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Psychosocial interventions for women enrolled in alcohol treatment during pregnancy.

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Abstract

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Background

Excessive alcohol use during pregnancy has been associated with adverse maternal and neonatal effects. It is therefore important to develop and evaluate effective interventions during this important time in a woman's life. To our knowledge there have been no systematic reviews of randomised control trials (RCT) in this population.

Objectives

To evaluate the effectiveness of psychosocial interventions in pregnant women enrolled in alcohol treatment programs for improving birth and neonatal outcomes, maternal abstinence and treatment retention.

Search methods

We searched the Cochrane Drugs and Alcohol Group's Trial register (December 2007); MEDLINE (1950 to 2007); PsycINFO (1806 to 2007); EMBASE (1974 to 2007); CINAHL (1982 to 2007)

Selection criteria

We sought to include randomised or quasi‐randomised studies comparing any psychosocial intervention versus pharmacological interventions or placebo or non‐intervention or another psychosocial intervention for treating alcohol dependence in pregnancy.

Data collection and analysis

Three review authors independently assessed trials for inclusion in review. Studies were to be assessed using standardized data extraction and quality assessment forms. No suitable trials were identified.

Main results

The search strategy identified 958 citations. 17 citations were deemed relevant for full text review, an additional 9 articles were retrieved through hand searching references, for a total of 26 articles. Following full text review no articles met the inclusion criteria. Data extraction and assessment of methodological quality were therefore not possible.

Authors' conclusions

The review question remains unanswered as there were no randomised control trials found relevant to the topic. There is a need for high quality randomised controlled trials to determine the effectiveness of psychosocial interventions in pregnant women enrolled in alcohol treatment programs.

Plain language summary

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Psychosocial interventions for women enrolled in alcohol treatment during pregnancy

Pregnancy can be seen as a window of opportunity where women may seek treatment for their addictions out of concern for their unborn child. Worldwide estimates of alcohol usage report that a large proportion of women continue to drink during their pregnancy. Light alcohol consumption has not been associated with adverse effects on a woman's baby, while excessive consumption of alcohol has been shown to cause a number of birth defects as well as foetal alcohol syndrome. Alcohol consumption during pregnancy is the most widely recognized cause of severe mental and developmental delay in the baby. Therefore pregnancy is an important point in time to treat women for their alcohol dependence. This review sought to find all trials which compared any psychosocial intervention to other treatment or no treatment for pregnant or postpartum women in alcohol treatment. No articles were found which fit our inclusion criteria; most trials assessed psychosocial interventions to reduce alcohol consumption in pregnant or reproductive age women, not pregnant or post‐partum women in alcohol treatment. We defined alcohol treatment as when the authors stated the women were in alcohol treatment or any validated psychosocial intervention for the treatment of alcohol dependence. Control trials need to be performed on this population of women to determine the most effective therapy for pregnant women seeking treatment for their alcohol dependence.