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. 2017 Aug:62:49-60.
doi: 10.1016/j.alcohol.2017.03.001. Epub 2017 Jun 15.

Drinking and smoking patterns during pregnancy: Development of group-based trajectories in the Safe Passage Study

Kimberly Dukes  1 , Tara Tripp  2 , Marian Willinger  3 , Hein Odendaal  4 , Amy J Elliott  5 , Hannah C Kinney  6 , Fay Robinson  2 , Julie M Petersen  2 , Cheryl Raffo  2 , Dale Hereld  7 , Coen Groenewald  4 , Jyoti Angal  5 , Gary Hankins  8 , Larry Burd  9 , William P Fifer  10 , Michael M Myers  10 , Howard J Hoffman  11 , Lisa Sullivan  12 ; PASS Network
Collaborators, Affiliations

Drinking and smoking patterns during pregnancy: Development of group-based trajectories in the Safe Passage Study

Kimberly Dukes et al. Alcohol. 2017 Aug.

Abstract

Precise identification of drinking and smoking patterns during pregnancy is crucial to better understand the risk to the fetus. The purpose of this manuscript is to describe the methodological approach used to define prenatal drinking and smoking trajectories from a large prospective pregnancy cohort, and to describe maternal characteristics associated with different exposure patterns. In the Safe Passage Study, detailed information regarding quantity, frequency, and timing of exposure was self-reported up to four times during pregnancy and at 1 month post-delivery. Exposure trajectories were developed using data from 11,692 pregnancies (9912 women) where pregnancy outcome was known. Women were from three diverse populations: white (23%) and American Indian (17%) in the Northern Plains, US, and mixed ancestry (59%) in South Africa (other/not specified [1%]). Group-based trajectory modeling was used to identify 5 unique drinking trajectories (1 none/minimal, 2 quitting groups, 2 continuous groups) and 7 smoking trajectories (1 none/minimal, 2 quitting groups, 4 continuous groups). Women with pregnancies assigned to the low- or high-continuous drinking groups were less likely to have completed high school and were more likely to have enrolled in the study in the third trimester, be of mixed ancestry, or be depressed than those assigned to the none/minimal or quit-drinking groups. Results were similar when comparing continuous smokers to none/minimal and quit-smoking groups. Further, women classified as high- or low-continuous drinkers were more likely to smoke at moderate-, high-, and very high-continuous levels, as compared to women classified as non-drinkers and quitters. This is the first study of this size to utilize group-based trajectory modeling to identify unique prenatal drinking and smoking trajectories. These trajectories will be used in future analyses to determine which specific exposure patterns subsequently manifest as poor peri- and postnatal outcomes.

Keywords: Ethanol; Exposure patterns; Group-based trajectory modeling; Pregnancy; Prenatal exposure; Smoking.

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Figures

Fig. 1
Fig. 1
Self-reported drinking and smoking exposure by trimester of pregnancy (n = 11,692 pregnancies).
Fig. 2
Fig. 2
Drinking trajectory groups based on drinks per drinking day in each month of pregnancy (n = 11,692 pregnancies).
Fig. 3
Fig. 3
Smoking trajectory groups based on cigarettes per day in each month of pregnancy (n = 11,692 pregnancies).
Fig. 4
Fig. 4
Pregnancy smoking by drinking trajectory groups (n = 11,692 pregnancies). For the five drinking groups, values in the bars indicate the percentage of pregnancies assigned to each of the seven smoking groups (e.g., “N 63%”: of pregnancies assigned to the None drinking group, 63% were also assigned to the None smoking group).
Fig. 5
Fig. 5
Drinks per drinking day by drinking trajectory group in each month of pregnancy (n = 11,692 pregnancies).
Fig. 6
Fig. 6
Cigarettes per day by smoking trajectory group in each month of pregnancy (n = 11,692 pregnancies).
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