Does Brief Intervention Reduce Drinking in Pregnant Women?

Alcohol
use by pregnant women can cause birth defects, developmental
disorders, and mental retardation in the exposed fetus.
To test if brief intervention reduces prenatal alcohol
use, researchers randomized 304 pregnant women—all of
whom scored positive on the T-ACE* questionnaire and were
drinking (or at risk for drinking**)—to either usual
care or a 25-minute brief intervention. On average, women
in both groups drank 20% of days and 1.8 drinks per drinking
day prior to pregnancy and 5% of days and 1.6 drinks per
drinking day at enrollment.

• Both
  the intervention and usual care groups decreased drinking,
  from enrollment to delivery, to 2% of days and 0.5 drinks
  per day (no significant differences between groups).
• Brief
  intervention was significantly more effective than was
  usual care at reducing drinking frequency in women who
  drank more often at baseline.
• Among
  these heavier-drinking women, those who had a partner
  participate in the intervention had greater reductions
  in drinking frequency than did those without partner
  involvement.

Comments:

Although
this study did not find an overall effect of brief intervention
on prenatal alcohol use, it does highlight that pregnancy
can strongly motivate women to change their drinking.
Most women substantially decreased their drinking after
learning of their pregnancies. The additional decreases
in both groups after enrollment suggest that screening
and assessment should be routinely performed. Further,
targeted interventions deserve further study given that
heavier-drinking women responded best to the intervention,
especially when their partners were involved.

Kevin L. Kraemer, MD, MSc

Reference:

Chang
G, McNamara TK, Orav EJ, et al. Brief intervention for prenatal alcohol use: a randomized trial. Obstet Gynecol. 2005;105(1):991-998.