Identifying psycho-social determinants and environmental conditions related to alcohol consumption during pregnancy

Abstract

Background: Fetal Alcohol Spectrum Disorders (FASD) represents a spectrum of birth defects caused by prenatal alcohol exposure. It is one of the most important preventable forms of non-genetic birth defects associated with intellectual disability. In order to systematically plan health promoting programs, it is necessary to identify specific psycho-social determinants and environmental conditions related to maternal drinking. Methods: A systematic literature search on psycho-social determinants of maternal alcohol drinking behaviors was conducted in multiple databases up to July 2016, including PubMed, PsychINFO, PsychARTICLES, ERIC, CINAHL, EMBASE and MEDLINE. A query was generated and resulting hits were exported and screened during three rounds (titles, titles and abstracts, full text). Screening took place by one screener and was randomly checked by a second screener. Results were then extracted and analyzed. Findings: Studies identified determinants related to maternal alcohol consumption using qualitative and quantitative research methods. None of the included studies was conducted primarily to investigate the association between psycho-social determinants and maternal drinking behavior(s). The focus of most researchers is on knowledge and risk perception. Attitudes and perceived norms get some attention, while self-efficacy and especially automaticity of behaviors get very little attention. Discussion: Changing maternal drinking behavior requires understanding the determinants and environmental conditions first. It is recommended that the determinants of risk behaviors related to FASD are identified following a theory- and evidence-based procedure. Recommendations for future research are provided.