Screening and Brief Intervention During Pregnancy

In pregnant women, quantity–frequency estimation is recommended to detect any consumption of alcohol (see Chapter 4). 

The Tolerance, Annoyance, Cut down and Eye opener (T-ACE) and Tolerance, Worried, Eye-opener, Amnesia, K-Cutdown (TWEAK) screening tests were designed for use with pregnant women and are adequately sensitive for detecting high-risk levels of consumption; in this the T-ACE performs better than TWEAK. T-ACE and TWEAK questionnaires may be used in this population to detect consumption at levels likely to place the foetus at significant risk of alcohol-related harm (see Appendix 1). Neither instrument is designed to detect low-level use of alcohol. The Alcohol Use Disorders Identification Test – Consumption (AUDIT-C) is a simple measure of quantity frequency that can be used to detect the amount of alcohol consumed. 

Brief interventions (see also Chapter 6) are effective in reducing drinking in pregnancy in non-alcohol dependent women and should be provided to all pregnant women as well as those contemplating pregnancy. Partner participation has also been shown to increase the effectiveness of brief interventions.  

It has been demonstrated that brief interventions in this population result in: 

• increased rates of abstinence before conception and during pregnancy 
• significant reduction of both daily and binge drinking 
• reduced foetal mortality rate 
• higher birth weight and birth length in the newborn.