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The effectiveness of a brief intervention to reduce alcohol consumption in pregnancy: a controlled trial

Published online by Cambridge University Press:  03 July 2014

J. Sheehan ,
A. Gill  and
B. D. Kelly
J. Sheehan*
Affiliation:
Rotunda Hospital, Dublin, Ireland Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
A. Gill
Affiliation:
Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland
B. D. Kelly
Affiliation:
Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin, Ireland School of Medicine and Medical Science, University College Dublin, Belfield, Dublin, Ireland
*
*Address for correspondence to: Dr John Sheehan, Department of Adult Psychiatry, Mater Misericordiae University Hospital, Dublin 7, Ireland. (Email: [email protected])
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Abstract

Objectives

Alcohol consumption during pregnancy potentially has significant effects on both mother and baby. The aim of the study was to determine the effectiveness of a brief intervention to reduce alcohol consumption during pregnancy.

Methods

This study was performed at the outpatient antenatal clinics of a large academic maternity teaching hospital in Dublin city centre. Six hundred and fifty-six women who drank alcohol before pregnancy were recruited at their first antenatal clinic visit. Drinking patterns before pregnancy, since becoming pregnant, and in later pregnancy (at ~32 weeks of gestation) were assessed using the Alcohol Use Disorders Identification Test (AUDIT). A controlled study was conducted – participants were allocated to either the brief intervention group (screening and 5 minutes of non-directive discussion of their drinking pattern) or a control group (screening and treatment as usual).

Results

Before pregnancy, 57% of women consumed five or more units of alcohol per drinking occasion (i.e. binge drinking); during pregnancy, the rate of binge drinking fell to 4.8%. Sixty per cent of women who drank before pregnancy ceased drinking when pregnant, and a further 9% reduced their intake substantially. Four hundred and ninety-nine women were followed up in later pregnancy. The brief intervention did not produce any significant reduction in alcohol consumption above that attributable to pregnancy and comprehensive screening in antenatal care. Larger reductions in alcohol intake during pregnancy were associated with younger age, non-Irish nationality and greater intake of alcohol before first antenatal clinic visit.

Conclusion

Pregnancy itself produces abstinence and large reductions in alcohol consumption, even among women who drink relatively heavily. Consequently, a universal screening and brief intervention programme is not warranted but screening and targeted interventions could be appropriate such as repeated interventions for those who continue to binge drink. Future research could include evaluating interventions for those women who continue to binge drink during pregnancy and exploring ways of maintaining reductions in alcohol consumption among women who decreased consumption during pregnancy.

Keywords

Alcoholbrief interventionpregnancy
Type
Original Research
Information
Irish Journal of Psychological Medicine , Volume 31 , Issue 3 , September 2014 , pp. 175 - 189
Copyright
© College of Psychiatrists of Ireland 2014 

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References

Abel, EL (1998). Fetal Alcohol Abuse Syndrome. Plenum Pub Corp.: New York.CrossRefGoogle Scholar
Babor, TF, De la Fuente, JR, Saunders, J, Grant, M (1992). The Alcohol Use Disorders Identification Test. Guidelines for Use in Primary Health Care. World Health Organisation: Geneva, Switzerland.Google Scholar
Babor, TF, Higgins-Biddle, JC (2001). Brief Intervention for Hazardous and Harmful Drinking. A Manual for Use in Primary Care. World Health Organisation: Geneva.Google Scholar
Barry, S, Kearney, A, Daly, S, Lawlor, E, McNamee, E, Barry, J (2007). The Coombes Women's Hospital Study of Alcohol, Smoking and Illicit Drug Use (1987–2005). Coombe Women’s Hospital & Department of Health & Children: Dublin.Google Scholar
Carew, AM, Bellerose, D, Lyons, S, Long, J (2009). Treated problem alcohol use in Ireland: figures for 2007 from the National Drug Treatment Reporting System. Alcohol and Drug Research Unit, Health Research Board: Dublin.Google Scholar
Central Statistics Office (2009). Statistical Yearbook of Ireland 2009. The Stationery Office: Dublin.Google Scholar
Centres for Disease Control and Prevention (CDC) (2002). Alcohol use among women in childbearing age – United States, 1991–1999. Morbidity and Mortality Weekly Report 51, 273–276.Google Scholar
Chang, G, McNamara, TK, Orav, EJ, Koby, D, Lavigne, A, Ludman, B, Vincitorio, NA, Wilkins-Haug, L. (2005). Brief intervention for prenatal alcohol use: A randomised trial. Obstetrics and Gynecology 105, 991–998.Google Scholar
Chang, G, McNamara, TK, Orav, EJ, Wilkins-Haug, L (2006). Alcohol use by pregnant women: partners, knowledge, and other predictors. Journal of Studies on Alcohol 67, 245–251.Google Scholar
Chang, G, Wilkins-Haug, L, Berman, S, Goetz, MA (1999). A brief intervention for alcohol use in pregnancy: a randomized controlled trial. Addiction 94, 1499–1508.Google Scholar
Crome, IB (1997). Alcohol problems. In The Essentials of Postgraduate Psychiatry (ed. R. Murray, P. Hill and P. McGuffin), pp. 247–280. Cambridge University Press: Cambridge.Google Scholar
Department of Health & Children (2000). The National Health Promotion Strategy 2000-2005. Department of Health and Children: Dublin, Ireland.Google Scholar
Department of Health & Children (2004). Strategic Task Force on Alcohol Second Report. Department of Health and Children: Dublin, Ireland.Google Scholar
Donnelly, JC, Cooley, SM, Walsh, TA, Sarkar, R, Durnea, U, Geary, M (2008). Illegal drug use, smoking and alcohol consumption in a low-risk Irish primigravid population. Journal of Perinatal Medicine 36, 70–72.CrossRefGoogle Scholar
Gladstone, JLM, Nulman, I, Koren, G (1997). Characteristics of pregnant women who engage in binge alcohol consumption. Canadian Medical Association 156, 789–794.Google Scholar
Goransson, M, Magnusson, A, Bergman, H, Rydberg, U, Heilig, M (2003). Fetus at risk: prevalence of alcohol consumption during pregnancy estimated with a simple screening method in Swedish antenatal clinics. Addiction 98, 1513–1520.Google Scholar
Handmaker, NS, Miller, W, Manicke, M (1999). Findings of a pilot study of motivational interviewing with pregnant drinkers. Journal of Studies on Alcohol 60, 285–287.Google Scholar
Harrison, P, Sidebottom, A (2009). Alcohol and drug use before and during pregnancy: an examination of use patterns and predictors of cessation. Maternal Child Health 13, 386–394.Google Scholar
Kesmodel, U, Kesmodal, PS, Larsen, A, Secher, NJ (2003). Use of alcohol and illicit drugs among pregnant Danish women, 1998. Scandinavian Journal of Public Health 31, 5–11.Google Scholar
MacÉinrí, P (2001). Immigration into Ireland: Trends, Policy, Responses, Outlook. Irish Centre For Migration Studies: Cork.Google Scholar
May, PA, Gossage, JP (2001). Estimating the prevalence of fetal alcohol syndrome: a summary. Alcohol Res Health 25, 159–167.Google Scholar
Mehta, C, Masson, G, Iqbal, Z, O’Mahony, F, Khalid, R (2009). Prevalence of excessive alcohol consumption in pregnancy. Public Health 123, 630–631.Google Scholar
Naimi, TS, Lipscomb, LE, Brewer, RD, Gilbert, BC (2003). Binge drinking in the preconception period and the risk of unintended pregnancy: Implications for women and their children. Pediatrics 111, 1136–1141.CrossRefGoogle ScholarPubMed
Nilsen, P (2009). Brief alcohol intervention to prevent drinking during pregnancy: an overview of research findings. Current Opinion in Obstetrics and Gynecology 21, 496–500.Google Scholar
Nilsen, P, Holmqvist, M, Hultgren, E, Bendtsen, P, Cedergren, M (2008). Alcohol use before and during pregnancy and factors influencing change among Swedish women. Acta Obstetricia et Gynecologica Scandinavica 87, 768–774.Google Scholar
O’Connor, J, Whaley, SE (2007). Brief intervention for alcohol use by pregnant women. American Journal of Public Health 97, 252–258.CrossRefGoogle ScholarPubMed
Ramstedt, M, Hope, A (2005). The Irish drinking habits of 2002: drinking and drinking-related harm, a European comparative perspective. Journal of Substance Use 10, 273–283.Google Scholar
Rotunda Hospital (2009). Annual Report 2008. Rotunda Hospital: Dublin.Google Scholar
Sampson, PD, Streissguth, AP, Bookstein, FL, Little, RE, Clarren, SK, Dehaene, P, Hanson, JW, JrGraham, JM (1997). Incidence of fetal alcohol syndrome and prevalence of alcohol-related neurodevelopment disorder. Teratology 56, 317–326.Google Scholar
Saunders, JB, Aasland, OG, Babor, TF, De La Fuente, JR, Grant, M (1993). Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption – II. Addiction 88, 791–804.Google Scholar
Skagerstrom, J, Chang, G, Nilsen, P (2011). Predictors of drinking during pregnancy: a systematic review. Journal of Women’s Health (Larchmt) 20, 901–913.Google Scholar
Sokol, R, Delaney-Black, V, Nordstrom, B (2003). Fetal alcohol spectrum disorder. The Journal of the American Medical Association 290, 2996–2999.Google Scholar
Sommers, MS, Dyehouse, JM, Howe, SR, Weksekman, K, Fleming, M (2002). Nurse I only had a couple of beers. Validity of self-reported drinking before serious vehicular injury. American Journal of Critical Care. 11, 106–114.Google Scholar
SPSS Inc. (2003). SPSS 12.0 Base Users Guide. Prentice-Hall Regents: Upper Saddle River, New Jersey.Google Scholar
World Health Organisation (WHO) (2004). WHO Global Report on Alcohol. WHO: Geneva.Google Scholar
Zammit, SL, Skouteris, H, Wertheim, EH, Paxton, SJ, Milgrom, J (2008). Pregnant women’s alcohol consumption: the predictive utility of intention to drink and prepregnancy drinking behaviour. Journal of Women’s Health 17, 1513–1522.Google Scholar