Predictors of Drug use During Pregnancy: The relative effects of Socioeconomic, demographic, and mental health risk factors

Alcohol, tobacco, and cannabis use during pregnancy are associated with poor neonatal outcomes. Excessive use of these substances are preventable causes of neonatal morbidity and mortality. Various risk factors have been identified as predictors of alcohol and drug use during pregnancy.

In this study, Rachel Brown, H. Dakkak, Jason Gilliland, and Jamie A. Seabrook assessed the effects of socioeconomic, demographic, and mental health risk factors associated with drug use during pregnancy. Secondary outcomes included predictors of an Apgar score <7 and fetal macrosomia.

The retrospective cohort study investigated a sample of pregnant women from Southwestern Ontario, using data obtained from perinatal and neonatal databases. A Geographic Information System was used to identify location of maternal home neighborhoods. Neighborhood-level socioeconomic status (SES) variables from the 2011 National Household Survey were used in analysis, and maternal self-report of alcohol or drug use were primary outcome variables.

Results reflected increased odds of drug and alcohol use with older age, lone-parent households, depression, and anxiety. Immigration and visual minority prevalence were negatively correlated with tobacco use, while low education was predictive of tobacco and cannabis use. Low income was correlated with increased odds of tobacco and cannabis use, but not alcohol. Depression was the top risk factor overall. Healthy, overweight, or obese BMI were associated with an Apgar score <7 and macrosomia. Anxiety and depression were only increased risk for an Apgar score of <7, while tobacco reduced risk of macrosomia.

Significant findings from this analysis include maternal depression being the top risk factor for alcohol and drug use during pregnancy, and mental health having a larger influence than SES. These results highlight the importance of mental health awareness and advocacy of mental health programs for women at-risk.


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