Counseling Can Reduce Alcohol Exposure During Pregnancy
Two recent studies assessed the potential benefits of alcohol counseling for women who were or at risk of becoming pregnant.
In the first study, 345 pregnant women who drank were randomized to receive one of the following at monthly prenatal visits for as long as they continued to drink: an alcohol assessment and advice to stop drinking, or the assessment, advice, and a 10- to 15-minute scripted counseling session delivered by a nutritionist.
- Women in the intervention group were significantly more likely than women in the assessment-only group to report abstinence (odds ratio 5.4).
- Fetal mortality was lower in the intervention group than in the assessment-only group (0.9% versus 2.9%).
In the second study, researchers randomized 830 women of childbearing potential who were not pregnant or planning to become pregnant, did not use effective contraception, and drank risky amounts (>8 drinks per week or >5 drinks on any day) to receive one of the following: alcohol and contraception information only, or information plus 5 counseling sessions (4 motivational interviewing sessions and 1 contraceptive counseling session) over 14 weeks.
- At 9 months, women in the counseling group versus those in the information-only group were less likely to be drinking risky amounts or not using effective contraception (31% versus 46%).
The first study highlights the importance of brief interventions during prenatal care and suggests that clinic team members can effectively provide them. The second study is important because of its focus on preconception and contraceptive counseling for women who were not planning pregnancy. Implementing either intervention in clinical practice will be a challenge.Joseph Conigliaro, MD, MPH
Richard Saitz, MD, MPH
O’Connor MJ, Whaley SE. Brief intervention for alcohol use by pregnant women. Am J Public Health. 2007;97(2):252–258.
Floyd RL, Sobell M, Velasquez MM, et al. Preventing alcohol-exposed pregnancies: a randomized controlled trial. Am J Prev Med. 2007;32(1):1–10.