title: Prenatal alcohol use: the role of lifetime problems with alcohol, drugs, depression, and violence.
abstract: OBJECTIVE
  The purpose of this study was to examine a broader array of lifetime factors that theoretically may be associated with prenatal alcohol use than have previously been studied together, including family history of alcohol-use problems, history of physical or sexual abuse, lifetime major depressive disorder, alcohol-use disorder, illicit-drug-use problems, and partner violence.
  
  
  METHODS
  A total of 186 pregnant women, all of whom used alcohol in the year before pregnancy, were initially recruited in prenatal care settings. Women who reported no prenatal alcohol use (n = 96) were compared with women who drank 1-10 standard drinks during pregnancy (n = 75) and with women who drank more than 10 standard drinks during pregnancy (n = 13), considered to be a higher risk group, on the lifetime risk variables. Because of the public health implications, secondary analyses compared women who abstained during pregnancy with those who used any alcohol.
  
  
  RESULTS
  Significant intercorrelations were found among most of the lifetime risk factors studied. Multivariate analyses showed that drug-use problems and partner violence were most strongly associated with prenatal alcohol use than any other variable studied.
  
  
  CONCLUSIONS
  Consistent with a life span risk framework for alcohol-use problems, results of this study show that childhood abuse, familial alcoholism, lifetime major depressive disorder, and alcohol- and drug-use problems are interrelated. However, when considered together, only lifetime partner violence and drug use are significantly related to various levels of prenatal alcohol use. Identification, assessment, and intervention efforts should integrate these important factors.
authors.affiliation: Department of Psychiatry, Rachel Upjohn Building, University of Michigan, 4250 Plymouth Road, Ann Arbor, Michigan 48109-5766, USA. hflynn@umich.edu
authors.forename: Heather A
authors.initials: HA
authors.lastname: Flynn
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Chermack
mesh_terms: D000328:Adult; D054523:Adult Survivors of Child Abuse / Q000523:psychology / Q000706:statistics & numerical data; D000437:Alcoholism / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D005260:Female; D006801:Humans; D013287:Illicit Drugs; D008403:Mass Screening / Q000706:statistics & numerical data; D008824:Michigan; D015999:Multivariate Analysis; D011247:Pregnancy; D011295:Prenatal Care / Q000706:statistics & numerical data; D012307:Risk Factors; D013179:Spouse Abuse / Q000523:psychology / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics / Q000523:psychology*; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data
chemical_list: D013287:Illicit Drugs