Time course of stress and illicit drug use among low income women from pre-pregnancy to postpartum

Aim: To document the time course of stress and illicit drug use among women from 4 months pre-pregnancy to 6 months post-partum. Methods: Participants were 126 women attending community-based family planning clinics who became pregnant during the course of a longitudinal study of women's drug use. Self-reported drug use and stress were examined at 4 months pre-pregnancy, during each trimester, and 6 months postpartum. These were compared to 221 matched non-pregnant women. Stress was measured with Turner's ongoing stress scale and Cohen's Perceived Stress Scale (PSS). Results: Levels of ongoing stress and PSS scores were higher for those who used any illicit drugs at baseline. Drug use (45%) and stress among the matched non-pregnant women remained unchanged over time. Among pregnant women, rates of drug use were: Baseline 43%; 1-4 months pre-pregnancy 22%; 1-3 trimesters 42%, 18% and 22%; 1-2 months postpartum 31%; and 5-6 months postpartum 48%. Drug-using pregnant women reported that ongoing stress was lowest during the second trimester and increased postpartum. Non-drug using pregnant women also reported that ongoing stress was lowest during the second trimester but did not report a substantial increase post-partum. Regarding perceived stress, drug using pregnant women reported their highest PSS scores 3-4 months postpartum, while non-drug using women reported their highest PSS scores at 1-2 months postpartum. Conclusion: Use of illicit drugs decreased during pregnancy. However, drug use rates rose again within 6 months postpartum. Self-reported stress differed by drug use status, particularly in the postpartum period.