Alcohol prevention in Swedish antenatal care: effectiveness and perceptions of the Risk Drinking project counseling model.

OBJECTIVE

To compare an earlier Swedish antenatal care counseling routine concerning alcohol consumption with an expanded model in terms of effectiveness in achieving abstinence in pregnancy. A further objective was to assess the women's perceptions of the alcohol counseling.

DESIGN

Cohort study.

SETTING

Antenatal care center in a provincial Swedish university town.

POPULATION: Women who received alcohol counseling; 1533 in cohort 1 (routine counseling) and 1476 in cohort 2 (expanded model). Approximately 93% of all pregnant women in Linköping are registered at this center.

METHODS

Data were collected by means of an anonymous questionnaire. Thirteen questions in the questionnaire were analysed for this study.

MAIN OUTCOME MEASURES: Replies from three questions concerning pre-pregnancy drinking and three questions on drinking during pregnancy.

RESULTS

The response rate was 60% for cohort 1 and 64% for cohort 2. Perceptions of the advice from the antenatal care center were generally favorable. Similar proportions of women, approximately 6%, in both cohorts drank at least once during the pregnancy (after pregnancy recognition). There were four predictors for drinking during pregnancy: older age; having previously given birth to a child; frequency of pre-pregnancy drinking; and perceiving the message from antenatal care as "small amounts of alcohol during pregnancy don't matter."

CONCLUSIONS

An expanded counseling model implemented in Swedish antenatal care did not reduce the proportion of women who continued drinking during pregnancy in comparison with a previous counseling model, although the advice provided in the new model was perceived more favorably.