Pregnant women and mothers using alcohol, tobacco and illegal drugs

Česká verzia

Authors: B. Nechanská ¹; V. Mravčík ^2,3; B. Sopko ³ ; P. Velebil ⁴
Authors place of work: Ústav zdravotnických informací a statistiky ČR, Praha, ředitel Mgr. J. Holub ¹; Klinika adiktologie 1. LF UK a VFN, Praha, přednosta doc. PhDr. M. Miovský, Ph. D. ²; Národní monitorovací středisko pro drogy a drogové závislosti ³; Ústav pro péči o matku a dítě, Praha, ředitel doc. MUDr. J. Feyereisl, CSc. ⁴
Published in the journal: Ceska Gynekol 2012; 77(5): 457-469

Summary

This analysis is focused on use of addictive substances among women hospitalised during delivery or puerperium. Analysed data come from National Registry of Mothers at Childbirth and from National Registry of Newborns, which are managed by the Institute of Health Information and Statistics.

Goal:
To describe the prevalence of addictive substances use among women during gestation and to study its relation to health complications during pregnancy, delivery or puerperium and to health status of foetus and newborns.

Methods and materials:
The reporting to registries is provided in the Report on mother at childbirth and in the Report on newborn. Both registers provide basic socio-demographic information about mother, information about previous pregnancies and abortions, about current pregnancy, course of delivery, birth and neonatal treatment and health of newborn during hospitalization of mother during delivery or puerperium. Use of addictive substances is monitored in the National Registry of Mothers at Childbirth since 2000. Addictive substances are divided to tobacco, alcohol and drugs. Descriptive analysis of data was performed and binary logistic regression was used to test association of substance use with education and marital status (adjusted for age), analysis of variance was used to test association of substance use with selected health complications of pregnancy, delivery or puerperium and with health status of foetus/newborns (adjusted for age, education, marital status and interaction between addictive substances).

Results:
In 2000–2009, 1,008,821 mothers were reported of whom 60,502 women were registered as cigarette smokers, 1,528 used alcohol and 1,836 used other (illegal) drugs. Total of 1,027,200 newborns were reported. The average age of mothers using addictive substances were about 0.5–3 years lower in comparison with nonusers, in average mothers using illegal drugs were the youngest. Mothers using addictive substances were more often unmarried and had lower education than nonusers – almost 2/3 of mothers using addictive substances were unmarried or didn’t live in permanent partnership and more than 82% of mothers-users have lower education (primary or secondary school without a diploma). The association between substance use and induced and spontaneous abortions was observed only in smokers. Serious complications of pregnancy were associated with all monitored addictive substances – in mothers-smokers, a probability of serious complications were about 40 %, in users of illicit drugs about 13 % and in alcohol users about 5 % higher as compared to nonusers. Substance use showed almost no association with problems during childbirth. Alcohol and illegal drugs use increased probability of complications in puerperium. Health status of foetus/newborn was negatively significantly altered mainly in those born to mothers-smokers in almost all observed characteristics. Mother’s alcohol use during pregnancy was associated primarily with the overall health status of foetus immediately after delivery, congenital anomalies, stillbirth or need for treatment of newborn in the theatre. Infants of mothers using addictive substances had higher probability of consequent hospitalization after discharge from the neonatal department, transfer to infant home and death of infant.

Conclusion:
Association between complications during pregnancy, delivery and puerperium and health status of newborns and substance use of mothers during pregnancy was found mainly in cigarette smoking. Alcohol use was found significant in some (but serious) health problems of mothers and newborns. The association between illegal drugs and monitored indicators wasn’t found. Following the results of this work, criteria for reporting of illegal drug use in mothers during pregnancy should be improved.

Key words:
addictive substances, tobacco smoking, alkohol, drug, mother, newborn.

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