title: Predictors of alcohol and tobacco use prior to and during pregnancy in the US: the role of maternal stressors.
abstract: The purpose of the study was to understand the association between stressful life events prior to conception (PSLEs) and women's alcohol and tobacco use prior to and during pregnancy, and the continuation of such use through pregnancy. Data were from the Early Childhood Longitudinal Study-Birth Cohort (n = 9,350). Data were collected in 2001. Exposure to PSLEs was defined by indications of death of a parent, spouse, or previous live born child, divorce or marital separation, or fertility problems prior to conception. Survey data determined alcohol and tobacco usage during the 3 months prior to and in the final 3 months of pregnancy. Weighted regressions estimated the effect of PSLEs on alcohol and tobacco use at each time point and on the continuation of use, adjusting for confounders. Experiencing any PSLE increased the odds of tobacco use prior to (adjusted odds ratio [AOR] 1.52, 95 % confidence interval (CI) 1.23-1.87) and during pregnancy (AOR 1.57, 95 % CI 1.19-2.07). Women exposed to PSLEs smoked nearly five additional packs of cigarettes in the 3 months prior to pregnancy (97 cigarettes, p = 0.011) and consumed 0.31 additional alcoholic drinks during the last 3 months of pregnancy than unexposed women. PSLEs are associated with tobacco use before pregnancy and alcohol and tobacco use during pregnancy. Alcohol and tobacco screening and cessation services should be implemented prior to and during pregnancy, especially for women who have experienced PSLEs.
authors.affiliation: Maternal and Child Health Research, Truven Health Analytics, 4819 Emperor Boulevard, Suite 125, Durham, NC, 27703, USA, whitney.witt@truvenhealth.com.
authors.forename: Whitney P
authors.initials: WP
authors.lastname: Witt
authors.forename: Kara C
authors.initials: KC
authors.lastname: Mandell
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Wisk
authors.forename: Erika R
authors.initials: ER
authors.lastname: Cheng
authors.forename: Debanjana
authors.initials: D
authors.lastname: Chatterjee
authors.forename: Fathima
authors.initials: F
authors.lastname: Wakeel
authors.forename: Hyojun
authors.initials: H
authors.lastname: Park
authors.forename: Dakota
authors.initials: D
authors.lastname: Zarak
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D016742:Preconception Care; D011237:Predictive Value of Tests; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D012959:Socioeconomic Factors; D013997:Time Factors; D064424:Tobacco Use / Q000009:adverse effects / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology