title: Preventing alcohol-exposed pregnancies: a randomized controlled trial.
abstract: BACKGROUND
  Prenatal alcohol exposure is a leading preventable cause of birth defects and developmental disabilities in the United States.
  
  
  METHODS
  A randomized controlled trial (2002-2005; data analyzed 2005-2006) of a brief motivational intervention to reduce the risk of an alcohol-exposed pregnancy (AEP) in preconceptional women by focusing on both risk drinking and ineffective contraception use.
  
  
  METHODS
  A total of 830 nonpregnant women, aged 18-44 years, and currently at risk for an AEP were recruited in six diverse settings in Florida, Texas, and Virginia. Combined settings had higher proportions of women at risk for AEP (12.5% overall) than in the general population (2%).
  
  
  METHODS
  Participants were randomized to receive information plus a brief motivational intervention (n=416) or to receive information only (n=414). The brief motivational intervention consisted of four counseling sessions and one contraception consultation and services visit.
  
  
  METHODS
  Women consuming more than five drinks on any day or more than eight drinks per week on average, were considered risk drinkers; women who had intercourse without effective contraception were considered at risk of pregnancy. Reversing either or both risk conditions resulted in reduced risk of an AEP.
  
  
  RESULTS
  Across the follow-up period, the odds ratios (ORs) of being at reduced risk for AEP were twofold greater in the intervention group: 3 months, 2.31 (95% confidence interval [CI]=1.69-3.20); 6 months, 2.15 (CI=1.52-3.06); 9 months, 2.11 (CI=1.47-3.03). Between-groups differences by time phase were 18.0%, 17.0%, and 14. 8%, respectively.
  
  
  CONCLUSIONS
  A brief motivational intervention can reduce the risk of an AEP.
authors.affiliation: National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia 30329, USA. rlf3@cdc.gov
authors.forename: R Louise
authors.initials: RL
authors.lastname: Floyd
authors.forename: Mark
authors.initials: M
authors.lastname: Sobell
authors.forename: Mary M
authors.initials: MM
authors.lastname: Velasquez
authors.forename: Karen
authors.initials: K
authors.lastname: Ingersoll
authors.forename: Mary
authors.initials: M
authors.lastname: Nettleman
authors.forename: Linda
authors.initials: L
authors.lastname: Sobell
authors.forename: Patricia Dolan
authors.initials: PD
authors.lastname: Mullen
authors.forename: Sherry
authors.initials: S
authors.lastname: Ceperich
authors.forename: Kirk
authors.initials: K
authors.lastname: von Sternberg
authors.forename: Burt
authors.initials: B
authors.lastname: Bolton
authors.forename: Kenneth
authors.initials: K
authors.lastname: Johnson
authors.forename: Bradley
authors.initials: B
authors.lastname: Skarpness
authors.forename: Jyothi
authors.initials: J
authors.lastname: Nagaraja
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology / Q000517:prevention & control*; D003268:Contraception Behavior; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000517:prevention & control*; D006801:Humans; D011247:Pregnancy; D014481:United States / Q000453:epidemiology