Association of Prenatal Exposure to Maternal Drinking and Smoking With the Risk of Stillbirth

Odendaal, Hein J.; Dukes, Kimberly A.; Elliott, Amy J.; Willinger, Marian; Sullivan, Lisa; Tripp, Tara; Groenewald, Coen; Myers, Michael; Fifer, William P.; Angal, Jyoti; Boyd, Theonia K.; Burd, Larry; Cotton, Jacob; Folkerth, Rebecca D.; Hankins, Gary D.V.; Haynes, Robin L.; Hoffman, Howard J.; Jacobs, Perri; Petersen, Julie M.; Pini, Nicolò; Randall, Brad; Roberts, Drucilla J.; Robinson, Fay; Sens, Mary Ann; Eerden, Peter Van; Wright, Colleen A.; Holm, Ingrid A.; Kinney, Hannah C.

doi:10.1001/jamanetworkopen.2021.21726

Cited by 26 publications

(18 citation statements)

References 26 publications

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“…Notwithstanding the evidenced gestational consumption of psychoactive drugs in this examined cohort, no significant correlations were found between neonatal outcomes, mothers’ hair results, and interview answers. This is in contrast with previous studies showing a correlation between gestational consumption of tobacco and drugs of abuse and increased risk of spontaneous abortions, reduction in neonatal birth weight and birth length, newborn head circumference, and signs of a more severe neonatal abstinence syndrome [ 27 , 35 , 36 , 37 , 38 ]. It can be hypothesized that in this examined cohort, psychoactive drugs consumption during pregnancy was sporadic and, even if identifiable by hair testing, did not affect offspring features.…”

Section: Discussioncontrasting

confidence: 99%

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Gómez-Ruiz

Marchei²,

Rotolo³

et al. 2022

Pharmaceuticals

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For the first time, the present study employed hair testing to investigate the prevalence of classical drugs of abuse and new psychoactive substances use during gestation in a cohort of 300 Mexican pregnant women. An interview was conducted to collect data on sociodemographic aspects of the patients, and a 9 cm-long hair strand was taken from the back of the head of each mother one month after delivery. A validated ultra-high-performance liquid chromatography–high-resolution mass spectrometry method was used for the screening of classic drugs, new psychoactive substances, and medications in maternal hair. Out of 300 examined hair samples from pregnant women, 127 (42.3%) resulted positive for psychoactive substances: 45 (35.4%) for cannabis only, 24 (18.9%) for methamphetamine only, 13 (10.2%) for cocaine only, 1 (0.3%) for heroin, 1 for N-N-dimethyltryptamine (0.3%), 1 for ketamine (0.8%), and 35 (16.3%) for more than one psychoactive substance. Furthermore, seven samples (2.3%) resulted positive for new psychoactive substances (NPS): two samples for synthetic cannabinoids, two for synthetic cathinones, and three for nor-fentanyl, and 3.3% of women hair resulted positive for anticonvulsant, antidepressant, and antipsychotic medications. Finally, 83 women hair samples (27.7%) tested positive for nicotine. Nonsteroidal anti-inflammatory drugs (NSAIDs) and other painkillers (60.0%), medications for the treatment of nausea and vomiting (12.3%), antihistamines (8.7%) and nasal/sinus decongestants (6.7%), cough suppressants (5.0%), and bronchodilator agents (5.0%) were also detected in pregnant women hair. The gestational use of psychoactive substances and exposure to tobacco smoke, assessed by hair testing, were associated with a significantly younger age and with a low education grade of the mothers (p < 0.005). This study provides a significant preliminary indication of the under-reported gestational consumption of licit and illicit psychoactive and pharmacologically active drugs in a Mexican environment, showing the value of toxicological and forensic analyses in the global effort to determine the health risks caused by classic drugs and new psychoactive substances during pregnancy.

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Section: Discussioncontrasting

confidence: 99%

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Gómez-Ruiz

Marchei²,

Rotolo³

et al. 2022

Pharmaceuticals

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“…Women exposed to tobacco during pregnancy had a higher odds of alcohol consumption among our study participants. This double exposure to tobacco and alcohol increases the risk of stillbirth [48], sudden infant death syndrome (an important cause of post-neonatal mortality) [49] and other adverse outcomes more than each substance alone [50]. Additionally, we found that a history of induced abortion increased the likelihood of CEATU by fivefold compared with women without a similar history.…”

Section: Discussionmentioning

confidence: 91%

Alcohol consumption and tobacco exposure among pregnant women in Ibadan, Nigeria

Adeoye

2022

BMC Psychiatry

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Background Alcohol consumption and tobacco exposure during pregnancy are hazardous behaviours which are increasing significantly in low and middle-income countries, including sub-Saharan Africa. However, they have received little attention in Nigeria’s maternal health research and services. The prevalence, pattern and predictors of alcohol consumption and tobacco exposure among pregnant women in Ibadan, Nigeria, were investigated. Methods This is a part of a prospective cohort study among pregnant women in Ibadan, Nigeria (Ibadan Pregnancy Cohort Study (IbPCS), which investigated the associations between maternal obesity, lifestyle characteristics and perinatal outcomes in Ibadan. Alcohol consumption and tobacco exposure of 1745 pregnant women were assessed during enrollment by self-reports using an interviewer-administered questionnaire. Bivariate and multiple logistic regression analyses examined the associations at a 5% level of statistical significance. Results The prevalence of pre-pregnancy alcohol consumption and alcohol consumption during pregnancy were 551 (31.7%) and 222 (12.7%), respectively, i.e. (one in every eight pregnancies is exposed to alcohol). Palm wine (52%) and beer (12%) were the most common alcohol consumed among pregnant women. The predictors of alcohol consumption during were pre-pregnancy alcohol use [AOR = 10.72, 95% CI: 6.88–16.70) and religion i.e. Muslims were less likely to consume alcohol during pregnancy compared to Christians: [AOR = 0.60, 95% CI: 0.40–0.92). The prevalence of tobacco exposure in the index pregnancy was 64 (3.7%), i.e. one in every 27 pregnancies is exposed to tobacco. In contrast, cigarette smoking, second-hand smoke and smokeless tobacco were 0.4, 1.7 and 1.8%, respectively. Pre-pregnancy cigarette smoking was reported by 33(1.9%) and was the most significant predictor [AOR = 12.95; 95% CI: 4.93, 34.03) of tobacco exposure during pregnancy in our study population. Conclusions Alcohol consumption and tobacco exposure are not uncommon and have been an ongoing but neglected threat to maternal and child health in Nigeria. Alcohol and tobacco control policy and programmes to prevent the use among pregnant and reproductive-age women in Nigeria should be implemented primarily during antenatal care.

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“…A pregnancy loss or fetal death before 20 weeks, according to the US definition for the SPS, was defined as a miscarriage, whereas a non-live birth at ≥20 weeks was regarded as a stillbirth. [ 31 – 33 ] Terminations of pregnancies after 20 weeks were done for medical reasons. Death of a liveborn infant before the age of 1 year was defined as an infant death.…”

Section: Methodsmentioning

confidence: 99%

The tragedy of smoking, alcohol, and multiple substance use during pregnancy

et al. 2022

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Background. Antenatal substance use is a significant public health concern in South Africa (SA). Information on smoking, drinking and drug use during pregnancy was collected prospectively for the Safe Passage Study of the PASS (Prenatal Alcohol in Sudden infant death syndrome and Stillbirth) Network.Objectives. Data from 4 926 pregnant women in a community near Tygerberg Academic Hospital, Cape Town, were examined to determine whether associations between different substance use groups and postnatal infant outcomes at birth and 1 year were significant.Methods. Gestational age (GA) was determined by earliest ultrasound. Maternal data were collected at enrolment or first antenatal visit. Substance use data were obtained at up to four occasions. Birthweight data were derived from medical records, and birthweight z-scores (BWZs) were specifically calculated using INTERGROWTH-21st study data. Statistical analyses were done with Statistica version 13. Results. Women who used more substances enrolled later, were younger, and had smaller mid-upper arm circumferences (MUACs), less education and lower monthly income than women who used no substances (control group). Infants born to women who used more substances had lower GA at delivery, birthweight and BWZ than infants from the control group. At 1 year, infants born to women who used more substances had a lower weight, shorter length and smaller head circumference. Education was positively associated with all infant outcomes at birth and 1 year. MUAC was positively associated with infant BWZ, and weight and length at 1 year. Income was negatively associated with BWZ, but positively associated with all 1-year outcomes.Conclusion. Substance use during pregnancy affects infant outcomes at birth and 1 year of age. The addictive properties of substance use make cessation difficult, so prevention strategies should be implemented long before pregnancy. Higher maternal education, associated with better infant outcomes at birth and 1 year and acting as a countermeasure to substance use, is of paramount importance.

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Association of Prenatal Exposure to Maternal Drinking and Smoking With the Risk of Stillbirth

Cited by 26 publications

References 26 publications

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Prevalence of Licit and Illicit Drugs Use during Pregnancy in Mexican Women

Alcohol consumption and tobacco exposure among pregnant women in Ibadan, Nigeria

The tragedy of smoking, alcohol, and multiple substance use during pregnancy

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