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High rates of alcohol use and unintended pregnancies are common across many Western societies, and alcohol\u2010exposed pregnancies (AEPs) are a possible unintended outcome. The aim of the current study was to evaluate preconception interventions for the prevention of AEPs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of four electronic databases (PubMed, Embase, CINAHL, and PsycINFO) was undertaken for relevant peer\u2010reviewed articles published from 1970 onward. Studies were included if they enrolled women and\/or their support networks during the preconception period.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen studies met the inclusion criteria. The majority of studies (<jats:italic>n<\/jats:italic>\u00a0=\u00a014) evaluated CHOICES\u2010based interventions, which incorporate motivational interviewing approaches to change alcohol and\/or contraceptive behavior. The other five interventions included a range of different approaches and modes of delivery. The majority of interventions were successful in reducing AEP risk. Changes in AEP risk were more often driven by changes in contraceptive behavior, although some approaches led to changes in both alcohol and contraceptive behavior.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The review indicated that many interventions were efficacious at reducing AEP risk during the preconception period through preventing unplanned pregnancy. The effectiveness estimated from these clinical trials may be greater than that seen in interventions when implemented in practice where there is a lack of blinding and greater attrition of participants during follow\u2010up. Further research investigating the real\u2010world effectiveness of these intervention approaches implemented across a wide range of clinical settings would be beneficial.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acer.14725","type":"journal-article","created":{"date-parts":[[2021,9,30]],"date-time":"2021-09-30T08:18:57Z","timestamp":1632989937000},"page":"2414-2429","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Preconception interventions to reduce the risk of alcohol\u2010exposed pregnancies: A systematic review"],"prefix":"10.1111","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9813-5613","authenticated-orcid":false,"given":"Natasha","family":"Reid","sequence":"first","affiliation":[{"name":"Child Health Research Centre University of Queensland Brisbane Queensland 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