AN ENHANCED BRIEF INTERVENTION FOR PRENATAL ALCOHOL USE

目前还没有确定普遍安全的产前饮酒水平。怀孕期间饮酒的后果从细微的发育问题到胎儿酒精综合症不等。然而，近年来，孕妇频繁饮酒的比例大幅增加。简短的干预通常被推荐为治疗轻度到中度酒精问题的第一种方法，并且在一些精心设计的研究中证明了它们的有效性。鉴于产前饮酒的潜在后果以及这一人群中依赖酒精使用的相对较少，有产前饮酒风险的孕妇是特别适合接受简短干预的群体。我们之前为改进孕期酒精使用的识别和修改所做的努力表明，随机接受短期干预的妇女戒酒率较高。本研究的目的是测试一个由孕妇选择的个体参与的强化简短干预的有效性。这一支持伙伴将协助维持和应用在短暂干预中学习到的技能。300名开始产前护理的孕妇，她们酒精筛查呈阳性，目前正在饮酒，或在以前怀孕期间饮酒，或在怀孕前每天至少喝一杯酒，将被随机分配到增强的简短干预与评估或仅评估。这项随机临床试验的具体目的是验证这样一个假设，即70%的妇女在经过强化的短暂干预后会戒酒，而只有50%的妇女在经过评估后会戒酒。这项拟议的研究寻求干预措施，以防止孕妇饮酒，并建立在我们之前的研究基础上，结合女性心理学的进步，认识到关系在女性生活中的重要性。

No universally safe level of prenatal alcohol consumption has been identified. The consequences of drinking while pregnant range from subtle developmental problems to fetal alcohol syndrome. Yet, the rate of frequent drinking by pregnant women has increased substantially in recent years. Brief interventions have been generally recommended as the first approach to treatment for mild to moderate alcohol problems, and their effectiveness documented in several well designed studies. Pregnant women at risk for antenatal consumption are an especially appropriate group to receive brief interventions, given the potential consequences of prenatal drinking and the relative infrequency of dependent alcohol use in this population. Our previous efforts to improve the identification and modification of alcohol use in pregnancy have demonstrated higher rates of abstinence among women randomized to a brief intervention. The purpose of this study is to test the effectiveness of an enhanced brief intervention involving an individual chosen by the pregnant woman. This support partner will assist in the maintenance and application of skills learned as a result of the brief intervention. Three hundred pregnant women initiating prenatal care, who are alcohol screen positive and currently drinking, or drank during a previous pregnancy, or drank at least one drink daily before pregnancy will be randomized to either the enhanced brief intervention with assessment or assessment only. The aim specific to this proposed randomized clinical trial is to test the hypothesis that 70 percent of the women will be abstinent after the enhanced brief intervention in contrast to 50 percent of the women after the assessment only. This proposed study seeks interventions to prevent drinking by pregnant women, and builds upon our previous research by incorporating advances in feminine psychology which recognize the importance of relationships in women's lives.