Case management reduces drinking during pregnancy among high-risk women

  • Philip A. May The University of North Carolina at Chapel Hill, Gillings School of Public Health, Nutrition Research Institute The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA) Stellenbosch University
  • Anna-Susan Marais Stellenbosch University
  • J. Phillip Gossage The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
  • Ronel Barnard Stellenbosch University
  • Belinda Joubert Stellenbosch University
  • Marise Cloete Stellenbosch University
  • Natalie Hendricks Stellenbosch University
  • Sumien Roux Stellenbosch University
  • Annalien Blom Stellenbosch University
  • Jeanetta Steenekamp Stellenbosch University
  • Theresa Alexander Stellenbosch University
  • Romena Andreas Stellenbosch University
  • Suzanne Human Stellenbosch University
  • Cudore Snell Stellenbosch University
  • Soraya Seedat Stellenbosch University
  • Charles D. Parry Stellenbosch University Medical Research Council
  • Wendy O. Kalberg The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
  • David Buckley The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
  • Jason Blankenship The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
Keywords: fetal alcohol spectrum disorders (FASD), prevention, case management, alcohol abuse

Abstract

May, P., Marais, A., Gossage, J., Barnard, R., Joubert, B., Cloete, M., Hendricks, N., Roux, S., Blom, A., Steenekamp, J., Alexander, T., Andreas, R., Human, S., Snell, C., Seedat, S., Parry, C., Kalberg, W., Buckley, D., & Blankenship, J. (2013). Case management reduces drinking during pregnancy among high-risk women. The International Journal Of Alcohol And Drug Research, 2(3), 61-70. doi:10.7895/ijadr.v2i3.79 (http://dx.doi.org/10.7895/ijadr.v2i3.79)

Aim: To estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD).

Design: Women were recruited from antenatal clinics and engaged in 18 months of CM.

Setting: A South African community with a subculture of heavy, regular, weekend, recreational drinking and with high documented rates of FASD.

Participants: Forty-one women who were at high risk for bearing a child with FASD.

Measures: Statistical analysis of trends in drinking and other risk factors.

Findings: At intake, 87.8% of the women were pregnant, most had previous alcohol-exposed pregnancies, 67.5% reported that most or all of their friends drank alcohol, and 50.0% had stressful lives. CM was particularly valuable for pregnant women, as statistically significant reductions in alcohol risk were obtained for them in multiple variables: total drinks on weekends after six months of CM (p = .026) and estimated peak blood alcohol concentration (BAC) at six (p < .001) and 18 months (p < .001). For participants completing 18 months of CM, AUDIT scores improved significantly by 6-month follow-up (from 19.8 to 9.7, p = .000), and although there were increases at 12 and 18 months, AUDIT scores indicate that problematic drinking remained statistically significantly lower than baseline throughout CM.  Happiness scale scores correlated significantly with reduced drinking in most time periods.

Conclusions: Making an enduring change in drinking behavior is difficult in this social setting. Nonetheless, CM provided by skilled and empathic case managers reduced maternal drinking at critical times, and, therefore, alcohol exposure levels to the fetus.

Author Biographies

Philip A. May, The University of North Carolina at Chapel Hill, Gillings School of Public Health, Nutrition Research Institute The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA) Stellenbosch University

Department of Nutrition

Research Professor

Anna-Susan Marais, Stellenbosch University

Department of Psychiatry

Program Manager

J. Phillip Gossage, The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
Senior Research Scientist
Ronel Barnard, Stellenbosch University

Department of Psychiatry

Project Officer

Belinda Joubert, Stellenbosch University

Department of Psychiatry

staff

Marise Cloete, Stellenbosch University

Department of Psichiatry

staff

Natalie Hendricks, Stellenbosch University

Department of Psychiatry

staff

Sumien Roux, Stellenbosch University

Department of Psychiatry

staff

Annalien Blom, Stellenbosch University

Department of Psychiatry

staff

Jeanetta Steenekamp, Stellenbosch University

Department of Psychiatry

staff

Theresa Alexander, Stellenbosch University

Department of Psychiatry

staff

Romena Andreas, Stellenbosch University

Department of Psychiatry

staff

Suzanne Human, Stellenbosch University

Department of Psychiatry

staff

Cudore Snell, Stellenbosch University
Dean of Social Work
Soraya Seedat, Stellenbosch University
Chair Department of Psychiatry
Charles D. Parry, Stellenbosch University Medical Research Council
Professor
Wendy O. Kalberg, The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
Senior Research Scientist
David Buckley, The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
Research Scientist
Jason Blankenship, The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions (CASAA)
Senior Research Scientist
Published
2013-03-20
How to Cite
May, P. A., Marais, A.-S., Gossage, J. P., Barnard, R., Joubert, B., Cloete, M., Hendricks, N., Roux, S., Blom, A., Steenekamp, J., Alexander, T., Andreas, R., Human, S., Snell, C., Seedat, S., Parry, C. D., Kalberg, W. O., Buckley, D., & Blankenship, J. (2013). Case management reduces drinking during pregnancy among high-risk women. The International Journal of Alcohol and Drug Research, 2(3), 61-70. https://doi.org/10.7895/ijadr.v2i3.79
Section
Papers