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.