Prevalence of alcohol use in pregnant women with substance use disorder

Bakhireva, Ludmila N.; Shrestha, Shikhar; Garrison, Laura; Leeman, Lawrence; Rayburn, William F.; Stephen, Julia M.

doi:10.1016/j.drugalcdep.2018.02.025

Cited by 25 publications

(17 citation statements)

References 45 publications

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“…The median number of drinks consumed per individual per week during the periconceptional period (defined as 2 weeks before and 2 weeks after the last menstrual period) was 3.5 drinks in the general obstetrics cohort versus 5.5 drinks in the OUD cohort, a statistically significant difference. 49 Similarly, the median number of binge drinking episodes in early pregnancy (defined as the last menstrual period to pregnancy recognition) was 1 episode in the general obstetrics cohort versus 3 episodes in the OUD cohort, also statistically significant. 49 Given the risks of NAS and FAS, studies such as the one by Bakhireva et al, further underscore the need for screening and intervention for alcohol use during pregnancy, perhaps especially for women with OUD.…”

Section: The Concurrent Use Of Opioids and Alcohol Among Pregnant Womenmentioning

confidence: 84%

“…49,50 Overall, the lack of research is surprising given that aggregate data from the 2005 to 2014 NSDUH indicate that, among pregnant women who used opioids non-medically, almost half reported alcohol use and nearly one-third binge drinking in the past 30 days. 51 In one of the two studies (mentioned above) that focused on the concurrent use of opioids and alcohol during pregnancy, Bakhireva et al 49 analyzed data from the ENRICH (Ethanol, Neurodevelopment, Infant and Child Health) prospective birth cohort study, which compared the prevalence of selfreported alcohol use among women receiving prenatal care from general obstetrics clinics (n = 365) with women receiving prenatal care from an OUD program (n = 295), and found significant differences in the intensity of alcohol consumption between the two study cohorts. The median number of drinks consumed per individual per week during the periconceptional period (defined as 2 weeks before and 2 weeks after the last menstrual period) was 3.5 drinks in the general obstetrics cohort versus 5.5 drinks in the OUD cohort, a statistically significant difference.…”

Section: The Concurrent Use Of Opioids and Alcohol Among Pregnant Womenmentioning

confidence: 99%

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Concurrent Opioid and Alcohol Use Among Women Who Become Pregnant: Historical, Current, and Future Perspectives

Klaman

Andringa²,

Horton³

et al. 2019

Subst�Abuse

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The numbers of women using opioids who become pregnant have captured the attention of media, research, policy, and community. At the same time, there is an ever-growing use of alcohol among women who continue drinking during pregnancy that has received less focus. Although both untreated opioid use disorder and alcohol misuse pose risks for maternal, fetal, and child morbidities, alcohol is the substance with the most significant documentation of harms. As we focus on the opioid epidemic in the United States, it is critical that we do not overlook alcohol use during pregnancy. Both opioid use and alcohol use during pregnancy are important public health challenges and often happen concurrently. Thus, this commentary aims to (1) highlight the historical and current context of opioid and alcohol use during pregnancy; (2) summarize the current knowledge of opioids and alcohol use during pregnancy; and (3) detail future directions in how health care providers can help identify and therapeutically respond to women with concurrent opioid and alcohol use disorder.

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Section: The Concurrent Use Of Opioids and Alcohol Among Pregnant Womenmentioning

confidence: 84%

Section: The Concurrent Use Of Opioids and Alcohol Among Pregnant Womenmentioning

confidence: 99%

Concurrent Opioid and Alcohol Use Among Women Who Become Pregnant: Historical, Current, and Future Perspectives

Klaman

Andringa²,

Horton³

et al. 2019

Subst�Abuse

View full text Add to dashboard Cite

show abstract

“…As AUDs are associated with neurobiological adaptations that reduce an individual’s cognitive control, clinicians must be non-judgmental, non-directive, and private [ 37 , 38 ]. Empathy and mutual respect are also important as previous research has found a positive association between these factors and recovery from substance abuse among pregnant women [ 39 ].…”

Section: Discussionmentioning

confidence: 99%

Alcohol Use Disorders and Increased Risk of Adverse Birth Complications and Outcomes: An 11-Year Nationwide Cohort Study

Jee

Park

et al. 2020

IJERPH

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For women who suffer from Alcohol Use Disorders (AUDs), the use of alcohol before and/or during pregnancy may result in various birth complications, including miscarriage, stillbirth, or preterm delivery. Thus, this study aimed to explore whether Alcohol Use Disorders (AUDs) are associated with increased risk of adverse birth complications and outcomes. A total of 76,799 deliveries between 2003 and 2013 in the Korean National Health Insurance Service National Sample Cohort (NHIS-NSC) were analyzed. Women with an AUD diagnosis preceding delivery were identified as individuals with alcohol dependence. A multivariate Cox proportional hazards model was used to estimate the hazard ratio of adverse birth complications and outcomes associated with alcohol dependence. Diagnosis of an AUD was associated with increased risk of adverse birth complications (Hazard Ratio [HR]: 1.15, 95% CI: 1.01–1.31, p = 0.0302). This was especially the case for women whose AUD diagnosis was in the same year as their delivery (HR: 1.53, 95% CI: 1.24–1.88, p < 0.0001). AUDs were associated with increased risk of adverse birth outcomes, especially when prevalent in the same year as a woman’s delivery. Our study confirms that the monitoring of expecting women with a diagnosis of alcohol-related problems may be useful in preventing adverse birth complications.

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“…The use of biomarkers to detect substance exposure such as hair, urine, blood, and meconium (Bakhireva et al, 2018;Bearer et al, 1999;Gutierrez et al, 2015;Ostrea Jr, Brady, Gause, Raymundo, & Stevens, 1992) has enhanced exposure identification. However, biomarkers which rely on metabolic evidence in body tissue, by their very nature, primarily identify recent use.…”

Section: Considerations For Accurate Measurement Of the Independent Vmentioning

confidence: 99%

Fifty Years of Research on Prenatal Substances: Lessons Learned for the Opioid Epidemic

et al. 2020

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Current efforts to design research on developmental effects of prenatal opioid exposure can benefit from knowledge gained from 50 years of studies of fetal alcohol and prenatal drug exposures such as cocaine. Scientific advances in neurobiology, developmental psychopathology, infant assessments, genetics, and imaging support the principles of developmental neurotoxicology that guide research in prenatal exposures. Important to research design is accurate assessment of amount, frequency, and timing of exposure which benefits from accurate self-report and biomarkers of exposure. Identifying and control of pre-and postnatal factors that impact development are difficult and dependent on appropriate research design and selection of comparison groups and measurement of confounding, mediating, and moderating variables. Polysubstance exposure has increased due to the number of prescribed and nonprescribed substances used by pregnant women and varying combinations of drugs may have differential effects on the outcome. Multiple experimental and clinical assessments of infant behavior have been developed but predicting outcome before 18-24 months of age remains difficult. With some exceptions, prenatal substance exposure effect sizes have been small, and cognitive and behavioral effects tend to be specific rather than global. Studies require large sample sizes, adequate retention, and support for social services in atrisk samples. The ethical and legal contexts and stigma associated with drug/alcohol use disorder should be considered in order to prevent harm to families in research programs. Recognition of the pervasive use of addictive substances in this nation should lead to broad scientific efforts to understand how substances affect child outcomes and to initiate prevention and intervention where needed.

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Prevalence of alcohol use in pregnant women with substance use disorder

Cited by 25 publications

References 45 publications

Concurrent Opioid and Alcohol Use Among Women Who Become Pregnant: Historical, Current, and Future Perspectives

Concurrent Opioid and Alcohol Use Among Women Who Become Pregnant: Historical, Current, and Future Perspectives

Alcohol Use Disorders and Increased Risk of Adverse Birth Complications and Outcomes: An 11-Year Nationwide Cohort Study

Fifty Years of Research on Prenatal Substances: Lessons Learned for the Opioid Epidemic

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