摘要：We assessed alcohol consumption and depression in 234 American Indian/Alaska Native women (aged 18–45 years) in Southern California. Women were randomized to intervention or assessment alone and followed for 6 months (2011–2013). Depression was associated with risk factors for alcohol-exposed pregnancy (AEP). Both treatment groups reduced drinking ( P < .001). Depressed, but not nondepressed, women reduced drinking in response to SBIRT above the reduction in response to assessment alone. Screening for depression may assist in allocating women to specific AEP prevention interventions. Women who consume alcohol and do not practice effective contraception are at risk for an alcohol-exposed pregnancy (AEP). AEPs can lead to fetal alcohol spectrum disorders, the leading known cause of developmental disabilities. 1–3 Prepregnancy drinking, particularly heavy episodic or binge drinking, is a robust predictor of AEP. 4 Depression has been linked to problem alcohol consumption in women 5–7 and appears to predate 8,9 and perhaps predict 10 alcohol problems. Among American Indian/Alaska Native (AI/AN) women, studies have linked depression to problem drinking. 11–13 However, risk factors for an AEP and interventions to reduce risk for AEP have not been well studied in AI/AN women. 14 This is further complicated by variability among AI/AN populations in the prevalence of alcohol consumption 11,15–20 and depression. 13,21–23 One approach to prevention of AEPs is screening, brief intervention, and referral to treatment (SBIRT). 24,25 We previously tested the effectiveness of an SBIRT intervention in AI/AN women and found that whether women received an assessment followed by the SBIRT intervention or assessment alone, they reported a significant reduction in alcohol use. We examined depression as a predictor of vulnerability to having an AEP and explored whether depressed AI/AN women respond differently than nondepressed women to an SBIRT intervention.
