Highlights
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Alcohol, cannabis, tobacco, and opioid use among women has increased in recent decades
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Co-use of these substances compounds adverse effects and may lead to adverse maternal and fetal health outcomes, including restricted fetal growth and adverse neurocognitive outcomes
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Prevalence of substance co-use among pregnant women in the United States is 5.1% and among non-pregnant women is 23.6%
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Nearly all of the most frequent co-use patterns included either alcohol, tobacco, or both
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Pregnant women who were younger and reported a past year history of substance use had higher rates of co-use
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Public health efforts, including public education campaigns and provider initiated patient education, to improve maternal and fetal health should address the complexity of substance use during pregnancy
Abstract
Background
The use, misuse and co-use of alcohol, cannabis, and other licit and illicit controlled substances has increased in past decades leading to higher rates of morbidity, overdose, and mortality in women of reproductive age. Co-use compounds the adverse health effects of substance use compared to single-use of similar substances. Little is known about the full range of substance combinations used by pregnant and non-pregnant women. We sought to describe patterns of co-use of alcohol, tobacco, and controlled substances, and examine correlates of co-use in a nationally-representative sample of women.
Methods
Cross-sectional study using self-reported survey data from 2006 to 2014 for women ages 18-49 years (N = 160,371) in NSDUH. We use weighted proportions and 95% confidence intervals (CI) to report differences in substance use patterns in pregnant and non-pregnant women. Multivariate logistic regression models assessed association between characteristics and type of substance use pattern.
Results
Prevalence of co-use among pregnant women is 5.1% and among non-pregnant women is 23.6%. Nearly all of the most frequent co-use patterns included either alcohol, tobacco, or both. Determinants of co-use among pregnant women included: younger age (18-25 years) compared to ≥ 26 years [AOR (95% CI): 1.81 (1.18, 2.80)]; and past year history of substance use [AOR 5.42 (3.59, 8.20)].
Conclusions
Co-use of several substances, including and especially of tobacco, alcohol and cannabis, persists among pregnant women in the United States. Efforts that aim to improve maternal and child health should address the complexity of substance use during pregnancy, including and beyond opioids.
Retrieved from https://www.sciencedirect.com/science/article/abs/pii/S037687161930506X
The opinions expressed in this post are those of the authors. They do not purport to reflect the opinions or views of the FASD Prevention Conversation Project or its members.