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Risk factors associated to tobacco and alcohol use in a large French cohort of pregnant women

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Abstract

Tobacco and/or alcohol use during pregnancy is a major public health concern. The aim of our study was to identify risk factors associated to maternal alcohol and tobacco use assessed by maternal self-reports combined with biological measurements in meconium samples of cotinine and ethylglucuronide which reflect fetal exposure to tobacco and alcohol, respectively, during the 3rd trimester of pregnancy. We conducted a prospective study in three maternity hospitals in a large urban area during consecutive weeks (2010 and 2011). Maternal sociodemographic and clinical characteristics were assessed after delivery, using the French version of the Addiction Severity Index. Cotinine and ethylglucuronide were measured in meconium samples. Seven hundred and twenty-four women were included, and 645 meconium samples collected. Using multivariate analyses, we found that not being married or having a smoking partner predicts maternal tobacco use. In contrast, a decreased risk was associated with higher education level and wanted pregnancy. The risk for alcohol use increased when the mother had been in conflict with any relative or her partner for a long time throughout her life, as well as in case of previous treatment for any mental or emotional disorder. Using multivariate analyses and cotinine presence in meconium samples, the risks were similar except for marital status, which was not associated to cotinine presence. Community education and prevention programs should urgently be improved for all women of childbearing age with a special focus on those with past histories of mental or emotional disorders and addictive disorders. Smoking cessation should be recommended to both parents.

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Acknowledgments

Mothers and children who participated in the study; the Perinatal Network of Upper-Normandy coordinated by C. Levèque and L. Marpeau (M.D., Ph.D., Professor, Head of Department of Gynaecology-Obstetrics, Rouen University Hospital); P. Fournet (M.D., Department of Gynaecology-Obstetrics, Belvédère Hospital); M. Durand-Réville (M.D., Department of Gynaecology-Obstetrics, Mathilde Hospital); Association of Midwives of Upper-Normandie, INSERM CIC-CRB 1404 (A. Cailleux and J. Weber); FEDER (Fonds Européens pour le Développement Régional de Haute-Normandie); Fédération rouennaise d’addictologie coordinated by F. Thibaut. The authors thank the reviewers for their helpful comments on this manuscript. This study was promoted by Rouen University Hospital.

Funding

This study was supported by PHRC inter-régional 2008, MILDT-INSERM-INcA 2008, IREB 2009 et 2011 and FEDER (European Regional Development Fund of Upper-Normandie).

Author information

Authors and Affiliations

  1. Department of Addictology, SSR Petit Colmoulins, Ramsay-General de Santé, Harfleur, France

    Sandrine Lamy

  2. Department of Biostatistics and Clinical Research, INSERM U 1219, University of Rouen, Rouen University Hospital, CIC 1404, Rouen, France

    Estelle Houivet & Jacques Benichou

  3. Department of Neonatal Medicine-Neuropediatrics, Rouen University Hospital and Region-INSERM U1245, Team 4 Neovasc, Institute of Biomedical Research and Innovation, School of Medicine, Normandy University, Rouen, France

    Stéphane Marret

  4. Unité Fonctionnelle de Toxicologie, CHU Lille, 59000, Lille, France

    Benjamin Hennart & Delphine Allorge

  5. Department of Psychiatry, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, Brazil

    Heloise Delavenne

  6. EA 4483-IMPECS-IMPact de l’Environnement Chimique sur la Santé humaine, Univ. Lille, 59000, Lille, France

    Delphine Allorge

  7. University Sorbonne Paris-Cité (Faculty of Medicine Paris Descartes), INSERM U894, Centre Psychiatry and Neurosciences, Department of Psychiatry and Addictive Disorders, University Hospital Cochin (site Tarnier), 89 rue d’assas, 75006, Paris, France

    Florence Thibaut

Authors
  1. Sandrine Lamy
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  2. Estelle Houivet
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  3. Stéphane Marret
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  4. Benjamin Hennart
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  5. Heloise Delavenne
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  6. Jacques Benichou
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  7. Delphine Allorge
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  8. Florence Thibaut
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Consortia

for the Perinatal Network of Upper-Normandy

Corresponding author

Correspondence to Florence Thibaut.

Ethics declarations

The ethical committee gave approval for this study (EudraCT: 2010-A00035-34). A written informed consent was obtained from all mothers

Conflict of interest

F Thibaut is Editor-in-Chief of Dialogues in Clinical Neurosciences (the journal receives a grant from Servier).

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Lamy, S., Houivet, E., Marret, S. et al. Risk factors associated to tobacco and alcohol use in a large French cohort of pregnant women. Arch Womens Ment Health 22, 267–277 (2019). https://doi.org/10.1007/s00737-018-0892-4

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  • DOI: https://doi.org/10.1007/s00737-018-0892-4

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