Interventions delivered during antenatal care to reduce alcohol consumption during pregnancy: A systematic review

Abstract

Despite the importance of reducing prenatal exposure to alcohol, a recent Cochrane review found limited evidence from randomised controlled trials (RCTs) regarding effectiveness of interventions to reduce drinking during pregnancy. The aim of this systematic review was to consider additional evidence by including RCTs and non-RCTs to determine whether pregnant women reduced alcohol consumption during pregnancy following interventions delivered during antenatal care. Five electronic databases were searched using keywords: e.g. pregnancy, maternal, alcohol, consumption, drinking, cognitive-behavioural therapy, motivational interviewing (MI), brief intervention, health education, social support and self-efficacy. Papers were excluded through a consecutive method using the title, abstract and full text paper. Two authors assessed the full text papers, including quality assessment. Eight trials were included in the review, including six RCTs and two non-RCTs. Interventions included brief interventions, MI, a self-help manual, supportive counselling, high feedback ultrasound and basic educational interventions. In general, methodological quality in all but two studies was poor, limiting the conclusions that could be drawn from this review. However, there was some evidence from a small number of studies that single-session face-to-face brief interventions resulted in positive effects on the maintenance of alcohol abstinence during pregnancy. Women choosing abstinence as their drinking goals and heavier drinking women who participated with a partner were more likely to be abstinent at follow-up. However, more intensive interventions may be required to encourage women who continue to drink during pregnancy to reduce their consumption. Implications for practice and future research directions are discussed.