"The Problem Is that We Hear a Bit of Everything…": A Qualitative Systematic Review of Factors Associated with Alcohol Use, Reduction, and Abstinence in Pregnancy.

Vivian Lyall,Karen M Moritz,Natasha Reid,Annette J Browne,Lindsay Wolfson,Nancy Poole,Deborah A Askew,Sonya Egert

doi:10.3390/ijerph18073445

Abstract

Understanding the factors that contribute to women’s alcohol use in pregnancy is critical to supporting women’s health and wellness and preventing Fetal Alcohol Spectrum Disorder. A systematic review of qualitative studies involving pregnant and recently postpartum women was undertaken to understand the barriers and facilitators that influence alcohol use in pregnancy (PROSPERO: CRD42018098831). Twenty-seven (n = 27) articles were identified through EMBASE, CINAHL, PsycINFO, PubMed and Web of Science. The included articles were thematically analyzed using NVivo12. The analysis was informed by Canada’s Action Framework for Building an Inclusive Health System to articulate the ways in which stigma and related barriers are enacted at the individual, interpersonal, institutional and population levels. Five themes impacting women’s alcohol use, abstention and reduction were identified: (1) social relationships and norms; (2) stigma; (3) trauma and other stressors; (4) alcohol information and messaging; and (5) access to trusted equitable care and essential resources. The impact of structural and systemic factors on prenatal alcohol use was largely absent in the included studies, instead focusing on individual choice. This silence risks perpetuating stigma and highlights the criticality of addressing intersecting structural and systemic factors in supporting maternal and fetal health.

Highlights

IntroductionAn estimated 10% of women consume alcohol during pregnancy, with the highest rates of alcohol use during pregnancy being found in Russia (36.5%), the United
The current systematic review explored the qualitative literature on the barriers and facilitators to alcohol use during pregnancy and in the recent postpartum period
Many of the included studies focused on individual behavioural approaches to alcohol reduction and abstinence with little attention to exploring the potential contextual influences on alcohol use

Summary

Introduction

An estimated 10% of women consume alcohol during pregnancy, with the highest rates of alcohol use during pregnancy being found in Russia (36.5%), the United. Despite ongoing public health efforts to address alcohol use during pregnancy in countries like. Canada, Denmark, France, and the USA, rates are expected to increase [1,2,3]. In Canada and the USA, researchers have noted that while the prevalence of alcohol use remains higher among boys and men, the gender gap is narrowing, between young adults. In some countries, this convergence has been attributed to changes in gender norms and roles [3,4].

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Conclusion