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Physical abuse, smoking, and substance use during pregnancy: prevalence, interrelationships, and effects on birth
J McFarlane1, B Parker, K Soeken
1Health Promotton & Disease Prevention, Texas Woman's University, College of Nursing, Houston 77030, USA.
Insights
Physical abuse during pregnancy is common and linked to higher rates of smoking and substance use. Integrated clinical interventions are crucial for improving maternal and infant health outcomes.
Area of Science:
- Obstetrics and Gynecology
- Public Health
- Addiction Medicine
Background:
- Physical abuse, smoking, and substance use are prevalent issues during pregnancy.
- These behaviors can negatively impact maternal and fetal health.
- Understanding their combined occurrence is vital for effective intervention.
Purpose of the Study:
- To determine the prevalence of physical abuse, smoking, and substance use (alcohol and illicit drugs) during pregnancy.
- To examine the combined effects of these behaviors on birth weight.
- To identify associations between physical abuse and substance use/smoking.
Main Methods:
- Prospective cohort analysis conducted in urban public prenatal clinics.
- Involved 414 African American, 412 Hispanic, and 377 white pregnant women.
- Assessed the occurrence of physical abuse, smoking, and alcohol/illicit drug use.
Main Results:
- Physical abuse occurred in 16% of pregnant women.
- Smoking was reported by 29.5%, and alcohol/illicit drug use by 11.9%.
- Physical abuse was significantly associated with higher rates of smoking and substance use, particularly among African American and white women. The triad of abuse, smoking, and substance use significantly impacted birth weight.
Conclusions:
- Physical abuse during pregnancy is common and detectable.
- It is strongly associated with increased tobacco, alcohol, and illicit drug use.
- Integrated clinical protocols for assessing and intervening in physical abuse, smoking, and substance use are essential for improving cessation rates and preventing harm.
Objective:
To establish the singular and combined occurrence of physical abuse, smoking, and substance use (i.e., alcohol and illicit drugs) during pregnancy and its effect on birth weight.
Design:
Prospective cohort analysis.
Setting:
Urban public prenatal clinics.
Participants:
414 African American, 412 Hispanic, and 377 white pregnant women.
Main Outcome Measure(S):
Occurrence of physical abuse was 16%; smoking, 29.5%; and alcohol/illicit drug use, 11.9%. Significant relationships existed between physical abuse and smoking for African American and white women. For African American women, 33.7% of women who were not abused smoked, versus 49.5% of women who were abused (chi 2 = 8.21; df = 1; p < 0.005). Alcohol/illicit drug use was 20.8% for nonabused women compared with 42.1% for abused women (chi 2 = 18.18; df = 1; p < 0.001). For white women, 46.6% of women who were not abused smoked, versus 59.6% of those who were abused (chi 2 = 5.22; df = 1; p < 0.005). As a triad, physical abuse, smoking, and alcohol/ illicit drug use were significantly related to birth weight (F[3, 1040] = 30.19, p < 0.001).
Conclusions:
Physical abuse during pregnancy is common, readily detected with a five-question screen, and associated with significantly higher use of tobacco, alcohol, and illicit drugs. Clinical protocols that integrate assessment and intervention for physical abuse, smoking, and substance use are essential for preventing further abuse and improving smoking and substance cessation rates.