Pregnant, alcohol-abusing women

Background: This paper reviews the literature on the identification and treatment of pregnant, alcohol-abusing women, with special emphasis on poor women who have access to treatment through Medicaid. Methods: The paper discusses the gaps and controversies in the literature and suggests five priorities for future research. Results: Studies that attempt to identify pregnant women who drink conclude that heavier drinkers enter prenatal care later than other women, that many health care providers fail to recognize alcohol abuse by pregnant women, and that research on screening techniques is still in the early stages. Treatment research suggests that comprehensive, holistic treatment approaches, as well as brief interventions and case management, have been successful in reducing prenatal alcohol use. Debate continues over whether treatment should be voluntary. Conclusions: The five areas identified as priorities for future research include (1) developing reliable and valid measures to identify alcohol abuse in pregnant women, (2) creating training programs for providers, (3) generating programs to reduce barriers to care, (4) determining which treatment programs are most successful, and (5) estimating the costs and benefits of various treatment approaches.