Psychosocial interventions for women enrolled in alcohol treatment during pregnancy.

 

Abstract

Background

Excessive alcohol use during pregnancy has been associated with adverse maternal and neonatal effects. It is therefore important to develop and evaluate effective interventions during this important time in a woman's life. To our knowledge there have been no systematic reviews of randomised control trials (RCT) in this population.

Objectives

To evaluate the effectiveness of psychosocial interventions in pregnant women enrolled in alcohol treatment programs for improving birth and neonatal outcomes, maternal abstinence and treatment retention.

Search methods

We searched the Cochrane Drugs and Alcohol Group's Trial register (December 2007); MEDLINE (1950 to 2007); PsycINFO (1806 to 2007); EMBASE (1974 to 2007); CINAHL (1982 to 2007)

Selection criteria

We sought to include randomised or quasi-randomised studies comparing any psychosocial intervention versus pharmacological interventions or placebo or non-intervention or another psychosocial intervention for treating alcohol dependence in pregnancy.

Data collection and analysis

Three review authors independently assessed trials for inclusion in review. Studies were to be assessed using standardized data extraction and quality assessment forms. No suitable trials were identified.

Main results

The search strategy identified 958 citations. 17 citations were deemed relevant for full text review, an additional 9 articles were retrieved through hand searching references, for a total of 26 articles. Following full text review no articles met the inclusion criteria. Data extraction and assessment of methodological quality were therefore not possible.

Authors' conclusions

The review question remains unanswered as there were no randomised control trials found relevant to the topic. There is a need for high quality randomised controlled trials to determine the effectiveness of psychosocial interventions in pregnant women enrolled in alcohol treatment programs.

 

Plain language summary

Psychosocial interventions for women enrolled in alcohol treatment during pregnancy

Pregnancy can be seen as a window of opportunity where women may seek treatment for their addictions out of concern for their unborn child. Worldwide estimates of alcohol usage report that a large proportion of women continue to drink during their pregnancy. Light alcohol consumption has not been associated with adverse effects on a woman's baby, while excessive consumption of alcohol has been shown to cause a number of birth defects as well as foetal alcohol syndrome. Alcohol consumption during pregnancy is the most widely recognized cause of severe mental and developmental delay in the baby. Therefore pregnancy is an important point in time to treat women for their alcohol dependence. This review sought to find all trials which compared any psychosocial intervention to other treatment or no treatment for pregnant or postpartum women in alcohol treatment. No articles were found which fit our inclusion criteria; most trials assessed psychosocial interventions to reduce alcohol consumption in pregnant or reproductive age women, not pregnant or post-partum women in alcohol treatment. We defined alcohol treatment as when the authors stated the women were in alcohol treatment or any validated psychosocial intervention for the treatment of alcohol dependence. Control trials need to be performed on this population of women to determine the most effective therapy for pregnant women seeking treatment for their alcohol dependence.

 

摘要

背景

對於婦女懷孕期間酗酒治療的心理社會介入

在懷孕期間飲酒過量與產婦和新生兒產生不良影響有關。因此；在對於女性人生有重大影響期間，發展和評估有效的介入是重要的。就我們所知，在這群人當中還沒有隨機對照試驗的系統性回顧。

目標

為了改善分娩和新生兒的效果、節制孕婦的行為與持續接受治療，針對參加酒精治療課程的孕婦，評估心理社會介入的有效性。

搜尋策略

我們搜查了Cochrane Drugs and Alcohol Group's Trial register (2007年12月);MEDLINE(1950年至2007年); PsycINFO(1806年至2007年);EMBASE(1974年至2007年); CINAHL(1982至2007年)

選擇標準

針對孕婦酒癮的治療，我們尋求並納入任何心理社會介入與藥物介入、或安慰劑、或無介入、或其他心理社會介入相比較的隨機或半隨機的研究。

資料收集與分析

三個審查作者獨立評估列入回顧中的試驗。採用標準化數據提取和品質評價的形式評估這些研究,確認沒有合適的試驗。

主要結論

搜索策略確認引用958篇文章。其中17篇是相關的全文回顧文章，另外9篇重新由徒手參考文獻搜尋獲得，共26篇文章。根據全文文章內容，沒有文章符合納入標準。因此數據取得和評估方法的品質不足採信。

作者結論

沒有發現與本主題相關的隨機對照試驗，此回顧的問題仍然無法回答。需要有高品質的隨機對照試驗，以確定心理社會介入在於孕婦參加酗酒治療計劃的有效性。

翻譯人

本摘要由高雄榮民總醫院洪碧蓮翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

對於孕婦參加酗酒治療的心理社會介入：懷孕可以視作是一個機會之窗，婦女可藉由對胎兒關切，尋求酒癮的治療。全球性的酒精使用報告估計，很大比例的懷孕婦女仍繼續喝酒。飲用含些微酒精的飲品，對於婦女的嬰兒沒有不利影響，而飲酒過量已證明會造成了一些先天缺陷以及胎兒酒精中毒症後群。在懷孕期間飲酒已被廣受認定是引發嚴重的精神和發展遲緩嬰兒的原因；因此，懷孕是一個治療婦女酒癮的重要時刻。本回顧針對懷孕或產後婦女酒癮治療，尋求所有比較任何心理社會介入和其他的治療或不治療的試驗。我們發現沒有文章符合納入標準；大多數試驗評估在懷孕或育齡的婦女、沒有懷孕或產後婦女的酒精治療，以心理社會介入減少飲酒量。我們視作者陳述婦女接受酒精治療或經確效的心理社會介入酒癮治療為「酒精治療」(alcohol treatment)的定義，控制試驗須要針對尋求酒癮治療的孕婦群尋求最有效的治療。