173161 Behavioral, psychosocial, and environmental risk factors associated with substance use during pregnancy: Comparisons of substance-using and non-using pregnant women

Monday, October 27, 2008

Janel Alberts, PhD , Planning and Research, Orange County Health Care Agency, Santa Ana, CA
Taigy T. Thomas, DrPH , Planning and Research, Orange County Health Care Agency, Santa Ana, CA
Ryan Ramos, MA , Planning and Research, Orange County Health Care Agency, Santa Ana, CA
Juliana Fuqua, PhD , California State Polytechnic University, Pomona, Pomona, CA
Curtis J. Condon, PhD , Planning and Research, Orange County Health Care Agency, Santa Ana, CA
Behavioral, psychosocial, and environmental factors have independently been associated with use of alcohol, tobacco, and/or other drugs (ATOD) during pregnancy. However, few studies have assessed the constellation of risk factors that substance-using pregnant women exhibit.

In 2007, the Orange County Health Care Agency, using a multi-method approach, investigated risk factors associated with ATOD use during pregnancy. Nearly 2,600 pregnant women participated in an anonymous assessment, which included urinalysis and chart review of women giving birth at participating hospitals, and self-report assessments of women presenting at prenatal care providers.

Risk factor profiles of women who used substances while pregnant were compared to profiles of non-using women. Compared with non-users, women who used ATOD while pregnant were more likely to have initiated prenatal care later or not receive prenatal care (χ2=48.83, p<.01), have a close family member with a substance problem (OR=3.18; CI 1.93, 5.22), be exposed to second-hand smoke (OR=7.56; CI 4.47, 12.79) and experience high stress (OR=2.09; CI 0.73, 6.03) during pregnancy. Moreover, substance-users were more likely to have babies born prematurely (OR=4.67; CI 2.73, 8.00) and with lower birth weight (OR=3.98; CI 2.07, 7.63).

Findings suggest that women who use ATOD during pregnancy may face a variety of additional behavioral, psychosocial, and environmental risk factors while pregnant, many of which could compound the deleterious effects on the unborn child. Early identification and amelioration of these risk factors is critical to improving birth outcomes.

Learning Objectives:
1. Identify behavioral, psychosocial, and environmental risk factors associated with substance use during pregnancy. 2. Describe impact of substance use on birth outcomes. 3. Develop screening procedures for early identification of risk factors associated with ATOD use during pregnancy.

Keywords: Substance Abuse, Pregnancy

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I was one of the primary investigators on the project, and oversaw the project from beginning to end.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.