From the, Child Health Research Centre, (MNE, NR), The University of Queensland, South Brisbane, QLD, Australia.
School of Public Health, (AS), The University of Queensland, Herston, QLD, Australia.
Alcohol Clin Exp Res. 2020 Dec;44(12):2431-2448. doi: 10.1111/acer.14489. Epub 2020 Nov 20.
Prenatal alcohol exposure can result in a wide range of adverse health outcomes, including in some cases fetal alcohol spectrum disorder (FASD), a lifelong neurodevelopmental disorder. Thus, there is pressing need for effective interventions to prevent alcohol-exposed pregnancies (AEPs).
A systematic review was undertaken to provide an up-to-date analysis of the current prevention literature. PubMed, Embase, CINAHL, and PsycINFO were searched for relevant English-language articles published from 1970 onward. Studies were eligible for the current systematic review if the interventions included pregnant and postpartum women and/or their support networks to prevent AEPs and FASD. Outcomes of interest included alcohol consumption, knowledge, contraceptive use, neonatal outcomes, family well-being or functioning, economics, and healthcare utilization outcomes.
Thirty-four peer-reviewed studies met the inclusion criteria. Fifteen studies employed brief intervention (BI) methods, 6 used long-term/intensive strategies, and 5 were educational interventions. A further 3 studies assessed counseling approaches, 2 evaluated multicomponent interventions, and 3 assessed nutritional supplementation interventions.
The current review identified variable results from available interventions to prevent alcohol use among pregnant and postpartum women. Preliminary evidence demonstrated that BIs may be effective among subgroups of pregnant women with higher initial alcohol consumption, those with partner involvement, and those who used alcohol and other substances concurrently. Some preliminary evidence relating to long-term interventions with pregnant women with polysubstance use emerged, specifically case management that not only focused on reduction in substance use, but also on addressing the complex interplay between health and social well-being of families. Overall, additional research is required to improve the effectiveness of preventative approaches during pregnancy and the postpartum period.
产前酒精暴露可导致一系列不良健康后果，在某些情况下还会导致胎儿酒精谱系障碍（FASD），这是一种终生的神经发育障碍。因此，迫切需要有效的干预措施来预防酒精暴露的妊娠（AEPs）。
进行了系统评价，以提供当前预防文献的最新分析。检索了 PubMed、Embase、CINAHL 和 PsycINFO 中的相关英文文章，这些文章发表于 1970 年以后。如果干预措施包括孕妇和产后妇女及其支持网络，以预防 AEPs 和 FASD，则当前系统评价将符合纳入标准。感兴趣的结果包括酒精消费、知识、避孕措施使用、新生儿结局、家庭福祉或功能、经济学和医疗保健利用结果。
34 项同行评审研究符合纳入标准。15 项研究采用了简短干预（BI）方法，6 项研究采用了长期/强化策略，5 项研究是教育干预。另有 3 项研究评估了咨询方法，2 项研究评估了多组分干预，3 项研究评估了营养补充剂干预。
目前的综述确定了预防孕妇和产后妇女饮酒的现有干预措施的结果各不相同。初步证据表明，BI 可能对初始酒精摄入量较高、有伴侣参与以及同时使用酒精和其他物质的孕妇亚组有效。一些与有多种物质使用的孕妇进行长期干预的初步证据出现了，特别是不仅关注减少物质使用，还关注解决家庭健康和社会福祉之间复杂相互作用的案例管理。总体而言，需要进一步研究以提高妊娠和产后期间预防措施的有效性。
