Continuities in maternal substance use from early adolescence to parenthood: findings from the intergenerational cohort consortium

Abstract

Background This study assessed the extent to which women's preconception binge drinking, tobacco use and cannabis use, reported prospectively in adolescence and young adulthood, predicted use of these substances during pregnancy and at 1 year postpartum. Methods Data were pooled from two intergenerational cohort studies: the Australian Temperament Project Generation 3 Study (395 mothers, 691 pregnancies) and the Victorian Intergenerational Health Cohort Study (398 mothers, 609 pregnancies). Alcohol, tobacco and cannabis use were assessed in adolescence (13–18 years), young adulthood (19–29 years) and at ages 29–35 years for those transitioning to parenthood. Exposures were weekly or more frequent preconception binge drinking (5 + drinks in one session), tobacco use and cannabis use. Outcomes were any alcohol, tobacco and cannabis use prior to awareness of the pregnancy, after awareness of pregnancy (up to and including the third trimester pregnancy) and at 1 year postpartum. Results Frequent preconception binge drinking, tobacco use and cannabis use across both adolescence and young adulthood were strong predictors of continued use post-conception, before and after awareness of the pregnancy and at 1 year postpartum. Substance use limited to young adulthood also predicted continued use post-conception. Conclusions Persistent alcohol, tobacco use and cannabis use that starts in adolescence has a strong continuity into parenthood. Reducing substance use in the perinatal period requires action well before pregnancy, commencing in adolescence and continuing into the years before conception and throughout the perinatal period.

The Australian Temperament Project Generation 3 study: a population-based multigenerational prospective cohort study of socioemotional health and development

“…29 We have also shown that for most mothers, perinatal alcohol (65%), tobacco (90%) and cannabis (59%) use is commonly preceded by preconception use, which was also prospectively assessed in adolescence and young adulthood. 30 We have further shown important associations between prospectively assessed preconception parental mental health histories and relational and child outcomes. A history of persistent symptoms of depression or anxiety predicted poorer emotional bonding with infants at 1 year post-birth in both mothers and fathers (β range =−0.42 to −0.55).…”

“… 29 We have also shown that for most mothers, perinatal alcohol (65%), tobacco (90%) and cannabis (59%) use is commonly preceded by preconception use, which was also prospectively assessed in adolescence and young adulthood. 30 …”

Prevalence and Patterns of Prenatal Alcohol Exposure in Australian Cohort and Cross-Sectional Studies: A Systematic Review of Data Collection Approaches

“…Overall, 1 out of the 14 general cohort studies (not including the 2 alcohol-focused studies) included information on alcohol exposure pre-pregnancy recognition; however, the level of alcohol consumed was not examined. Notably, two of the more recently conducted smaller cohort studies examined these periods, and generated estimates similar to the alcohol-focused studies [ 128 , 129 ]. Considering the potential impacts of PAE on birth outcomes, and the known influence of both timing and exposure threshold, the variability in data collection methods may limit the clinical relevance of findings [ 51 , 163 ].…”

“…Where data for overall prevalence were not reported for n > 1000 participants (The Barwon Infant Study and NDSHS Cohort from 2010), these results were also excluded from the meta-analysis. Findings from 55 small cohort studies (<1000 participants) and/or case-control studies were reported by 59 publications, from which all relevant data were extracted and tabulated ( Supplementary Tables S8 and S9 ) [ 18 , 19 , 95 , 96 , 97 , 98 , 99 , 100 , 101 , 102 , 103 , 104 , 105 , 106 , 107 , 108 , 109 , 110 , 111 , 112 , 113 , 114 , 115 , 116 , 117 , 118 , 119 , 120 , 121 , 122 , 123 , 124 , 125 , 126 , 127 , 128 , 129 , 130 , 131 , 132 , 133 , 134 , 135 , 136 , 137 , 138 , 139 , 140 , 141 ...…”

“…Two of the more recent studies, however, did examine this time period. Prevalence of PAE pre-awareness was between 76% and 77%, and post-awareness (trimester 3) was between 12% and 24% [ 128 , 129 ].…”