Preconception interventions to reduce the risk of alcohol-exposed pregnancies: A systematic review

Reid, Natasha; Schölin, Lisa; Erng, May Na; Montag, Annika; Hanson, Jessica; Smith, Lesley

Abstract

Background: The preconception period provides a unique opportunity to optimize the health of women and children. High rates of alcohol use and unintended pregnancies are common across many Western societies, and alcohol-exposed pregnancies (AEPs) are a possible unintended outcome. The aim of the current study was to evaluate preconception interventions for the prevention of AEPs. Methods: A systematic search of four electronic databases (PubMed, Embase, CINAHL, and PsycINFO) was undertaken for relevant peer-reviewed articles published from 1970 onward. Studies were included if they enrolled women and/or their support networks during the preconception period. Results: Nineteen studies met the inclusion criteria. The majority of studies (n = 14) evaluated CHOICES-based interventions, which incorporate motivational interviewing approaches to change alcohol and/or contraceptive behavior. The other five interventions included a range of different approaches and modes of delivery. The majority of interventions were successful in reducing AEP risk. Changes in AEP risk were more often driven by changes in contraceptive behavior, although some approaches led to changes in both alcohol and contraceptive behavior. Conclusions: The review indicated that many interventions were efficacious at reducing AEP risk during the preconception period through preventing unplanned pregnancy. The effectiveness estimated from these clinical trials may be greater than that seen in interventions when implemented in practice where there is a lack of blinding and greater attrition of participants during follow-up. Further research investigating the real-world effectiveness of these intervention approaches implemented across a wide range of clinical settings would be beneficial.

Citation

Reid, N., Schölin, L., Erng, M. N., Montag, A., Hanson, J., & Smith, L. (2021). Preconception interventions to reduce the risk of alcohol-exposed pregnancies: A systematic review. Alcoholism: Clinical and Experimental Research, 45(12), 2414-2429. https://doi.org/10.1111/acer.14725

• Journal Article Type: Review
• Acceptance Date: Sep 23, 2021
• Online Publication Date: Sep 30, 2021
• Publication Date: 2021-12
• Deposit Date: Apr 1, 2022
• Publicly Available Date: Oct 1, 2022
• Journal: Alcoholism: Clinical and Experimental Research
• Print ISSN: 0145-6008
• Electronic ISSN: 1530-0277
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 45
• Issue: 12
• Pages: 2414-2429
• DOI: https://doi.org/10.1111/acer.14725
• Keywords: Fetal alcohol spectrum disorder; Health and lifestyle; Health behaviors; Life course; Prenatal alcohol
• Public URL: https://hull-repository.worktribe.com/output/3895127