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

Aims: The aim of this study is to assess the effect of brief motivational enhancement intervention postpartum alcohol use.

Design: This 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 10-30 minutes each and occurring at study enrollment, 4 and 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks postpartum.

Setting: The setting is in a large, urban, obstetrics clinic.

Participants: Participants were women who were ≥ 18 years old, <20 weeks 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.

Measurements: The 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 8 weeks after enrollment, 32 weeks of gestation, and 6 weeks, 6 months, and 12 months postpartum.

Findings: In 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.

Conclusions: Brief motivational enhancement intervention delivered in an obstetrical outpatient setting did not conclusively decrease alcohol use during the postpartum period.