Division of Research, Kaiser Permanente Northern California, Oakland, CA (KCY-W, NS, VS, L-YT, SRA, MAA), Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA (KCY-W), Regional Offices, Kaiser Permanente Northern California, Oakland, CA (AC, NG, DA), Friends Research Institute, Baltimore, MD (MT).
J Addict Med. 2022;16(1):118-121. doi: 10.1097/ADM.0000000000000825.
The goal of this study was to evaluate the association between pregnancy intentions and substance use in early pregnancy among pregnant women receiving prenatal care in a large, integrated healthcare system.
The sample comprised 29,787 Kaiser Permanente Northern California pregnant women (12.1% aged <25, 36.4% non-Hispanic White) screened for prenatal substance use in 2018 via a self-reported questionnaire and urine toxicology test given as part of standard prenatal care (at ∼8 weeks gestation). Multivariable logistic regression models tested for associations of pregnancy intentions with prenatal substance use (any use and specific substances) by self-report and/or a positive urine toxicology test.
Adjusting for covariates, women with an unintended pregnancy (23.9% of the sample) had higher odds of any prenatal substance use than women with an intended pregnancy (28.8% vs 16.1%; adjusted odds ratio [aOR] = 1.80, 95% confidence interval [CI]:1.67-1.93). Having an unintended pregnancy was also associated with higher odds of using alcohol (14.4% vs 10.4%; aOR = 1.73, 95%CI:1.59-1.89), cannabis (15.6% vs 5.6%; aOR = 1.91, 95%CI:1.73-2.11), nicotine (3.8% vs 1.3%; aOR = 2.33, 95%CI:1.92-2.82), pain medication (2.3% vs 1.2%; aOR = 1.64, 95%CI:1.32-2.03), and stimulants (0.8% vs 0.3%; aOR = 1.85, 95%CI:1.23-2.79) early in pregnancy.
Having an unintended pregnancy was associated with higher odds of substance use during early pregnancy. Connecting women of reproductive age with health education about pregnancy prevention and recognition of early signs of pregnancy, effective contraception, and early screening and interventions for prenatal substance use may help to reduce prenatal substance use and its associated consequences.
本研究旨在评估在大型综合医疗保健系统中接受产前护理的孕妇中，妊娠意图与早孕期间物质使用之间的关联。
该样本包括 29787 名接受产前物质使用筛查的 Kaiser Permanente 北加州孕妇（12.1%年龄<25 岁，36.4%非西班牙裔白人），通过自我报告问卷和尿液毒理学测试在 2018 年进行筛查，作为标准产前护理的一部分（在怀孕 8 周左右进行）。多变量逻辑回归模型通过自我报告和/或尿液毒理学测试阳性来测试妊娠意图与产前物质使用（任何使用和特定物质）之间的关联。
调整了混杂因素后，意外怀孕的女性（样本的 23.9%）比有计划怀孕的女性更有可能进行任何产前物质使用（28.8%比 16.1%；调整后的优势比[aOR] = 1.80，95%置信区间[CI]：1.67-1.93）。意外怀孕也与更高的酒精使用几率相关（14.4%比 10.4%；aOR = 1.73，95%CI：1.59-1.89）、大麻（15.6%比 5.6%；aOR = 1.91，95%CI：1.73-2.11）、尼古丁（3.8%比 1.3%；aOR = 2.33，95%CI：1.92-2.82）、止痛药（2.3%比 1.2%；aOR = 1.64，95%CI：1.32-2.03）和兴奋剂（0.8%比 0.3%；aOR = 1.85，95%CI：1.23-2.79）在怀孕早期。
意外怀孕与早孕期间物质使用的几率增加有关。为育龄妇女提供有关妊娠预防和早期妊娠迹象识别、有效避孕以及产前物质使用早期筛查和干预的健康教育，可能有助于减少产前物质使用及其相关后果。
