Prevalence and correlates of alcohol and tobacco use among pregnant women in the United States: Evidence from the NSDUH 2005–2014

Oh, Sehun; González, Jennifer M. Reingle; Salas-Wright, Christopher P.; Vaughn, Michael G.; DiNitto, Diana M.

doi:10.1016/j.ypmed.2017.01.006

Cited by 39 publications

(33 citation statements)

References 37 publications

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“…In addition, there may be value in integrating alcohol interventions with smoking cessation programs for this population. In keeping with findings from high‐income countries (Oh et al., ), hazardous tobacco use was significantly associated with hazardous alcohol use in this sample. In contrast to previously published studies (Aliyu et al., ; Vanker et al., ), we found no evidence in support of the independent or synergistic effects (unreported analyses) of hazardous tobacco and alcohol use on fetal growth.…”

Section: Discussionsupporting

confidence: 91%

Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study

Myers

Koen

Donald

et al. 2017

Alcoholism Clin & Exp Res

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BackgroundCohort studies have noted associations between hazardous alcohol use during pregnancy and infant growth outcomes, but many have not controlled for potential psychosocial confounders. To assess the unique contribution of hazardous alcohol use, we examined its effect on infant growth outcomes while controlling for maternal psychosocial stressors and hazardous tobacco and drug use in a cohort of 986 pregnant South African women enrolled into the Drakenstein Child Health Study between 2012 and 2015.MethodsData on psychosocial stressors and maternal risk behaviors were collected between 28 and 32 weeks of gestation. Participants were categorized as hazardous alcohol users if they obtained moderate or high scores (>10) on the Alcohol, Smoking and Substance Involvement Screening Test at this assessment or retrospectively reported drinking at least 2 drinks weekly during any trimester of pregnancy. Infant growth outcomes were recorded at delivery. Multivariable regression models examined correlates of hazardous alcohol use and associations between hazardous alcohol use and birth outcomes.ResultsOverall, 13% of mothers reported hazardous alcohol use. Recent exposure to intimate partner violence (adjusted odds ratio (aOR) = 2.08; 95% confidence interval (CI): 1.37, 3.18) and hazardous tobacco use (aOR = 5.03; 95% CI: 2.97, 8.52) were significant correlates of hazardous alcohol use. After controlling for potential psychosocial confounders, hazardous alcohol use remained associated with lower infant weight‐for‐age (B = −0.35, 95% CI: −0.56, −0.14), height‐for‐age (B = −0.46, 95% CI: −0.76, −0.17), and head‐circumference‐for‐age z‐scores (B = −0.43, 95% CI: −0.69, −0.17).ConclusionsInterventions to reduce hazardous alcohol use among pregnant women in South Africa are needed to prevent alcohol‐related infant growth restrictions. As these growth deficits may lead to neurodevelopmental consequences, it is critical to identify alcohol‐related growth restrictions at birth and link exposed infants to early interventions for neurodevelopment.

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Section: Discussionsupporting

confidence: 91%

Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study

Myers

Koen

Donald

et al. 2017

Alcoholism Clin & Exp Res

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“…Since fetal exposure in early pregnancy, even before pregnancy awareness, can cause significant damage 14 , public health campaigns aim to reduce drinking among women who are or might become pregnant 2,3,[14][15][16] . Such campaigns in the U.S. general population have shown some success 17,18 , with lower prevalence of drinking in pregnant women than in non-pregnant women [19][20][21][22][23][24][25][26][27][28] . Since 2002, drinking decreased in general population pregnant women 23,29 , and the prevalence of newborns affected by prenatal alcohol use decreased significantly 30,31 .…”

Section: Introductionmentioning

confidence: 99%

Risk factors for alcohol use among pregnant women, ages 15–44, in the United States, 2002 to 2017

Shmulewitz

Hasin

2019

Preventive Medicine

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Fetal alcohol exposure can lead to severe birth and developmental defects. Determining which pregnant women are most likely to drink is essential for targeting interventions. In National Survey on Drug Use and Health data on pregnant women from 2002-2017 (N=13,488), logistic regression was used to produce adjusted odds ratios (aOR) indicating characteristics associated with two past-month outcomes: any alcohol use and binge drinking. Risk factors were sociodemographic (age, race/ethnicity, marital status, education level, income) and clinical (trimester, substance use, alcohol use disorder, major depression). Where associations differed by pregnancy stage (trimester 1 vs. trimesters 2 and 3), association was evaluated by stage. Overall, higher risk for any and binge drinking was observed among those with other substance use (aORs 2.9-25.9), alcohol use disorder (aORs 4.5-7.5), depression (aORs=1.6), and unmarried women (aORs 1.6-3.2). For any drinking, overall, higher risk was observed in adolescents (aOR=1.5) and those with higher education (aOR=1.4), while lower risk was observed in those with lower income (aORs=0.7). For binge drinking, associations differed by pregnancy stage. In trimester 1, lower risk was observed in middle ages (aOR=0.4). In trimesters 2/3, higher risk was observed in Blacks (aOR=3.3) and those with lower income (aORs 3.5-3.9), while lower risk was observed in those with higher education (aOR=0.3). To prevent severe prenatal harm, health care providers should focus on women at higher risk for binge drinking during pregnancy: women with tobacco or drug use, alcohol use disorder, or depression, and women who are unmarried, Black, or of lower socioeconomic status.

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“…Among participants, 24% ( Oh et al, 2017 ) were smokers prior to pregnancy. There was not any significant difference between pre-pregnancy smokers' AUDIT-C mean (m = 2.90, sd = 2.77) and pre-pregnancy non-smokers' AUDIT-C mean (m = 2.01, sd = 1.95) ( Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Alcohol aversion in pregnancy has been demonstrated in rats ( Means & Goy, 1982 ), monkeys ( Elton & Wilson, 1977 ), alcohol-preferring mice ( Randall, Lochry, Hughes, & Boggan, 1980 ) and women with severe alcohol use disorders ( Little et al, 1976 , Little and Streissguth, 1978 ). In a recent analysis of the prevalence of alcohol use among pregnant women in the United States, 8.7% used alcohol in the past 30 days compared to 58.2% of non-pregnant adults ( Oh, Gonzalez, Salas-Wright, Vaughn, & DiNitto, 2017 ). Many have argued that nausea and vomiting resulting from the first trimester pregnancy hormone, beta human choriogonadotropin (beta hcg) may be part of an endogenous embryo-protective mechanism to deter women from ingesting toxic substances like alcohol ( Flaxman and Sherman, 2000 , Cardwell, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Alcohol reduction in the first trimester is unrelated to smoking, patient or pregnancy characteristics

Schmidt

Lancia

Alvi

et al. 2017

Addictive Behaviors Reports

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IntroductionStudies show alcohol-preferring mice reduce their alcohol intake during pregnancy; this study questions if the same is true for humans. The current investigation compares women's pre-pregnancy and first trimester alcohol consumption, examines if women with problem drinking diminish their alcohol intake during pregnancy, and determines if prenatal alcohol reduction is associated with characteristics of pregnancy, patients or smoking.Methods126 participants in weeks 1–12 of pregnancy, recruited from Obstetric and Family Practices, completed a survey during their initial prenatal visit including two gender-specific AUDITs (Alcohol Use Disorders Identification Tests) querying current and pre-pregnancy alcohol use. AUDIT-C (AUDIT items 1–3) scores measuring pre-pregnancy and first trimester alcohol consumption were compared, analyzed and tested using general linear model repeated. A p ≤ 0.05 was accepted as significant.ResultsMost participants were multiparous, Caucasian high school graduates experiencing nausea and vomiting. Pre-pregnancy alcohol use was significantly (p = 0.019, Fisher's exact) higher among women seeing obstetricians. Pre-pregnancy AUDIT-C scores (m (mean) = 2.22, sd (standard deviation) = 2.19) were significantly higher (p < 0.001) than first trimester scores (m = 0.143, sd = 0.532). Among 49 with pre-pregnancy AUDIT-C scores ≥ 3, 45/49 (92%) reduced their alcohol use to zero during the first trimester. Age, race, education, marital status, parity, nausea and vomiting, gestational age and smoking were non-factors in score reduction.ConclusionsWomen reported reducing their alcohol consumption during pregnancy, including those screening positive for pre-pregnancy problem drinking. First trimester alcohol reduction cannot be accounted for by smoking, patient or pregnancy characteristics; public health initiatives, psychological factors and hormonal mechanisms may be implicated.

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Prevalence and correlates of alcohol and tobacco use among pregnant women in the United States: Evidence from the NSDUH 2005–2014

Cited by 39 publications

References 37 publications

Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study

Effect of Hazardous Alcohol Use During Pregnancy on Growth Outcomes at Birth: Findings from a South African Cohort Study

Risk factors for alcohol use among pregnant women, ages 15–44, in the United States, 2002 to 2017

Alcohol reduction in the first trimester is unrelated to smoking, patient or pregnancy characteristics

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