title: Alcohol consumption, smoking, and drug use in pregnancy: Prevalence and risk factors in Southern Thailand.
abstract: BACKGROUND
  Substance use during pregnancy contributes to the risk of adverse health outcomes in mothers and children-in utero and during later development. In this study, we investigated the prevalence of substance use and associated factors in pregnant women receiving antenatal care in public hospitals in Thailand.
  
  
  METHODS
  Women (3578) attending 7 antenatal care clinics in Songkhla for the first time during their current pregnancy were interviewed with a structured questionnaire focusing on demographic data, obstetric history, use of alcohol, tobacco, and other substances, and the General Health Questionnaire was administered. The use of substances was confirmed with the ultrarapid version of the Alcohol, Smoking, and Substance Involvement Screening Test and urine tests, which were also administered to 1 in 5 to 10 randomly selected women whose screening results were negative.
  
  
  RESULTS
  Based on self-reports and General Health Questionnaire results, the weighted prevalence of alcohol, tobacco, or illicit substance use and that of "mental health problems" were 5.6% (95% confidence interval [CI], 4.9-6.4) and 29.2% (95% CI, 27.5-30.9), respectively. On the basis of the ultrarapid version of the Alcohol, Smoking, and Substance Involvement Screening Test and urine tests, the prevalence of likely substance use disorder during the 3 months prior to assessment was 1.2% (95% CI, 0.8-1.5) and 7.7% (95% CI, 4.6-10.7), respectively. Factors associated with substance use were religion, unmarried status, unplanned pregnancy, previous abortion, and current mental health problem.
  
  
  CONCLUSIONS
  Our results emphasize the need for identification of substance use and mental health problems, with the help of questionnaires and biological markers, followed by early intervention.
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Sawitri
authors.initials: S
authors.lastname: Assanangkornchai
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Darika
authors.initials: D
authors.lastname: Saingam
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Nualta
authors.initials: N
authors.lastname: Apakupakul
authors.affiliation: Epidemiology Unit, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.|Department of Psychiatry, Royal South Hants Hospital and Southampton University Hospitals, Southampton, UK.
authors.forename: J Guy
authors.initials: JG
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D055030:Drug Users; D005260:Female; D006304:Health Status; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
keywords: ASSIST-Lite; mental health problem; pregnancy; prevalence; substance use; urine test