = 43.8%, T-2 = 51.1%) of the T-ACE at this threshold compared favorably with those of the AUDIT at the standard cut point of 8. Conclusions: The T-ACE may be a practical way for clinicians to identify risk drinking in both pregnant women and expectant fathers.