title: Risk of alcohol-exposed pregnancies among low-income, illicit drug-using women.
abstract: OBJECTIVE
  Poor women of childbearing age who use crack, cocaine, marijuana, and heroin may be at risk for having an alcohol-exposed pregnancy because of concurrent alcohol use. Women who use illicit drugs may not know the harmful effects of fetal alcohol exposure. Fetal alcohol exposure is a leading cause of developmental disabilities and mental retardation.
  
  
  METHODS
  We report findings of a survey administered to 2672 women 18-44 years of age in settings serving low-income women, including an urban jail, a drug treatment facility, and healthcare facilities in Florida, Virginia, and Texas. We compared women who reported using more than one illicit drug (drug users) and women who reported never using illicit drugs (nonusers) for frequent alcohol consumption, binge drinking, failure to use contraception, unplanned pregnancies, and drinking during pregnancy.
  
  
  RESULTS
  Of women interviewed, 75% (2000) reported using more than one illicit drug. Drug users were more likely to report frequent drinking (33%, relative risk [RR] 12.73, 95% confidence interval [CI] 7.9-20.4, binge drinking (39%, RR 5.7, 95% CI 4.9-7.6), and drinking during pregnancy (37%, RR 2.10, 95% CI 1.75-2.53) compared with nonusers (3%, 7%, 17%, respectively, p < 0.0001). Greater proportions of drug users (27%, RR 2.20, 95% CI 1.75-2.53) also failed to used contraception compared with nonusers (19%, p < 0.05). Notable proportions of both groups, drug users (91%) and nonusers (82%), reported unplanned pregnancies.
  
  
  CONCLUSIONS
  The findings suggest that poor women who reported ever using more than one illicit drug were at greater risk for having an alcohol-exposed pregnancy. Unplanned pregnancies in both groups surpassed national averages. Poor women likely require enhanced education about the hazards of drinking during pregnancy and methods to reduce unplanned pregnancies.
authors.affiliation: Office of Health Disparities, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Mail Stop E-07Atlanta, GA 30333, USA. tsharpe2@cdc.gov
authors.forename: Tanya T
authors.initials: TT
authors.lastname: Sharpe
authors.forename: Mary M
authors.initials: MM
authors.lastname: Velasquez
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000523:psychology*; D002487:Centers for Disease Control and Prevention, U.S.; D003267:Contraception / Q000523:psychology; D005260:Female; D063647:Fetal Alcohol Spectrum Disorders / Q000209:etiology; D005431:Florida / Q000453:epidemiology; D015438:Health Behavior / Q000208:ethnology; D006801:Humans; D013287:Illicit Drugs; D007407:Interviews as Topic; D011203:Poverty; D011247:Pregnancy; D049168:Pregnancy, Unplanned / Q000523:psychology*; D012307:Risk Factors; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000523:psychology*; D013781:Texas / Q000453:epidemiology; D014481:United States; D014768:Virginia / Q000453:epidemiology
chemical_list: D013287:Illicit Drugs