Effectiveness of a Novel Low Cost Intervention to Reduce Prenatal Alcohol Exposure in the Congo

Abstract

Objective: Determine the effectiveness of an intervention to reduce prenatal alcohol exposure in the Congo. Methods: We utilized a screening tool validated in the Congo to identify women who were drinking during pregnancy. The intervention was implemented by prenatal care providers comparing 162 women receiving the intervention with 58 (controls) who did not. The study endpoints were proportion of women who quit drinking, drinking days per week, drinks per drinking day, most drinks on any day, and number of binge episodes per week. Results: In the control group 36% of the women quit drinking compared to 54% in the intervention group (Chi-square 5.61; p = 0.02). The number of drinking days per week for the controls decreased by 50.1% compared to 68% for the intervention group (p = 0.008); drinks per drinking day for the controls decreased by 37% compared to 60.1% for the intervention group (p = 0.001); and most drinks on any occasion in the controls decreased by 38% compared to 61% for the intervention group (p = 0.004). Conclusions: This study demonstrates the effectiveness of a low cost in-office intervention to reduce prenatal alcohol exposure in the Congo. At $1.50 per beer, the reduction in drinks per week would more than pay for the cost of the intervention. In addition to efforts to reduce alcohol use prior to pregnancy in the Congo, providers can now offer an evidence based intervention to reduce exposure for women who continue to drink during pregnancy.

Alcohol consumption and tobacco exposure among pregnant women in Ibadan, Nigeria

“…Williams et al [ 54 ] demonstrated a low-cost community intervention strategy for reducing prenatal alcohol exposure in the Congo. Such interventions may also successfully control prenatal alcohol and tobacco in the Nigerian setting.…”

Quantifying patterns of alcohol consumption and its effects on health and wellbeing among BaYaka hunter-gatherers: A mixed-methods cross-sectional study

“…One possibility is that understanding the effects of alcohol on the baby from breastfeeding may be more intuitive because the baby is visibly ingesting fluid, whereas nutrient transfer via the placenta during pregnancy is unobservable. Despite key structural determinants of alcohol use, brief communication of the risks of alcohol can be an effective, low-cost and easy-to-administer intervention, and has been utilised successfully in urban Congolese settings [ 41 ]. Our findings suggests that such interventions may be beneficial for Mbendjele people, though their effectiveness among hunter-gatherer societies remains to be demonstrated.…”

Screening for Alcohol Use in Pregnancy: a Review of Current Practices and Perspectives

“…The PCAP model has been adopted in numerous locations in North America (Thanh et al, 2015) and is one example of an intervention that addresses the context of alcohol use during pregnancy for the targeted sub-population in a supportive manner (Pei et al, 2019). Another example is a very low cost, in-office pictorial intervention program for alcohol use in pregnancy that was developed and tested in the same communities in the Congo, which continues to be studied as a model for sub-Saharan countries (Williams et al, 2014). Furthermore, participation in programs such as the WIC in the USA can increase utilization of prenatal care among women at risk of alcohol-exposed pregnancies (Richards et al, 2010), which indirectly facilitates the detection and prevention of PAE.…”