title: Efficacy of motivational enhancement therapy to decrease alcohol and illicit-drug use in pregnant substance users reporting baseline alcohol use.
abstract: Approximately 35% of pregnant substance users in treatment report alcohol abuse, which increases the risk of fetal alcohol spectrum disorders (FASD) in their offspring. The present study was a preliminary evaluation of the efficacy of motivational enhancement therapy (MET) in decreasing alcohol use in pregnant women attending substance use treatment.
  
  
  
  Secondary analysis of a trial evaluating the efficacy of MET, relative to treatment as usual (TAU), in improving treatment outcomes in 200 pregnant substance users. The present study included the 41 women (n=27 MET and n=14 TAU) who reported alcohol use in the 28days prior to randomization. Alcohol and illicit-drug use days were assessed with self-report; illicit drug use was assessed with urine drug screens. All measures were obtained weekly for the 4week active study phase and at 1 and 3month follow-ups.
  
  
  
  Significant treatment-by-time interaction effects were found for illicit-drug use days during the active (X2=6.89, df=1, p<0.01) and follow-up (X2=8.26, df=1, p<0.01) phases and for alcohol use during the follow-up phase (X2=13.07, df=1, p<0.001), all reflecting a beneficial effect for MET, relative to TAU. All other treatment effects were non-significant.
  
  
  
  These findings suggest that MET may be effective in decreasing alcohol and illicit-drug use in pregnant substance users reporting alcohol use. With 2-5% of US births affected by FASD, future research to replicate these findings seems warranted.
  
  
  
  ClinicalTrials.gov http://www.clinicaltrials.gov; Identifier: NCT00078143.
authors.affiliation: University of Cincinnati College of Nursing, 3110 Vine Street, Cincinnati, OH 45219, USA. Electronic address: robin.osterman@uc.edu.
authors.forename: Robin
authors.initials: R
authors.lastname: Osterman
authors.affiliation: Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Lewis
authors.affiliation: Addiction Sciences Division, Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, 3131 Harvey Avenue, Cincinnati, OH 45229, USA.
authors.forename: Theresa
authors.initials: T
authors.lastname: Winhusen
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000517:prevention & control; D055030:Drug Users; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D062405:Motivational Interviewing / Q000379:methods*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000628:therapy*; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Alcohol use; Drug use; Fetal alcohol spectrum disorders; Motivational enhancement therapy; Pregnant