Department of Medicine, Federal University of São Carlos, São Paulo, Brazil.
PLoS One. 2019 Oct 4;14(10):e0223351. doi: 10.1371/journal.pone.0223351. eCollection 2019.
In Brazil, alcohol consumption is estimated to range from 7 to 40% in pregnant women. This research investigated the motivation for alcohol consumption or abstinence during pregnancy in a purposive sample of Brazilian women.
Clinical-qualitative research was conducted, in which 14 women participated, identified as risk-drinkers during pregnancy by the T-ACE screening tool. Data were collected through semi-structured individual interviews. Reports were recorded, transcribed and investigated by a thematic content analysis approach. The results were discussed based on a comprehensive and interpretive framework.
Sixteen themes were extracted and these were then classified into three thematic categories: (a) general motives for alcohol use, (b) specific motives for drinking during pregnancy, and (c) reasons for partly or fully abstaining from drinking during pregnancy. Social motives were the most relevant, particularly due to deeply rooted cultural values. Enhancement motives were widely mentioned and associated with a hedonic posture. Consumption also aimed to deal with negative emotions, characterizing two types of coping specifically to pregnancy: first, perceiving pregnancy as a period of less opportunity for social interaction and, therefore, drinking alcohol at home to compensate; secondly, perceiving pregnancy as a period of greater irritability, and hence experiencing difficulties to abstain. On the other hand, concern about fetal health, disapproval of consumption by relatives and health professionals, as well as the social construction of mothering were reported as reasons to abstain.
Some specificities influence the decision to continue or discontinue alcohol consumption during pregnancy. To reduce consumption, we suggest educational actions based on a collective health perspective, articulated with individualized measures that allow identification and proper intervention for women at risk.
在巴西，孕妇的饮酒率估计在 7%到 40%之间。本研究旨在有针对性地选取巴西孕妇作为研究对象，调查她们在孕期饮酒或戒酒的动机。
本研究采用临床定性研究方法，共纳入 14 名被 T-ACE 筛查工具识别为孕期风险饮酒者的女性。通过半结构化个体访谈收集数据。报告采用主题内容分析方法进行记录、转录和调查。结果基于综合和解释性框架进行讨论。
共提取了 16 个主题，并将其分为三个主题类别：（a）饮酒的一般动机，（b）孕期饮酒的具体动机，以及（c）孕期部分或完全戒酒的原因。社会动机是最相关的，特别是由于根深蒂固的文化价值观。增强动机被广泛提及，并与享乐主义姿态相关。饮酒还旨在应对负面情绪，这两个类型的应对方式与怀孕有关：首先，将怀孕视为社交互动机会减少的时期，因此在家中饮酒以弥补；其次，将怀孕视为情绪更易波动的时期，因此难以戒酒。另一方面，出于对胎儿健康的关注、亲属和卫生专业人员对饮酒的反对，以及对母性的社会建构，被报告为戒酒的原因。
一些特殊性影响了继续或停止孕期饮酒的决定。为了减少饮酒，我们建议采取基于集体卫生视角的教育行动，并与个体化措施相结合，以便识别和适当干预风险孕妇。
