Oh Sehun, Reingle Gonzalez Jennifer M, Salas-Wright Christopher P, Vaughn Michael G, DiNitto Diana M
School of Social Work, The University of Texas at Austin, United States.
Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas School of Public Health, United States.
Prev Med. 2017 Apr;97:93-99. doi: 10.1016/j.ypmed.2017.01.006. Epub 2017 Jan 19.
Alcohol and tobacco use during pregnancy are among the strongest and most preventable risk factors for adverse neonatal health outcomes, but few developmentally sensitive, population-based studies of this phenomenon have been conducted. To address this gap, the present study examined the prevalence and correlates of alcohol and tobacco use among pregnant adolescents (aged 12-17) and adults (aged 18-44) in the United States. Data were derived from the population-based National Survey of Drug Use and Health (80,498 adolescent and 152,043 adult women) between 2005 and 2014. Findings show disconcerting levels of past-month use among pregnant women with 11.5% of adolescent and 8.7% of adult women using alcohol, and 23.0% of adolescent and 14.9% of adult women using tobacco. Compared to their non-pregnant counterparts, pregnant adolescents were less likely to report past 30-day alcohol use (AOR=0.52, 95% CI=0.36-0.76), but more likely to report past 30-day tobacco use (AOR=2.20, 95% CI=1.53-3.18). Compared to their non-pregnant adult counterparts, pregnant adults were less likely to report using alcohol (AOR=0.06, 95% CI=0.05-0.07) and tobacco (AOR=0.47, 95% CI=0.43-0.52). Compared to pregnant abstainers, pregnant women reporting alcohol/tobacco use were more likely to have had a major depressive episode in the past 12months, report criminal justice system involvement, and endorse comorbid alcohol/tobacco use. Given alcohol and tobacco's deleterious consequences during pregnancy, increased attention to reducing use is critical. Findings suggest that tobacco use is especially problematic for both adolescents and adults and is strongly linked with depression and criminal justice involvement, especially among adults.
孕期饮酒和吸烟是导致新生儿不良健康结局的最主要且最可预防的风险因素，但针对这一现象的、对发育具有敏感性且基于人群的研究却很少。为填补这一空白，本研究调查了美国怀孕青少年（12至17岁）和成年人（18至44岁）中饮酒和吸烟的患病率及其相关因素。数据来自2005年至2014年基于人群的全国药物使用和健康调查（80498名青少年和152043名成年女性）。研究结果显示，令人担忧的是，过去一个月内孕妇的使用率较高，11.5%的青少年孕妇和8.7%的成年孕妇饮酒，23.0%的青少年孕妇和14.9%的成年孕妇吸烟。与未怀孕的同龄人相比，怀孕青少年报告过去30天饮酒的可能性较小（比值比=0.52，95%置信区间=0.36-0.76），但报告过去30天吸烟的可能性较大（比值比=2.20，95%置信区间=1.53-3.18）。与未怀孕的成年同龄人相比，怀孕成年人报告饮酒（比值比=0.06，95%置信区间=0.05-0.07）和吸烟（比值比=0.47，95%置信区间=0.43-0.52）的可能性较小。与不饮酒/吸烟的孕妇相比，报告饮酒/吸烟的孕妇在过去12个月内更有可能出现重度抑郁发作、报告涉及刑事司法系统，并认可合并饮酒/吸烟。鉴于酒精和烟草在孕期的有害后果，加大对减少使用的关注至关重要。研究结果表明，吸烟对青少年和成年人来说尤其成问题，并且与抑郁症和刑事司法参与密切相关，尤其是在成年人中。
