Adolescent childbirth, miscarriage, and abortion: associations with changes in alcohol, marijuana, and cigarette use

Abstract

Background Adolescent girls who become pregnant demonstrate greater risk for substance use than same‐aged peers. However, it remains unclear how risk relates to normative changes in adolescence. Few studies have examined adolescent substance use changes before, during, and after pregnancy and considered how pregnancy outcomes (childbirth, miscarriage, abortion) differentially influence substance use changes. The present study examined associations between different adolescent pregnancy outcomes and within‐person changes in substance use from prepregnancy to postpregnancy. Methods Participants included 2,450 girls (52% Black) oversampled from low‐income urban neighborhoods in Pittsburgh, PA. Participants self‐reported pregnancy outcomes and substance use frequency (alcohol, cigarette, marijuana) annually from ages 11–20. Fixed effects regressions focused on first births, first miscarriages, and first abortions occurring from ages 12–19 to test the associations between pregnancy outcomes and within‐individual changes in substance use from prepregnancy to postpregnancy. By design, models controlled for all potential time‐stable confounds, and models included age and subsequent pregnancies as time‐varying covariates. Results Consistent with prior studies, girls who became pregnant (20%) reported greater early risk for substance use problems than never‐pregnant adolescents, including earlier age of onset and more regular marijuana and cigarette use. Childbirth predicted a 26%–51% within‐individual reduction in alcohol, marijuana, and cigarette use that remained significantly lower than prepregnancy levels after childbirth. Alcohol and marijuana use decreased (32%–47%) after miscarriage. Abortion was not associated with long‐term changes in substance use; however, marijuana and cigarette use gradually increased (44%–46%) in the years leading up to the year of and after abortion, respectively, before returning to prepregnancy levels. Conclusions Findings highlight important differences in adolescent substance use patterns based on pregnancy outcome. For pregnant adolescents with heightened pre‐existing risk for substance use, pregnancy may be a window of opportunity for substance use screening and behavioral intervention.

Psychosocial Experiences of Adolescent Girls and Young Women Subsequent to an Abortion in Sub-saharan Africa and Globally: A Systematic Review

“…Additionally, four studies assessed levels of alcohol, nicotine, drug use, and dependence among AGYW who had an abortion. Smoking, drug use, and alcohol use were increased under certain circumstances among AGYW who had an abortion ( 50 , 67 – 69 ), although behaviors prior to an abortion and the continued experimentation in the neurodevelopmental phase of adolescence and early adulthood may be motivating these findings. Lastly, sexual well-being was assessed in two studies and indicated that AGYW had high levels of sexual satisfaction and function ( 61 , 70 ).…”

Adverse obstetric outcomes in early and late adolescent pregnancy

“…Teenage pregnancy has been found to be associated with low socioeconomic status, substance use during pregnancy, and mental health problems (6). The age at onset of substance use and smoking was found to be earlier in pregnant adolescents compared to non-pregnant adolescents (7).…”

Structure of reproductive losses of adolescent girls and women of reproductive age in the Tyumen

“…Проблема подростковой беременности широко освещена в мире [15][16][17][18][19][20]. Правда, в глобальной информационной базе репродуктивные потери девушек-подростков представлены преимущественно абортами, число которых в мире за один год достигает многомиллионных величин -5,6 млн, 3,9 млн из которых угрожают жизни (ВОЗ) 6 .…”