Substance use and postpartum depression, implications for research and treatment

Background: Postpartum substance use receives little attention, but women who use substances while pregnant are likely to continue use after birth, particularly if there is an untreated substance use problem. Objective: We reviewed available literature on postpartum substance use to identify common findings and key areas for research. Methods: Keyword searches of PubMed, Google Scholar, and PsychInfo using words such as postpartum depression and substance use identified over 100,000 articles. Most considered prenatal drug use and infant outcomes with no mention of the maternal postpartum period. Sources in relevant articles were downloaded and the cited by feature of search engines used to find additional articles. We found 35+ studies published from 1990 to 2012 that considered postpartum substance use. Results: Findings on perinatal substance use effects are mixed, but some substances appear to impede mother/child relations and could adversely affect long-term health. Most studies considered low-income, African American women. Different groups show different patterns of use, with poor women using more illicit drugs, such as crack cocaine, and with an elevated rate of problematic use. Women with mental health disorders also showed an elevated rate of problematic use. Residential facilities that integrate addiction treatment with parenting skills show potential for improved treatment outcomes. Conclusion: Postnatal substance use can negatively affect the long-term health of mothers and children. Research must assess the long-term outcomes and determine characteristics useful to identify candidates for intervention during the prenatal period when women are most likely to come into contact with care providers.