Department of Psychology, University of Liverpool, Liverpool, Merseyside, UK.
Liverpool Centre for Alcohol Research, University of Liverpool, Liverpool, Merseyside, UK.
Addiction. 2021 Jul;116(7):1638-1663. doi: 10.1111/add.15296. Epub 2020 Dec 10.
Alcohol use by pregnant and parenting women can have serious and long-lasting consequences for both the mother and offspring. We reviewed the evidence for psychosocial interventions to reduce maternal drinking.
Literature searches of PsycINFO, PubMed and Scopus identified randomised controlled trials of interventions with an aim of reduced drinking or abstinence in mothers or pregnant women.
Interventions were delivered in healthcare settings and homes.
Pregnant women and mothers with dependent children.
Psychosocial interventions were compared with usual care or no intervention.
The revised Cochrane risk-of-bias tool for randomised trials was used for quality assessments. Narrative synthesis summarised the findings of the studies with a subset of trials eligible for random-effects meta-analysis. General and alcohol-specific behaviour change techniques (BCTs) were identified to investigate potential mechanism of change.
Twenty-four studies were included (20 pregnancy, four motherhood). Because of quality of reporting, data from only six pregnancy and four motherhood studies could be pooled. A significant treatment effect was revealed by the meta-analyses of pregnancy studies regarding abstinence (OR = 2.31, 95% CI = 1.61, 3.32; P < 0.001) and motherhood studies regarding a reduction in drinking (standardised mean difference [SMD] = -0.20, 95% CI = -0.38, -0.02; P = 0.03). Narrative synthesis of the remaining trials yielded inconsistent results regarding intervention effectiveness. A wide range of BCTs were used, present in both effective and ineffective interventions. The most commonly used general and alcohol-specific BCTs included information about consequences, social support, goal setting and action planning.
In pregnant women identified as consuming alcohol, psychosocial interventions appear to increase abstinence rates compared with usual care or no intervention. Similarly, such interventions appear to lead to a reduction in alcohol consumption in mothers with dependent children. It is unclear that behaviour change techniques are contributing to these effects. Conclusions from randomised controlled trials are only meaningful if the behavioural outcome, population, setting, intervention and comparator are clearly reported. An important barrier when it comes to identifying effective behaviour change techniques is a widespread failure to provide enough information in study reports.
孕妇和哺乳期妇女饮酒会对母亲和后代造成严重且持久的后果。我们回顾了减少产妇饮酒的心理社会干预措施的证据。
对 PsycINFO、PubMed 和 Scopus 进行文献检索，以确定旨在减少饮酒或戒酒的干预措施的随机对照试验。
干预措施在医疗保健环境和家庭中进行。
孕妇和有受抚养子女的母亲。
将心理社会干预与常规护理或不干预进行比较。
使用修订后的 Cochrane 随机试验风险偏倚工具进行质量评估。对研究结果进行叙述性综合，其中一部分符合纳入随机效应荟萃分析的试验。确定一般和特定于酒精的行为改变技术（BCT），以调查潜在的变化机制。
纳入了 24 项研究（20 项妊娠，4 项母亲）。由于报告质量，只有 6 项妊娠和 4 项母亲研究的数据可以进行汇总。荟萃分析显示，妊娠研究中，干预措施对戒酒有显著的治疗效果（OR=2.31，95%CI=1.61，3.32；P<0.001），而母亲研究中，干预措施对减少饮酒有显著的治疗效果（SMD=-0.20，95%CI=-0.38，-0.02；P=0.03）。对其余试验的叙述性综合得出的干预效果不一致。广泛使用了一系列行为改变技术，包括有效和无效的干预措施。最常用的一般和特定于酒精的行为改变技术包括关于后果、社会支持、目标设定和行动计划的信息。
在被确定为饮酒的孕妇中，与常规护理或不干预相比，心理社会干预似乎可以提高戒酒率。同样，此类干预措施似乎也能减少有受抚养子女的母亲的饮酒量。目前尚不清楚行为改变技术是否对这些效果有贡献。只有当行为结果、人群、环境、干预措施和对照措施明确报告时，随机对照试验的结论才有意义。在确定有效的行为改变技术时，一个重要的障碍是研究报告普遍缺乏足够的信息。
