Despite public health campaigns, a surprising number of women continue to use substances such as tobacco, marijuana and alcohol during pregnancy and their usage rebounds to pre-pregnancy levels within two years of having a baby, according to a new University of Washington study.
Men's patterns of substance use during their partners' pregnancies were even bleaker. Men typically are not targeted by these campaigns, and their levels of binge drinking, daily smoking and marijuana use remained fairly stable before, during and after pregnancy, the study showed.
This is important, according to the study's lead authors Jennifer Bailey and Karl Hill, because men's substance use may make it harder for women to stop using while they're pregnant and may make it more likely that mothers will resume smoking or drinking after their child is born. Bailey and Hill are affiliated with the Social Development Research Group in the UW's School of Social Work.
"The months after childbirth are critical for intervening with mothers," said Bailey, who is a UW research scientist. "For example, many already have done the hard work of quitting smoking and haven't smoked a cigarette in six months or more. We should support that effort so that they can continue as nonsmokers. However, we know if dad is smoking or drinking it is more likely that mom will resume smoking or drinking."
The research is the first comprehensive look at mothers' and fathers' substance use on a month-by-month basis during a three-year period that included pregnancy. Substance use around pregnancy presents a wide variety of risks to fetuses and infants including fetal alcohol syndrome, cognitive and behavioral problems and impairments, asthma and higher incidences of sudden infant death syndrome.
The study found that:
- 77 percent of women cigarette smokers and 50 percent of the women who smoked marijuana used those substances at some time during pregnancy.
- 38 percent of women cigarette smokers and 24 percent of marijuana users reported using those substances throughout their pregnancies.
- While overall rates of cigarette and marijuana use and binge drinking for women declined during pregnancy, those rates began rising again during the first six months following the birth of a baby.
Month by month during pregnancy, rates of smoking among all pregnant women varied between 17 percent and 21 percent, binge drinking was between 2 percent and 3 percent and marijuana use was between 8 percent and 9 percent.
Data for the study came from the Seattle Social Development Project which is following the development of 808 Seattle children who are now young adults. The participants are interviewed every three years, and for this study data covered the period when they were 21 to 24 years of age. In interviews, they were asked about their month-by-month incidences of binge drinking (5 or more alcoholic drinks in a two-hour period) and their use of cigarettes and marijuana. They were also asked a number of questions about life events, including the birth of a child. One hundred and thirty-one women and 77 men reported the birth of 244 children during this period.
The high rate of marijuana use rivaled that of cigarette smoking and came as a surprise to the researchers, according to Hill, who is a research associate professor of social work. He said it may be partly attributed to study participants who came from a high-risk, low-income urban sample.
He and Bailey said the findings emphasize the need for more public health messages and preventive interventions.
"Women who are pregnant want the best for their baby and typically reduce their drinking and smoking," said Bailey. "But after birth part of their motivation to limit alcohol use and quit using cigarettes and marijuana is taken away. If their partner is still smoking, for example, they might think, 'Boy, that cigarette smells good.'"
"There are two ways we need to reach parents," said Hill. "Pregnancy health care providers need to talk to both fathers and mothers about their smoking, drinking and marijuana use. Pregnancy seems like such a great public health opportunity to reach parents, but no one is talking to dads and this study shows that they are not changing their substance use behavior. What dads do matters and we want them to reduce their substance use.
"We also need to change the way society presently looks at the social norms of using these drugs. Right now there is little discussion about marijuana use during pregnancy, although it may be a relatively prevalent problem."
The study was funded by the National Institute on Drug Abuse. Co-authors are J. David Hawkins and Richard Catalano, founding and current directors, respectively, of the Social Development Research Group, and Robert Abbott, a UW professor of educational psychology. The paper was published in the journal Birth Issues in Perinatal Care.
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