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. 2009 Apr 15:(2):CD004228.
doi: 10.1002/14651858.CD004228.pub2.

Psychological and/or educational interventions for reducing alcohol consumption in pregnant women and women planning pregnancy

Brenda C Stade  1 , Carol Bailey, Darlene Dzendoletas, Michael Sgro, Therese Dowswell, Daniel Bennett
Affiliations

Psychological and/or educational interventions for reducing alcohol consumption in pregnant women and women planning pregnancy

Brenda C Stade et al. Cochrane Database Syst Rev. .

Abstract

Background: It is estimated that more than 20% of pregnant women worldwide consume alcohol. Current research suggests that alcohol intake of seven or more standard drinks (one standard drink = 13.6 grams of absolute alcohol) per week during pregnancy places the baby at risk of serious, lifelong developmental and cognitive disabilities. Psychological and educational interventions may help women to reduce their alcohol intake during pregnancy.

Objectives: To determine the effectiveness of psychological and educational interventions to reduce alcohol consumption during pregnancy in pregnant women or women planning pregnancy.

Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2008), CENTRAL (The Cochrane Library 2007, Issue 4), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2007), CINAHL (1982 to November 2007), Counsel.Lit (1980 to November 2007), PsycLIT (1974 to November 2007) and PsycINFO (1967 to November 2007) and checked cited references from retrieved articles.

Selection criteria: Randomized controlled trials examining the effectiveness of psychological and educational interventions for reducing consumption of alcohol among pregnant women, or women planning for pregnancy.

Data collection and analysis: At least two review authors independently extracted information from the results sections of the included studies.

Main results: Four studies met the inclusion criteria (715 pregnant women), and reported on at least one of the outcomes of interest. We performed no meta-analyses as the interventions and outcomes measured in the studies were not sufficiently similar. For most outcomes there were no significant differences between groups; and results relating to abstaining or reducing alcohol consumption were mixed. Results from individual studies suggest that interventions may encourage women to abstain from alcohol in pregnancy. There was very little information provided on the effects of interventions on the health of mothers and babies.

Authors' conclusions: The evidence from the limited number of studies suggests that psychological and educational interventions may result in increased abstinence from alcohol, and a reduction in alcohol consumption among pregnant women. However, results were not consistent, and the paucity of studies, the number of total participants, the high risk of bias of some of the studies, and the complexity of interventions limits our ability to determine the type of intervention which would be most effective in increasing abstinence from, or reducing the consumption of, alcohol among pregnant women.

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References

References to studies included in this review

    1. Chang G. Personal communication. Email communication received. Aug, 2008.
    2. Chang G, Goetz MA, Wilkins-Haug L, Berman S. A brief intervention for prenatal alcohol use: an in-depth look. Journal of Substance Abuse Treatment. 2000;18:365–9. - PubMed

    3. *

    4. Chang G, Wilkins-Haug L, Berman S, Goetz MA. Brief intervention for alcohol use in pregnancy: randomized trial. Addiction. 1999;94(10):1499–508. - PubMed
    1. Handmaker N, Miller W, Manicke M. Findings of a pilot study of motivational interviewing with pregnant drinkers. Journal of Studies on Alcohol. 1999;60:285–7. - PubMed
    1. O’Connor M, Whaley S. Brief intervention for alcohol use by pregnant women. American Journal of Public Health. 97(2):252–8. 200. - PMC - PubMed
    2. O’Connor MJ. Personal communication. Email communication received. Jul, 2008.
    1. Reynolds KD, Coombs DW, Lowe JB, Peterson PL, Gayoso E. Evaluation of a self-help program to reduce alcohol consumption among pregnant women. International Journal of the Addictions. 1995;30(4):427–43. - PubMed

References to studies excluded from this review

    1. Aalto M, Saksanen R, Laine P, Forsstrom R, Ralkaa M, Kiviluoto M, et al. Brief intervention for female heavy drinkers in routine general practice: a 3-year randomized, controlled study. Alcoholism, Clinical and Experimental Research. 2000;24(11):1680–6. - PubMed
    1. Belizan JM, Barros F, Langer A, Farnot U, Victora C, Villar J. Impact of health education during pregnancy on behavior and utilization of health resources. American Journal of Obstetrics and Gynecology. 1995;173(3):894–9. - PubMed
    1. Calabro K, Taylor WC, Kapadia A. Pregnancy, alcohol use and the effectiveness of written health education materials. Patient Education & Counseling. 1996;29(3):301–9. - PubMed
    1. Eisen M, Keyser-Smith J, Dampeer J, Sambrano S. Evaluation of substance use outcomes in demonstration projects for pregnant and postpartum women and their infants: findings from a quasi-experiment. Addictive Behaviors. 2000;25(1):123–9. - PubMed
    1. Eustace LW. Fetal alcohol syndrome prevention: affecting maternal alcohol consumption behavior through nurse supportive-educative intervention [thesis] University of Alabama, at Birmingham; Birmingham: 2000.

References to studies awaiting assessment

    1. Chang G, McNamara TK, Orav EJ, Koby D, Lavigne A, Ludman B, et al. A brief intervention for prenatal alcohol use: results from a randomized trial of 304 couples [abstract]. 15th Annual Meeting of American Academy of Addiction Research.2004. p. 26.
    2. Chang G, McNamara TK, Orav EJ, Wilkins-Haug L. Brief intervention for prenatal alcohol use: the role of drinking goal selection. Journal of Substance Abuse Treatment. 2006;31(4):419–24. - PubMed
    3. Chang G, McNamara TK, Orav J, Koby D, Lavigne A, Ludman B, et al. Brief intervention for prenatal alcohol use: a randomized trial. Obstetrics & Gynecology. 2005;105(5 Pt 1):991–8. - PMC - PubMed

Additional references

    1. American Academy of Pediatrics Fetal alcohol syndrome and alcohol related neurodevelopmental disorders. Pediatrics. 2000;106:358–61. - PubMed
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    1. Abel EL, Sokol RJ. A revised conservative estimate of the incidence of FAS and its economic impact. Alcoholism, Clinical and Experimental Research. 1991;15:514–24. - PubMed
    1. Abel EL, Hannigan JH. Maternal risk factors in fetal alcohol syndrome: provocative and permissive influences. Neurotoxicology and Teratology. 1995;17:445–62. - PubMed
    1. Ait-Daoud N, Johnson BA, Prihoda TJ, Hargita ID. Combining ondansetron and naltrexone reduces craving among biologically predisposed alcoholics: preliminary clinical evidence. Psychopharmacology. 2001;154:23–7. - PubMed

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