Prevalence of marijuana use in pregnant women with concurrent opioid use disorder or alcohol use in pregnancy

Abstract Background A quarter of pregnant women use alcohol, 6.5/1000 deliveries are affected by opioid use disorder (OUD), and the prevalence of cannabis use in pregnant women is increasing. However, marijuana co-exposure in polysubstance-using women is not well described. Methods The well-characterized ENRICH-1 cohort (n = 251), which focused on the effects of two primary exposures of interest—opioids and alcohol, was used to (1) estimate the prevalence/frequency of marijuana use in those with OUD and/or alcohol use, and (2) examined correlates of marijuana use. Participants were classified into an OUD group (n = 125), Alcohol group (n = 69), and concurrent OUD and Alcohol (OUD + Alcohol) group (n = 57). Self-report and biomarkers ascertained substance use. Multivariable logistic regression identified correlates of marijuana use. Results The prevalence of any marijuana use in pregnancy was 43.2%, 52.6%, and 46.4% in the OUD, OUD + Alcohol, and Alcohol groups, respectively. Correspondingly, weekly or daily use was reported by 19.4%, 21.0%, and 24.6% of participants. In the OUD and OUD + Alcohol groups, the proportion of women using marijuana was significantly higher in those taking buprenorphine (45.8% and 58.3%, respectively) compared to women using methadone (37.5% and 42.9%, respectively). Mean maternal age was lower in women who used marijuana in all three groups compared to non-marijuana users. Independent correlates of marijuana use (controlling for group, race/ethnicity, education, and smoking) were maternal age (adjusted Odds Ratio (aOR) per 5-year increment 0.61; (95% CI 0.47, 0.79)), and polysubstance use (aOR 2.02; 95% CI 1.11, 3.67). There was a significant interaction between partnership status and group: among women who were not in a partnership, those in the OUD and OUD + Alcohol groups had lower odds of marijuana use relative to the Alcohol group. For women in the Alcohol group, partnered women had lower odds of marijuana use than un-partnered women (aOR 0.12; 95% CI: 0.02, 0.68). Conclusions Results indicate a relatively high prevalence and frequency of marijuana use in pregnant women being treated for OUD and/or women consuming alcohol while pregnant. These results highlight the need for ongoing risk reduction strategies addressing marijuana use for pregnant women receiving OUD treatment and those with alcohol exposure.

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The Spiritual and Ethical Implications of Medication-Assisted Recovery in Pregnancy: Preserving the Dignity and Worth of Mother and Baby

Social Work & Christianity ◽

10.34043/swc.v46i3.82 ◽

2019 ◽

Vol 46 (3) ◽

Cited By ~ 1

Author(s):

Cayce Watson ◽

April Mallory ◽

Amy Crossland

Keyword(s):

Pregnant Women ◽

Work Practice ◽

Social Work Practice ◽

Opioid Use Disorder ◽

Current Evidence ◽

Opioid Use ◽

Community Based Interventions ◽

Medication Assisted Treatment ◽

Ethical Implications ◽

In Pregnancy

Reducing harm, supporting autonomy, and affirming dignity are foundational values in social work practice. Attempts to balance personal beliefs, faith, and ethical responsibilities with client-centered therapies can elicit internal conflicts for practitioners. These challenges are even more evident when working with opioid dependent pregnant women in medication-assisted recovery. Medication-assisted treatment (MAT) is evidence-based and a recommended first-line approach for treating opioid use disorder in pregnancy; however, neonates exposed to opiates, either street drugs or MAT, may develop neonatal abstinence syndrome (NAS). Disagreement among treatment providers, insufficient resources for pregnant clients, and incomplete service delivery compound the stigma surrounding pregnant women living with opioid misuse. This article explores current evidence and best practices for pregnant women with opioid use disorder, the spiritual and ethical dilemmas of social workers supporting a harm reduction approach, and recommendations for individual and community-based interventions that support the dignity and worth of both mother and baby.

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Trajectories of Prenatal Alcohol Consumption in An Australian Population-Based Cohort of Pregnant Women - A Data Driven Approach

10.21203/rs.3.rs-760148/v1 ◽

2021 ◽

Author(s):

Evelyne Muggli ◽

Stephen Hearps ◽

Jane Halliday ◽

Elizabeth J Elliott ◽

Anthony Penington ◽

...

Keyword(s):

Alcohol Consumption ◽

Alcohol Use ◽

Pregnant Women ◽

Child Outcomes ◽

Alcohol Exposure ◽

Accurate Information ◽

Dose Frequency ◽

Maternal Characteristics ◽

Prenatal Alcohol ◽

In Pregnancy

Abstract Accurate information on dose, frequency and timing of maternal alcohol consumption is critically important when investigating fetal risks from prenatal alcohol exposure. Identification of distinct alcohol use behaviours can also assist in developing directed public health interventions to prevent adverse child outcomes, including Fetal Alcohol Spectrum Disorder. We aimed to determine group-based trajectories of time-specific, unit-level, alcohol consumption using data from 1458 pregnant women in the Asking Questions about Alcohol in Pregnancy (AQUA) longitudinal study in Melbourne, Australia. Six alcohol consumption trajectories were identified incorporating four timepoints across gestation. Labels were assigned based on consumption in trimester one and whether alcohol use was continued throughout pregnancy: abstained (33.8%); low discontinued (trimester one) (14.4%); moderate discontinued (11.7%); low sustained (13.0%); moderate sustained (23.5%); and high sustained (3.6%). Median weekly consumption in trimester one ranged from 3 grams (low discontinued) to 184 grams of absolute alcohol (high sustained). Alcohol use after pregnancy recognition decreased dramatically for all sustained drinking trajectories, indicating some awareness of fetal risk. Improved understanding of factors that contribute to alcohol consumption in pregnancy in specific sub-populations is critical when developing prevention strategies. Maternal characteristics associated with different trajectories can inform the strategic development of such initiatives.

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