235485 Depression and prenatal substance use: Evidence of the need for coordinated screening and care

Wednesday, November 2, 2011: 9:00 AM

Peggy L. O'Brien, MA, JD , Heller School for Social Policy and Management, Brandeis University, Waltham
Background: This study explores depression as a predictor of prenatal substance use. Methods: The 2008 National Survey on Drug Use and Health is used, with a sample size of 973 pregnant women. Dependent variables assess past-month use of tobacco, alcohol, binge drinking, and illicit drugs. The explanatory variable measures whether the woman experienced past-year depression. Logistic regressions modeled the effect of depression on substance use, controlling for age, race/ethnicity, poverty level and trimester. Results: Depression was associated with tobacco (OR: 2.21, p<0.01), and with illicit drug use, both including (OR: 2.80, p<0.01) and excluding marijuana (OR: 3.36, p<0.05). Depressed teens (OR: 13.78, p<0.001) and young adults (OR: 5.76, p<0.01) were more likely to use illicit drugs than were those over 25. Depressed teens were more likely to use illicit drugs excluding marijuana (OR: 8.19, p<0.05) than were those over 25. African-Americans (OR: 0.33, p<0.001) and Latinas with depression (OR: 0.12, p<0.001) had reduced likelihood of smoking, and Latinas had lower odds of illicit drug use (OR: 0.30, p<0.05) than did depressed whites. Those who were poor and near poor (OR: 3.28-4.40, p<0.001) were more likely to smoke, and the near poor had greater odds of binge drinking (OR: 2.63, p<0.05). Poverty had no relationship to prenatal use of any other substance. Conclusion: This study confirms that depression is a predictor of substance use in pregnancy, in particular tobacco and illicit drug use. Greater emphasis must be placed on screening and intervention for both depression and substance use among pregnant women.

Learning Areas:
Clinical medicine applied in public health
Diversity and culture
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Public health or related nursing
Social and behavioral sciences

Learning Objectives:
Describe the impact of depression on prenatal substance use. Differentiate the impact of depression on prenatal use of different substances, including alcohol, tobacco and illicit drugs. Explain the socio-demographic factors associated with substance use among pregnant women.

Keywords: Perinatal Health, Substance Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am qualified to present because I am a doctoral student in the area of behavioral health with a focus on prenatal substance use and have prior clinical experience working with depression.
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.