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Alcohol and Drug Use Before and During Pregnancy: An Examination of Use Patterns and Predictors of Cessation

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Abstract

Objectives This study examines alcohol and nonmedical drug use before and during pregnancy and identifies the predictors of use cessation before the first prenatal visit. Methods Data analyses were based on the Prenatal Risk Overview (PRO), a structured interview that screens for psychosocial risk factors associated with poor birth outcomes. The study sample includes 1,492 consecutive prenatal care patients from four urban clinics between November 2005 and June 2007. Results Reported alcohol and drug use pre-pregnancy was much higher among U.S.-born women than immigrants, and among unmarried women than married women. American Indians had the highest rates among racial/ethnic groups. Since learning of their pregnancy, 5.6% of patients reported alcohol use and 10.7% reported drug use, reflecting cessation rates of 87.0% for alcohol and 55.6% for drugs. In logistic regression analyses, older age, current smoking, and lack of transportation predicted both alcohol and drug use continuation. Alcohol use continuation was also predicted by pre-pregnancy alcohol use frequency, depression, and physical/sexual abuse by someone other than an intimate partner. Drug use continuation was also predicted by race (higher for American Indians and African Americans), and pre-pregnancy drug use frequency. Conclusions Women who continued to use alcohol or drugs after learning they were pregnant were more frequent users than spontaneous quitters, more likely to smoke cigarettes, and had more psychosocial stressors. Achieving higher rates of cessation may require approaches that simultaneously address substance use and impediments to quitting. Higher continuation rates among some cultural groups require further investigation.

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Acknowledgments

The development of the Twin Cities Healthy Start Screening and Case Management System and the Prenatal Risk Overview (PRO) were supported in part by Project Grant No. H49MC00073 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (Title V, Social Security Act). Software design was provided by IncWebs, Inc. Statistical consultation was provided by Gopalakrishnan Narayan, Timothy J. Beebe and Sarah M. Jenkins. The authors gratefully acknowledge the efforts of the Twin Cities Healthy Start Community Consortium and administrative staff and the participating sites: Community-University Health Care Center, Indian Health Board of Minneapolis, and NorthPoint Health and Wellness Center in Minneapolis, and West Side Community Health Services in St. Paul. The interpretations of the data and conclusions solely reflect those of the authors.

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  1. Minneapolis Department of Health and Family Support, 250 South 4th St., #510, Minneapolis, MN, 55415-1384, USA

    Patricia A. Harrison & Abbey C. Sidebottom

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  1. Patricia A. Harrison
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  2. Abbey C. Sidebottom
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Correspondence to Patricia A. Harrison.

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Harrison, P.A., Sidebottom, A.C. Alcohol and Drug Use Before and During Pregnancy: An Examination of Use Patterns and Predictors of Cessation. Matern Child Health J 13, 386–394 (2009). https://doi.org/10.1007/s10995-008-0355-z

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  • DOI: https://doi.org/10.1007/s10995-008-0355-z

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