Psychological and/or educational interventions for reducing alcohol consumption in pregnant women and women planning pregnancy.
BACKGROUND
It is estimated that more than 20% of pregnant women worldwide consume alcohol. Current research suggests that alcohol intake of seven or more standard drinks (one standard drink = 13.6 grams of absolute alcohol) per week during pregnancy places the baby at risk of serious, lifelong developmental and cognitive disabilities. Psychological and educational interventions may help women to reduce their alcohol intake during pregnancy.


OBJECTIVE
To determine the effectiveness of psychological and educational interventions to reduce alcohol consumption during pregnancy in pregnant women or women planning pregnancy.


METHODS
We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (August 2008), CENTRAL (The Cochrane Library 2007, Issue 4), MEDLINE (1966 to November 2007), EMBASE (1980 to November 2007), CINAHL (1982 to November 2007), Counsel.Lit (1980 to November 2007), PsycLIT (1974 to November 2007) and PsycINFO (1967 to November 2007) and checked cited references from retrieved articles.


METHODS
Randomized controlled trials examining the effectiveness of psychological and educational interventions for reducing consumption of alcohol among pregnant women, or women planning for pregnancy.


METHODS
At least two review authors independently extracted information from the results sections of the included studies.


RESULTS
Four studies met the inclusion criteria (715 pregnant women), and reported on at least one of the outcomes of interest. We performed no meta-analyses as the interventions and outcomes measured in the studies were not sufficiently similar. For most outcomes there were no significant differences between groups; and results relating to abstaining or reducing alcohol consumption were mixed. Results from individual studies suggest that interventions may encourage women to abstain from alcohol in pregnancy. There was very little information provided on the effects of interventions on the health of mothers and babies.


CONCLUSIONS
The evidence from the limited number of studies suggests that psychological and educational interventions may result in increased abstinence from alcohol, and a reduction in alcohol consumption among pregnant women. However, results were not consistent, and the paucity of studies, the number of total participants, the high risk of bias of some of the studies, and the complexity of interventions limits our ability to determine the type of intervention which would be most effective in increasing abstinence from, or reducing the consumption of, alcohol among pregnant women.
Department of Pediatrics, St Michael's Hospital, 30 Bond Street, 61 Queen Street East, 2nd Floor, Toronto, Ontario, Canada, M5C 2T2. stadeb@smh.toronto.on.ca
Brenda C
BC
Stade
Carol
C
Bailey
Darlene
D
Dzendoletas
Michael
M
Sgro
Therese
T
Dowswell
Daniel
D
Bennett
D000428:Alcohol Drinking / Q000009:adverse effects / Q000517:prevention & control*; D003376:Counseling / Q000379:methods*; D000431:Ethanol / Q000506:poisoning*; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000517:prevention & control; D006801:Humans; D016742:Preconception Care; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control; D011613:Psychotherapy / Q000379:methods*; D016032:Randomized Controlled Trials as Topic
D000431:Ethanol