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Linking Reductions in Alcohol and Birth Control Use Risk Behavior to Prevention of Alcohol-Exposed Pregnancy: A
Arielle R Deutsch1,2, Ali Akhavan3,4, Mohammad S Jalali3,4
1Avera Research Institute, Avera Health, Sioux Falls, South Dakota, USA.
Alcohol, Clinical & Experimental Research
|July 23, 2026
Summary
Different behavioral changes in alcohol-exposed pregnancy prevention programs (AEP-P) yield varying effectiveness. Focusing on both alcohol reduction and birth control use (BB) shows the greatest potential for preventing AEP.
Area of Science:
- Public Health
- Reproductive Health
- Behavioral Science
Background:
- Alcohol-exposed pregnancy prevention programs (AEP-P) are widely used.
- AEP-P interventions encourage reduced alcohol consumption and increased birth control use.
- Current evaluation methods often aggregate behavioral changes into a single binary outcome, potentially masking differential effects.
Purpose of the Study:
- To assess the comparative effectiveness of distinct AEP-P behavioral change outcomes.
- To determine if alcohol-only (AO), birth control-only (BCO), or both behaviors (BB) changes are equally effective in preventing AEP.
- To inform more nuanced evaluation of AEP-P interventions.
Main Methods:
- Simulated AEP-P implementation in a US metropolitan area across 252 policy scenarios.
- Varied the percentage of eligible population changing risk behavior, the proportion of participants in AO, BCO, and BB groups, and the ratio of alcohol reduction to abstinence vs. non-risky drinking.
- Calculated percent differences in new cases of total, high-risk, and low-risk AEP compared to a baseline with no AEP-P implementation.
Main Results:
- Policies prioritizing both behaviors (BB) demonstrated the largest reductions in total and high-risk AEP.
- A 100% BB policy yielded the highest prevention rates for total (5.58%-17.13%) and high-risk AEP (16.27%-42.43%).
- Most policies increased low-risk AEP, except for 100% BCO policies; higher BCO proportions led to smaller increases in low-risk AEP but lesser reductions in high-risk AEP.
Conclusions:
- Distinct behavioral change patterns resulting from AEP-P have varying impacts on preventing AEP.
- Utilizing a binary aggregate variable for AEP risk may inaccurately represent AEP-P's preventative efficacy.
- Further research is needed to understand how to optimize AEP-P by considering specific behavioral outcomes.
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