Separate or Concomitant Use of Alcohol and Tobacco during Pregnancy: Prevalence and Associated Factors
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Abstract
Introduction: Pregnancy is a crucial period for a child’s physiological and psychological development. Alcohol and tobacco consumption during gestation is a public health concern due to the potential harm to maternal health, fetal development, and infant health.
Objective: To identify the prevalence of separate and concomitant use of alcohol and tobacco during pregnancy and associated sociodemographic, obstetric, and clinical factors.
Method: A quantitative cross-sectional study conducted with 253 postpartum women in a public maternity hospital in Brazil. Alcohol and tobacco use in the last trimester of pregnancy was assessed using the Alcohol Smoking and Substance Involvement Screening Test (ASSIST). Bivariate analyses and multivariate logistic regressions were performed.
Results: The prevalence of alcohol use was 17.4%, tobacco use 7.9%, and combined use 4.7%. Alcohol use was associated with a history of abortion [Adjusted Odds Ratio (aOR) = 3.18] and higher family income. Tobacco use was associated with a higher number of children (aOR = 12.12 for four or more children). Combined use was associated with the absence of a partner (aOR = 4.11) and a previous history of depression (aOR = 3.63).
Discussion and conclusion: The results highlight the need for implementing strategic programs for the prevention and control of alcohol and tobacco use during pregnancy, considering the identified risk factors. Raising awareness among healthcare professionals and creating targeted public policies are essential for promoting healthy pregnancy and ensuring maternal-child well-being.
References
Bete, T., Asfaw, H., Nigussie, K., Alemu, A., Eyeberu Gebrie, A., Dechasa, D. B., Gemechu, K., Arkew, M., Daniel, B., Gelaye, H., Wolde, A., Kassa, M. A., & Anbesaw, T. (2023). Alcohol consumption and associated factors among pregnant women attending antenatal care at governmental hospitals in Harari regional state, Eastern, Ethiopia. Substance Abuse Treatment, Prevention, and Policy, 18(1). https://doi.org/10.1186/s13011-023-00567-6
Cabral, V. P., Moraes, C. L. D., Bastos, F. I., Abreu, A. M. M., & Domingues, R. M. S. M. (2023). Prevalence of alcohol use during pregnancy, Brazil, 2011-2012. Cadernos de Saúde Pública, 39(8). https://doi.org/10.1590/0102-311xen232422
Carson, G., Cox, L. V., Crane, J., Croteau, P., Graves, L., Kluka, S., Koren, G., Martel, M., Midmer, D., Nulman, I., Poole, N., Senikas, V., & Wood, R. (2010). Alcohol Use and Pregnancy Consensus Clinical Guidelines. Journal of Obstetrics and Gynaecology Canada, 32(8), S1-S2. https://doi.org/10.1016/s1701-2163(16)34633-3
Chagas, C., Paula, T. C. S. D., & Galduróz, J. C. F. (2021). A linguagem e o estigma: os termos utilizados na área de álcool e outras drogas. Epidemiologia e Serviços de Saúde, 30(1). https://doi.org/10.1590/s1679-49742021000100024
Chang, G. (2020). Maternal Substance Use: Consequences, Identification and Interventions. Alcohol Research: Current Reviews, 40(2). https://doi.org/ 10.35946/arcr.v40.2.06
Chapman, M., Bandoli, G., & Goldenberg, S. M. (2024). The association between depression and alcohol use among pregnant adults in the USA. Archives of Women's Mental Health, 27(3), 425-433. https://doi.org/10.1007/s00737-023-01417-x
Crisóstomo, B. dos S., Nascimento, A. S. do, Oliveira, R. A. de, Balsells, M. M. D., Ribeiro, S. G., Gadelha, I. P., & Aquino, P. de S. (2022). Social determinants of health and psychoactive drug use in pregnancy. Acta Paulista de Enfermagem, 35, eAPE0340345. https://doi.org/10.37689/acta-ape/2022AO03403459
Dias, L. E., Oliveira, M. L. F. D., Fernandes, C. A. M., Bernardy, C. C. F., Santos, G. A., Guedes, M. R. J., Gavioli, A., & Marangoni, S. R. (2024). Drugs during pregnancy in low-risk prenatal care and associated factors. Acta Paulista de Enfermagem, 37. https://doi.org/10.37689/acta-ape/2024ao00026222
Gherardi-Donato, E. C. D. S., Díaz-Serrano, K. V., Barbosa, M. R., Fernandes, M. N. D. F., Gonçalves-Ferri, W. A., Camargo Júnior, E. B., & Reisdorfer, E. (2023). The Impact of an Online Mindfulness-Based Practice Program on the Mental Health of Brazilian Nurses during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health, 20(4), 3666. https://doi.org/10.3390/ijerph20043666
Henrique, I. F. S., De Micheli, D., Lacerda, R. B. D., Lacerda, L. A. D., & Formigoni, M. L. O. D. S. (2004). Validação da versão brasileira do teste de triagem do envolvimento com álcool, cigarro e outras substâncias (ASSIST). Revista da Associação Médica Brasileira, 50(2), 199-206. https://doi.org/10.1590/s0104-42302004000200039
Kar, P., Tomfohr-Madsen, L., Giesbrecht, G., Bagshawe, M., & Lebel, C. (2021). Alcohol and substance use in pregnancy during the COVID-19 pandemic. Drug and Alcohol Dependence, 225, 108760. https://doi.org/10.1016/j.drugalcdep.2021.108760
Koly, K. N., Saba, J., Billah, M. A., McGirr, A., Sarker, T., Haque, M., Mustary, E., Hanifi, S. M. M. A., & Begum, F. (2023). Depressive symptoms and anxiety among women with a history of abortion living in urban slums of Bangladesh. BMC Psychology, 11(1). https://doi.org/10.1186/s40359-023-01224-0
Lange, S., Probst, C., Rehm, J., & Popova, S. (2018). National, regional, and global prevalence of smoking during pregnancy in the general population: a systematic review and meta-analysis. The Lancet Global Health, 6(7), e769-e776. https://doi.org/10.1016/s2214-109x(18)30223-7
Martinelli, J. L., Germano, C. M. R., de Avó, L. R. D. S., Fontanella, B. J. B., & Melo, D. G. (2021). Alcohol Consumption During Pregnancy in Brazil: Elements of an Interpretive Approach. Qualitative Health Research, 31(11), 2123-2134. https://doi.org/10.1177/10497323211023443
Ministério da Saúde. Governo do Brasil (2022). Manual de gestação de alto risco. https://portaldeboaspraticas.iff.fiocruz.br/atencao-mulher/manual-de-gestacao-de-alto-risco-ms-2022/
Minozzi, S., Ambrosi, L., Saulle, R., Uhm, S. S., Terplan, M., Sinclair, J. M., & Agabio, R. (2024). Psychosocial and medication interventions to stop or reduce alcohol consumption during pregnancy. Cochrane Database of Systematic Reviews, 4, CD015042. https://doi.org/10.1002/14651858.cd015042.pub2
Murakami, K., Obara, T., Ishikuro, M., Ueno, F., Noda, A., & Kuriyama, S. (2020). Associations of education and income with alcohol use among Japanese pregnant women. European Journal of Public Health, 30(Supplement_5). https://doi.org/10.1093/eurpub/ckaa166.307
Negrão, M., Rocha, P., Saraiva, M., Barbieri, M., Simões, V., Batista, R., Ferraro, A., & Bettiol, H. (2020). Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort. Brazilian Journal of Medical and Biological Research, 54(1), 10252. https://doi.org/10.1590/1414-431x202010252
Odendaal, H. J., Brink, L. T., Nel, D. G., Carstens, E., De Jager, M., Potter, M., Du Plessis, C., & Groenewald, C. A. (2020). Smoking and drinking habits of women in subsequent pregnancies after specific advice about the dangers of these exposures during pregnancy. South African Medical Journal, 110(11), 1100. https://doi.org/10.7196/samj.2020.v110i11.14667
Pavesi, E., Amorim, M. V. D. S., Boing, A. F., & Wagner, K. J. P. (2023). Influence of alcohol and tobacco consumption on maternal and perinatal outcomes of puerperal women attended at the Brazilian National Health System. Revista Brasileira de Saúde Materno Infantil, 23. https://doi.org/10.1590/1806-9304202300000286-en
Pereira, B., Figueiredo, B., Miguel Pinto, T., & Míguez, M. C. (2022). Tobacco consumption from the 1st trimester of pregnancy to 7 months postpartum: Effects of previous tobacco consumption, and depression and anxiety symptoms. Addictive Behaviors, 124, 107090. https://doi.org/10.1016/j.addbeh.2021.107090
Popova, S., Lange, S., Probst, C., Gmel, G., & Rehm, J. (2017). Estimation of national, regional, and global prevalence of alcohol use during pregnancy and fetal alcohol syndrome: a systematic review and meta-analysis. The Lancet Global Health, 5(3), e290-e299. https://doi.org/10.1016/s2214-109x(17)30021-9
Scott, S., & Sher, J. (2023). Effect of alcohol during pregnancy: a public health issue. The Lancet Public Health, 8(1), e4-e5. https://doi.org/10.1016/s2468-2667(22)00318-8
Tigka, M., Metallinou, D., Tzeli, M., & Lykeridou, K. (2023). Maternal tobacco, alcohol and caffeine consumption during the perinatal period: A prospective cohort study in Greece in the midst of COVID-19 pandemic. Tobacco Induced Diseases, 21(June), 1-12. https://doi.org/10.18332/tid/166109
World Health Organization (2014). Guidelines for the Identification and Management of Substance Use and Substance Use Disorders in Pregnancy. http://www.ncbi.nlm.nih.gov/books/NBK200701/
World Heatlh Organization (2013). WHO recommendations for the prevention and management of tobacco use and second-hand smoke exposure in pregnancy. https://www.who.int/publications/i/item/9789241506076
World Heatlh Organization (2021). Tobacco control to improve child health and development: Thematic brief. https://www.who.int/publications/i/item/ 9789240022218
