Continued Use of Alcohol by Adolescents during Pregnancy

Drugs and alcohol use by teen girls not only increases problem behavior such as risky sex and unplanned pregnancy but may also result in a child born with fetal alcohol syndrome. Understanding risk factors for continued alcohol and marijuana abuse may help providers tailor interventions to discontinue ATOD use during pregnancy. This paper will identify factors associated with continued use of alcohol and marijuana in teen girls during pregnancy. This report will identify factors associated with use of alcohol and marijuana in teen girls during the preconception period. Design/Methods: Analysis of baseline data of an RCT to reduce repeat teen pregnancy in Washington, DC is reported. African American and Latina pregnant teens (n= 187), ages 15-19, were interviewed during pregnancy. Measures of ATOD, risk behaviors, school, family problems and parent monitoring are examined. Teens report weekly use of alcohol (23%), with binging >/=5 drinks (8.6%), as well as use of marijuana (21.4%), tobacco (21%) and other drugs (3.7%) in the preconception period. CRAFFT screening score suggests 58% of weekly users have a problematic level of use. Their mothers self report weekly use of alcohol (26%), risk drinking >/=8 drinks/wk (6%) and marijuana use (5%). Teens with weekly substance use were more likely to have sex while under the influence of alcohol (OR=12.8, 95% CI: 5.3-30.8) or marijuana (OR=33.8, 13.3-85.3). Teen alcohol users were more likely to have family members who abuse alcohol (OR=9.5, 2.8-32.9), poor parent monitoring (OR=4.8, 2.0-11.5), be in a recent fight (OR=3.3, 1.6-6.9), and drink alone (OR=7.9, 3.3-18.8). Teens using marijuana weekly were more likely to have substance abuse by a family member (OR=3.1, 1.2-8.6), sexual abuse (OR=4.1, 1.9-8.5), truancy (OR=3.2, 1.6-6.6), problems with the police (OR=3.4, 1.6-7.0) and postpartum depression (OR=2.3, 1.1-4.7). Of particular concern, 11% of teens continue to use alcohol (OR=9.3, 3.2-27.1), tobacco (3%) and marijuana (3%) during pregnancy. Teen mothers with weekly use of alcohol and/or marijuana show increased risk for problem behaviors. Careful family history and use of reliable screening tools may assist health practitioners in identifying substance use in family members and their teenage girls and referring them for treatment. Alarmingly, 50% of weekly alcohol users continued to drink during pregnancy. Infants of alcohol abusing teens are at risk for Fetal Alcohol Syndrome and future behavior problems. Funded by NICHD.