142nd APHA Annual Meeting and Exposition

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302139
Preconception and Prenatal Substance Use in the United States: The Role of Preconception Stressful Life Events

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 10:50 AM - 11:10 AM

Whitney P. Witt, PhD, MPH , Truven Health Analytics, Bethesda, MD
Kara Mandell, MA , Department of Population Health, University of Wisconsin-Madison, Madison, WI
Lauren Wisk, PhD , Department of Population Medicine, Center for Child Health Care Studies, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
Erika Cheng, PhD, MPA , Division of General Academic Pediatrics, Harvard Medical School and Massachusetts General Hospital for Children, Boston, MA
Debanjana Chatterjee, MA , Population Health Sciences, University of Wisconsin Madison, Madison, WI
Fathima Wakeel, PhD, MPH , Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI
Hyojun Park, MA , Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison, WI
Dakota Zarak , of Wisconsin School of Medicine and Public Health, Department of Population Health Sciences, Madison, WI
Audio (mp3) recording Recorded Presentation (mp4)
Background: It is unknown how exposure to stressful life events prior to conception (PSLEs) influences alcohol and tobacco use in the perinatal period. The goal of this study was to understand the association between PSLEs and women’s alcohol and tobacco use prior to and during pregnancy, and with the continuation of use through the final three months of pregnancy.

Methods: Data were from the Early Childhood Longitudinal Study-Birth Cohort (n=9,350). Exposure to PSLEs was defined by indications of death of a parent, spouse, or previous live born child; divorce or marital separation; or fertility problems prior to conception. Survey data determined women’s alcohol and tobacco use during the three months prior to and in the final three months of pregnancy. Weighted regressions estimated the effect of PSLEs on alcohol and tobacco use at each time point and on the continuation of use, adjusting for confounders.

Principal Findings: Experiencing any PSLE increased the odds of tobacco use prior to (adjusted odds ratio [AOR]: 1.52, 95% CI: 1.23-1.87) and during pregnancy (AOR: 1.57. 95% CI: 1.19-2.07). Exposed women smoked approximately five additional packs of cigarettes in the three months prior to pregnancy (P=0.010) and consumed 0.31 additional alcoholic drinks during the last three months of pregnancy than unexposed women.

Conclusions:  Exposure to PSLEs is associated with tobacco use before pregnancy and both alcohol and tobacco use during pregnancy. Alcohol and tobacco screening and cessation services should be implemented prior to and during pregnancy, especially for women who have experienced PSLEs.

Learning Areas:

Epidemiology
Public health or related research
Social and behavioral sciences

Learning Objectives:
Discuss the relationships among preconception stressful life events, alcohol and tobacco use prior to and during pregnancy, and the continuation of alcohol and tobacco use in the final three months of pregnancy. Discuss programmatic and policy implications of our findings.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the maternal and child health. Among my scientific interests has been the application of the life course approach to understanding the social, behavioral, and psychological factors that contribute to human development and disparities in health and healthcare in women, children, and families.
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.

Back to: 4149.0: Improving Pregnancy Outcomes: Psychosocial Influences on Birth Outcomes