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. 2022 May-Jun;16(3):278-285.
doi: 10.1097/ADM.0000000000000886.

Preconception Substance Use and Risk of Unintended Pregnancy: Pregnancy Risk Assessment Monitoring System 2016-17

Saima Shafique  1 , Amna Umer, Kim E Innes, Toni Marie Rudisill, Wei Fang, Lesley Cottrell
Affiliations

Preconception Substance Use and Risk of Unintended Pregnancy: Pregnancy Risk Assessment Monitoring System 2016-17

Saima Shafique et al. J Addict Med. 2022 May-Jun.

Abstract

Objective: This study examined the association between preconception substance use and unintended pregnancy in a large, nationally representative sample of women.

Methods: In this cross-sectional study, we used data from the Pregnancy Risk Assessment Monitoring System (PRAMS) comprising, 74,543women who had birth during 2016-17. Logistic regression was used to assess the independent association of unintended pregnancy overall and by subtypes to preconception substance use (smoking and other nicotine/tobacco use, alcohol consumption, and use of cannabis, illicit/recreational drugs) and specific medication including prescription opioids, antidepressants and over the counter pain relief.

Results: Overall, 41% of pregnancies were unintended. Nearly 57% of participants reported alcohol consumption during the preconception period, with 32% indicating binge drinking, 17% reported preconception smoking, and 10% cannabis use. Unintended pregnancy was significantly associated with substance use, including smoking (adjusted odds ratio [AOR]:1.5, 95% confidence interval [CI]: 1.4-1.6); as well as the use of other nicotine/tobacco (AOR:1.4, 95% CI: 1.3-1.5); cannabis (AOR: 1.9, 95% CI: 1.5-2.3); illicit/recreational drugs (AOR:1.7, 95% CI: 1.2-2.4), prescription opioids (AOR:1.4, 95% CI: 1.02-1.9), and prescription antidepressants (AOR 1.8, 95% CI: 1.1-3.0). The likelihood of unintended pregnancy was significantly elevated with heavy smoking, heavy alcohol consumption, and binge drinking. Analyses by unintended pregnancy subtype yielded similar results.

Conclusions: Preconception substance use was significantly and positively associated with unintended pregnancy. Evidence-based interventions are needed addressing substance use behavior and effective contraceptive use to prevent unintended pregnancy and related adverse effects on maternal and child health.

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Conflict of interest statement

The authors report no conflicts of interest.

References

    1. Finer LB, Zolna MR. Declines in unintended pregnancy in the United States, 2008–2011. N Engl J Med. 2016;374(9):843–852. - PMC - PubMed
    1. Gipson JD, Koenig MA, Hindin MJ. The effects of unintended pregnancy on infant, child, and parental health: A review of the literature. Stud Fam Plann. 2008;39(1):18–38. - PubMed
    1. Institute of Medicine (US) Committee on Unintended Pregnancy. In: Brown SS, Eisenberg L, eds. The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington (DC): National Academies Press (US); 1995. - PubMed
    1. Kost K, Lindberg L. Pregnancy intentions, maternal behaviors, and infant health: Investigating relationships with new measures and propensity score analysis. Demography. 2015;52(1):83–111. - PMC - PubMed
    1. McHugh RK, Wigderson S, Greenfield SF. Epidemiology of substance use in reproductive-age women. Obstet Gynecol Clin North Am. 2014; 41(2):177–189. - PMC - PubMed