Drug Use, "Binge" Alcohol Use, Cigarette Use, and Pregnancy (Table 13.4)

Given the deleterious effects of drug use on human embryos and fetuses, substantial public health attention has been directed toward estimating the number of pregnant women who use licit and illicit drugs and trying to reduce these numbers (NIDA, 1996; Su, Larison, Ghadialy, Johnson, & Rohde, 1997). Consistent with this attention, Table 13.4 explores the relationship between pregnancy among females aged 15 to 44 and past month illicit drug use, "binge" alcohol use (drinking five or more drinks on the same occasion on at least 1 day during the past 30 days), and past month cigarette use. Except for women who had been pregnant for less than 1 month, these measures of past month use indicate use during pregnancy. To ensure adequate precision of estimates for pregnant women, estimates in Table 13.4 are based on combined data from the 1996 and 1997 NHSDAs and represent annual average estimates for 1996 and 1997. Combining data from these two survey years yielded 871 pregnant and 16,508 nonpregnant women aged 15 to 44.

Among women aged 15 to 44 who were currently pregnant, 2.5% used one or more illicit drugs in the past month, 1.3% had engaged in "binge" alcohol use, and slightly fewer than 20% were past month cigarette users. These percentages translate to approximately 60,000 pregnant women who used any illicit drug in the past month, 30,000 who were "binge" drinkers, and almost half a million who smoked cigarettes (OAS, 1998c, Table 31A). Women in this age group who were not pregnant were 3 to 10 times more likely than pregnant women to report illicit drug use or "binge" alcohol use in the past month. Women who were not pregnant also were significantly more likely than pregnant women to be current smokers. These findings suggest that most women who use illicit drugs, alcohol, or cigarettes reduce or curtail their use when they become pregnant. Other NHSDA data, however, suggest that many women who used these substances before becoming pregnant resume their substance use after giving birth (OAS, 1998c, Table 31B).

The demographic subgroups that had higher rates of past month substance use among pregnant women often were the same groups that had higher rates among women who were not pregnant. For example, rates of past month illicit drug use among pregnant women were significantly higher among young women aged 15 to 25 compared with those aged 26 to 44. With respect to race/ethnicity, black women who were pregnant were significantly more likely than their Hispanic counterparts to be past month illicit drug users. Although white women who were not pregnant had a significantly higher rate of illicit drug use compared with their Hispanic counterparts, there was no significant difference among white and Hispanic women who were pregnant. In addition, the prevalence of current cigarette use was significantly lower among Hispanic pregnant women compared with their white and black counterparts.

Substance use among pregnant women was associated with marital status (more prevalent among pregnant women who were not married). Illicit drug use and cigarette use among pregnant women also were associated with adult education (more prevalent among adult pregnant women with less than a high school education). In particular, about 40% of pregnant women aged 18 to 44 who had not finished high school were current cigarette smokers compared with 20% of pregnant women who were high school graduates, 16% of pregnant women who had some college education, and only 8% of pregnant women who were college graduates. These analyses did not control for associations between age, marital status, and education, except to exclude pregnant women under the age of 18 from the education estimates. Consequently, the associations between substance use, marital status, and education among pregnant women may reflect the higher rates of use among younger pregnant women. Multivariate analyses involving combined data from more than one NHSDA year (to increase the sample size of pregnant women) would help to establish whether race/ethnicity, marital status, andeducation are independent risk factors for substance use among pregnant women, when associations between age and these characteristics are taken into account.

This page was last updated on December 30, 2008.