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Prevalence and magnitude of perinatal substance exposures in California

W A Vega1, B Kolody, J Hwang

  • 1School of Public Health, Center for Community Health, University of California, Berkeley 94720.

The New England Journal of Medicine
|September 16, 1993
PubMed

Insights

Perinatal substance exposure, including drugs, alcohol, and smoking, affects over 11% of pregnant women in California. Black women showed the highest prevalence across most substance categories.

Area of Science:

  • Epidemiology
  • Public Health
  • Obstetrics

Background:

  • Perinatal substance exposure is linked to adverse neonatal and obstetrical outcomes.
  • Limited population-based studies exist on the prevalence and demographics of substance use during pregnancy.

Purpose of the Study:

  • To estimate the prevalence and demographic profiles of perinatal substance exposures in California.
  • To identify specific substances (drugs, alcohol, smoking) and associated risk factors.

Main Methods:

  • A probabilistic, stratified-cluster sample of 29,494 women delivering in 202 California hospitals in 1992.
  • Urine toxicology screening for drugs and alcohol, linked to self-reported tobacco and prescribed drug use.
  • Urinary toxicology provides conservative estimates of recent substance use.

Main Results:

  • Weighted prevalence: 5.16% for drugs, 6.72% for alcohol, 8.82% for smoking. 11.35% tested positive for any drug or alcohol.
  • Black women exhibited the highest prevalence for total drug use (14.22%), alcohol (11.58%), cocaine (7.79%), and tobacco (20.12%).
  • White non-Hispanic and Hispanic women showed significant drug and alcohol exposures, with varying prevalence rates by substance.

Conclusions:

  • In 1992, an estimated 67,361 perinatal drug/alcohol exposures and 52,346 tobacco exposures occurred in California.
  • Findings highlight significant clinical and public health implications for maternal and infant health.
  • Disparities in prevalence across racial and ethnic groups necessitate targeted interventions.
Abstract

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