IFM | FASDs in Primary Care: Recognition, Prevention, and Support

Margot Savoy, MD, MPH, welcomes back Jeffrey Quinlan, MD, FAAFP, a family physician and University of Iowa department leader with a 28-year US Navy career, to discuss his AAFP work on fetal alcohol spectrum disorders (FASDs) and substance use in pregnancy. Dr. Quinlan contrasts limited substance exposure in the Navy with higher alcohol and cannabis use during pregnancy in Iowa, along with fewer available resources. He emphasizes that alcohol is a teratogen with no safe amount or timing in pregnancy and outlines associated neurodevelopmental, craniofacial, organ, growth and behavioral effects. The conversation covers primary care screening and early identification using exposure history and clinical signs, common diagnostic frameworks (COFASP and the University of Washington 4-digit code), multidisciplinary care coordination and prevention through routine screening (AUDIT-C or NIAAA single-question), preconception counseling and stigma reduction. For longitudinal care, Quinlan highlights early intervention, individualized care plans, family support and training, school accommodations, behavioral therapies, nutrition support and medications for comorbid conditions, all using a strength-based approach. Topics by Timestamp 00:00 Welcome and Guest Intro 00:51 Clinical Background and Exposure 01:55 No Safe Alcohol in Pregnancy 04:02 Screening and Diagnosis Basics 06:46 Building the Care Team 09:05 Preventing Alcohol Exposed Pregnancy 12:38 Long Term Care and Interventions 20:13 Key Takeaways and Closing Additional Resources: September 2024 FASDs episode: Dr. Jeffrey Quinlan on addressing alcohol and cannabis use during pregnancy in primary care: https://aafp.libsyn.com/ifm-medical-i... Clinician Resources: https://www.aafp.org/clinical-insight... Excessive Alcohol Use webpage: https://www.aafp.org/family-physician... Tobacco & nicotine use: prevention and cessation resources https://www.aafp.org/clinical-insight... Patient Resources: https://familydoctor.org/condition/su... https://familydoctor.org/condition/op... Related AAFP CME Activities: DEA Training CME | AAFP - https://www.aafp.org/cme-and-events/t... Addiction Treatment and Care CME for Family Physicians | AAFP - https://www.aafp.org/cme-and-events/t... Funding Statement: This activity is supported by the Centers for Disease Control and Prevention of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award totaling $1,219,331 with 100 percent funded by CDC/HHS. The contents are those of the author(s) and do not necessarily represent the official views of, nor an endorsement, by CDC/HHS, or the U.S. Government. Disclaimer: Copyright 2026. AAFP. The views presented in this broadcast are the speaker’s own and do not represent those of AAFP. The information presented is for general, educational, or entertainment purposes and should not be considered legal, health, financial, or other advice. AAFP makes no representation as to the accuracy or completeness of the information and is not responsible for results that may arise from its use. Consult an appropriate professional concerning your specific situation and respective governing bodies for applicable laws. Reference to any specific product or entity does not constitute an endorsement or recommendation by AAFP unless specifically stated otherwise. AAFP and the AAFP logo are registered trademarks of American Academy of Family Physicians.