AN ENHANCED BRIEF INTERVENTION FOR PRENATAL ALCOHOL USE

目前还没有确定产前饮酒的普遍安全水平。怀孕期间饮酒的后果从轻微的发育问题到胎儿酒精综合症。然而，近年来，孕妇频繁饮酒的比例大幅上升。简单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，其有效性在几项精心设计的研究中得到了证明。考虑到产前饮酒的潜在后果以及依赖酒精的使用在这一人群中相对较少，有产前消费风险的孕妇是特别适合接受短暂干预的群体。我们之前为改善怀孕期间酒精使用的识别和修改所做的努力表明，在随机接受短暂干预的女性中，禁酒率更高。这项研究的目的是测试加强的短暂干预的有效性，该干预涉及孕妇选择的个人。该支持伙伴将协助维护和应用通过短暂干预所学到的技能。开始产前护理的300名孕妇，如果酒精筛查阳性，目前正在饮酒，或在上一次怀孕期间饮酒，或在怀孕前每天至少喝一杯，将被随机分为强化短暂干预和评估，或仅进行评估。这项拟议的随机临床试验的具体目的是检验这样一种假设，即70%的女性在强化的短暂干预后将会禁欲，而只有50%的女性在评估后会禁欲。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，纳入了女性心理学的进步，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.