CLINICAL QUESTION

Are psychosocial interventions effective for reducing alcohol use during pregnancy?

EVIDENCE-BASED ANSWER

Psychosocial interventions may increase the rate of sustained alcohol cessation during pregnancy (number needed to treat [NNT] for one more patient to stay continuously abstinent for 2–6 months = 6; 95% CI, 4–15).¹ However, they may have little to no effect on the number of drinks consumed per day or treatment retention. (Strength of Recommendation: C, disease-oriented evidence.)

PRACTICE POINTERS

Prenatal alcohol use causes dose-dependent negative health effects for the pregnant person as well as the developing embryo or fetus.¹ Risks include early pregnancy loss, fetal demise, fetal growth restriction, placental abruption, preterm labor, and premature birth. Alcohol consumption is the leading cause of preventable developmental disability and structural congenital anomalies in the United States.^1,2 Despite the known risks, prenatal alcohol use is common, and its prevalence in the United States has increased in recent years.³ Per 2018–2020 national surveillance data, approximately 1 in 7 pregnant people reported any alcohol use, and 1 in 20 reported binge drinking (ie, four or more drinks on a single occasion) within the past month.³ The authors of this Cochrane review sought to investigate the effectiveness of prenatal interventions (psychosocial or pharmacologic) to reduce or stop alcohol use during pregnancy.