Effectiveness of brief alcohol interventions for pregnant women: a systematic literature review and meta-analysis

BMC Pregnancy and Childbirth

Research

Marcos Sanches¹  Steven J. Ondersma²  Krista Brower³  Ekta Pandya⁴  Svetlana Popova⁵  Danijela Dozet⁶  Lidia Segura⁷ 

[1] Biostatistics Core, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada;Department of Obstetrics, Gynecology, & Reproductive Biology, Michigan State University, 965 Wilson Rd, 48824, East Lansing, MI, USA;Edmonton Oliver Primary Care Network, 130, 11910-111 Avenue NW, Edmonton, Alberta, Canada;Department of Educational Research, Lancaster University, LA1 4YW, Lancaster, UK;Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada;Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada;Dalla Lana School of Public Health, University of Toronto, 155 College Street, M5T 3M7, Toronto, ON, Canada;Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, M5S 1V4, Toronto, ON, Canada;Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, M5S 1A8, Toronto, ON, Canada;Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, 33 Ursula Franklin Street, M5S 2S1, Toronto, ON, Canada;Institute of Medical Science, Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King’s College Circle, M5S 1A8, Toronto, ON, Canada;Program on Substance Abuse, Public Health Agency of Catalonia, C.Roc Boronat 81 – 95, 08005, Barcelona, Catalonia, Spain;

关键词: Alcohol;    Brief interventions;    Medical disorders in pregnancy;    Substance misuse in pregnancy;    Birth outcomes;    Fetal alcohol spectrum disorder;   

DOI  :  10.1186/s12884-023-05344-8

 received in 2022-05-25, accepted in 2023-01-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundPrenatal alcohol exposure (PAE) can result in a range of adverse neonatal outcomes, including Fetal Alcohol Spectrum Disorder (FASD). This systematic review and meta-analysis sought to investigate the effectiveness of brief interventions (BIs) in eliminating or reducing 1) alcohol consumption during pregnancy; and 2) PAE-related adverse neonatal outcomes; and 3) cost-effectiveness of BIs.MethodWe conducted a systematic literature search for original controlled studies (randomized control trials (RCTs); quasi-experimental) in any setting, published from 1987 to 2021. The comparison group was no/minimal intervention, where a measure of alcohol consumption was reported. Studies were critically appraised using the Centre for Evidence-based Medicine Oxford critical appraisal tool for RCTs (1). The certainty in the evidence for each outcome was assessed using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) (2). Meta-analysis of continuous and binary estimates of effect-size for similar outcome measures for BIs versus control groups were pooled and reported as mean difference (MD) Hedges’ g and odds ratios (ORs), respectively.ResultsIn total, 26 studies, all from high income countries, met inclusion criteria. Alcohol abstinence outcome available in 12 studies (n = 2620) found modest effects in favor of BIs conditions by increasing the odds of abstinence by 56% (OR = 1.56, 95% confidence interval (CI) = 1.15–2.13, I2 = 46.75%; p = 0.04). BIs effects for reduction in mean drinks/week (Cohen’s d = − 0.21, 95%CI = - 0.78 to 0.36; p = 0.08) and AUDIT scores (g = 0.10, 95%CI = − 0.06 to 0.26; p = 0.17) were not statistically significant. Among seven studies (n = 740) reporting neonatal outcomes, BI receipt was associated with a modest and significant reduction in preterm birth (OR = 0.67, 95% CI = 0.46–0.98, I2 = 0.00%; p = 0.58). No statistically significant differences were observed for mean birthweight or lower likelihood of low birth weight (LBW). Certainty in the evidence was rated as ‘low’. No eligible studies were found on cost-effectiveness of BIs.ConclusionBIs are moderately effective in increasing abstinence during pregnancy and preventing preterm birth. More studies on the effectiveness of BIs are needed from low- and middle-income countries, as well as with younger mothers and with a broader range of ethnic groups.

【 授权许可】

CC BY   
© The Author(s) 2023

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