title: Maternal self concept as a provider and cessation of substance use during pregnancy.
abstract: OBJECTIVE
  Maternal substance use during pregnancy is a common modifiable risk factor for poor birth outcomes, and is associated with long term psychological risks to offspring. As self concept is known to affect substance use behaviors in non-pregnant women, we hypothesized that self concept as a provider may be particularly salient to cessation of use during pregnancy. To isolate psychological processes specific to pregnancy from those associated with the transition to parenthood, we examined birth mothers who made adoption placements participating in the Early Growth and Development Study.
  
  
  METHODS
  We obtained lifetime and pregnancy substance use history and psychological measures at 3 to 4months postpartum from 693 women recruited from the Northwest, Southwest, and Mid-Atlantic regions of the United States. Life history calendar and computer-assisted personal interviewing methods were used to minimize reporting bias. Using logistic regression, we assessed the association of self concept as an adequate provider with cessation of substance use during pregnancy, controlling for sociodemographic variables, depressive symptoms experienced during pregnancy, past year antisocial behaviors, family history of substance abuse, timing of pregnancy recognition, timing of initiation of prenatal care, and emotional adjustment to the adoption decision.
  
  
  RESULTS
  More positive self-concept as an adequate provider was independently associated with cessation of substance use and earlier initiation of prenatal care during pregnancy [OR=1.223; 95% C.I. (1.005-1.489); B(SE)=.201(.100)]. Familial substance abuse, depressive symptoms, and antisocial behaviors during pregnancy, were also independent predictors, and more strongly associated with cessation [OR=.531; 95% C.I. (.375-.751); B(SE)=-.634 (.178)], [OR. 940; 95% C.I. (.906-.975); B(SE)=-.062 (.019)], [OR=.961; 95% C.I. (.927-.996); B(SE)=-.040 (.018)].
  
  
  CONCLUSIONS
  Enhancing maternal identity as a provider for the fetus during pregnancy, along with treatment of depression, may improve motivation to stop substance use.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, George Washington University School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Washington, DC 20037, USA. smassey@mfa.gwu.edu
authors.forename: Suena H
authors.initials: SH
authors.lastname: Massey
authors.forename: Jenae M
authors.initials: JM
authors.lastname: Neiderhiser
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Shaw
authors.forename: Leslie D
authors.initials: LD
authors.lastname: Leve
authors.forename: Jody M
authors.initials: JM
authors.lastname: Ganiban
authors.forename: David
authors.initials: D
authors.lastname: Reiss
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D011247:Pregnancy / Q000523:psychology*; D011248:Pregnancy Complications / Q000523:psychology* / Q000534:rehabilitation; D011446:Prospective Studies; D012307:Risk Factors; D012649:Self Concept; D019966:Substance-Related Disorders / Q000523:psychology* / Q000534:rehabilitation; D014481:United States; D055815:Young Adult