Brief motivational enhancement intervention to prevent or reduce postpartum alcohol use: A single-blinded, randomized controlled effectiveness trial

Abstract

AimsThe aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use. DesignThis study is a single-blinded, randomized controlled effectiveness trial in which pregnant women were assigned to receive usual care or up to 5 face-to-face brief motivational enhancement sessions lasting 10–30minutes each and occurring at study enrollment, 4 and 8weeks after enrollment, 32weeks of gestation, and 6weeks postpartum. SettingThe setting is in a large, urban, obstetrics clinic. ParticipantsParticipants were women who were ≥18years old, <20weeks of gestation, and consumed alcohol during pregnancy. Of 3438 women screened, 330 eligible women were assigned to usual care (n = 165) or intervention (n=165). Due to missing data, we analyzed 125 in the intervention group and 126 in the usual care group. MeasurementsThe measurements were the proportion of women with any alcohol use and the number of drinks per day, reported via follow-up telephone interviews at 4 and 8weeks after enrollment, 32weeks of gestation, and 6weeks, 6months, and 12months postpartum. FindingsIn random effects models adjusted for confounders, the intervention group was less likely to use any alcohol (odds ratio 0.50; 95% confidence interval [CI], 0.23–1.09; P=0.08) and consumed fewer drinks per day (coefficient −0.11; 95% CI −0.23–0.01; P=0.07) than, the usual care group in the postpartum period but these differences were non-significant. Missing data during the prenatal period prevented us from modeling prenatal alcohol use. ConclusionsBrief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period.