Rural-urban differences in substance use during pregnancy

Area of Science:

• Public Health
• Epidemiology
• Maternal Health

Background:

• Drug overdoses are a leading cause of pregnancy-related deaths in the U.S.
• Rural-urban disparities in substance use are documented, but not specifically for perinatal periods.
• A national examination of these disparities is needed.

Purpose of the Study:

• To comprehensively examine rural-urban disparities in perinatal substance use.
• To identify differences in tobacco, alcohol, and illicit drug use among pregnant women based on geographic location.

Main Methods:

• Utilized cross-sectional data from 3499 pregnant women (2015-2019 National Survey on Drug Use and Health).
• Analyzed rural (nonmetro) vs. urban (metro) differences in past-month substance use.
• Employed Rao-Scott chi-square tests and multivariable logistic regression with complex survey weights.

Main Results:

• Rural pregnant women had higher past-month tobacco use (24.7%) compared to small (15.2%) and large (8.2%) urban areas.
• After adjustments, rural pregnant women were more likely to use tobacco (aOR: 2.32) but less likely to use alcohol (aOR: 0.58) than large urban counterparts.
• No significant rural-urban differences were found for binge drinking, illicit drug use, or marijuana-only use.

Conclusions:

• Geographic variations in perinatal substance use necessitate targeted interventions.
• Prioritize tobacco prevention in rural areas and alcohol interventions in urban settings for pregnant individuals.
• Addressing these disparities is crucial for improving maternal and infant health outcomes.