Single counseling session can cut prenatal drinking

One short counseling session with a doctor or nurse can be enough to get pregnant women to reduce their drinking, a new study shows.

Drinking during pregnancy is associated with a range of birth defects and developmental disorders — from mild learning disabilities to, most seriously, fetal alcohol syndrome. FAS is a collection of birth defects and developmental problems that can include delayed growth, significant learning disabilities and abnormal facial features.Because there is no known “safe” level of drinking for pregnant women, experts advise abstinence during pregnancy. Women who are trying to get pregnant are also urged to give up alcohol so they don’t end up drinking in the weeks soon after conception, before they know they are pregnant.Despite this advice, though, surveys show that many women continue to drink during pregnancy.”Any drinking during pregnancy is risky,” said Dr. Grace Chang of Brigham and Women’s Hospital in Boston, the lead author of the new study.But, she told Reuters Health, doctors may not always do a “great job” of clearly communicating that message to women.For their study, published in the journal Obstetrics and Gynecology, Chang and her colleagues looked at whether a short, structured discussion with a nurse or doctor about drinking could cut rates of prenatal alcohol use among 304 pregnant women. In most cases, the woman’s husband or partner was included as well.All of the women had been screened with a short questionnaire called the T-ACE, which helps identify women who are at particular risk of drinking during pregnancy. In general, the amount a woman drinks before she is pregnant is a good indicator of whether she will continue to drink during pregnancy, Chang noted.The women in her team’s study were not alcoholic. Rather, Chang said, they were simply generally unaware of the potential harm of prenatal drinking.Of the 304 women, half were randomly assigned to attend a counseling session where, among other things, they learned that abstinence from drinking is the best choice, and discussed ways they could avoid the temptation to drink. In general, women said social situations, such as weddings, presented the biggest challenge.The husband or partner attending the session talked about ways he could support his partner’s abstinence.The rest of the women in the study served as a comparison group, and only completed the T-ACE alcohol screening test.Overall, Chang and her colleagues found, women reduced their drinking after the counseling session and the intervention was most effective when a woman’s partner was involved.At the study’s outset, less than 20 percent of the women had stopped drinking completely, though many had cut down from their pre-pregnancy level. Women in the intervention group cut back further afterward, with those who had used alcohol the most making the biggest change in their drinking habits.Even women in the comparison group, Chang pointed out, cut back on their drinking. Just the “simple act” of taking an alcohol screening test, she said, apparently made a difference in their behavior.The findings, according to Chang, highlight the value of routinely screening pregnant women for alcohol use with the help of a simple, standard questionnaire.Moreover, she and her colleagues conclude, a brief intervention — particularly one that includes a woman’s partner — may be especially helpful in getting the heaviest drinkers to cut down.(Source: Obstetrics and Gynecology: Reuters Health: Amy Norton: May 2005.)