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Alcohol and drug use and attainment of pregnancy preferences in the southwestern United States: A longitudinal cohort study.

Aims: Addressing design and measurement limitations of prior studies, we examined whether individuals who use alcohol or drugs are less likely to attain their pregnancy preferences over one year. Design: Longitudinal cohort study. Setting: Five southwestern US states. Participants: 2015 individuals...

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Publicado en:Addiction Vol. 120; no. 12; pp. 2527 - 2538
Autores principales: Raifman, Sarah, Roberts, Sarah C. M., Rocca, Corinne H.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Dec2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Dec2025
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      pub: Wiley-Blackwell
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        atl: Alcohol and drug use and attainment of pregnancy preferences in the southwestern United States: A longitudinal cohort study.
      aug:
        au:
          Raifman, Sarah
          Roberts, Sarah C. M.
          Rocca, Corinne H.
        affil: Department of Obstetrics, Gynecology and Reproductive Sciences, Bixby Center for Global Reproductive Health, Advancing New Standards in Reproductive Health (ANSIRH), University of California, San Francisco, School of Medicine, Oakland CA, , USA
      sug:
        subj:
          Attitude to Pregnancy Evaluation
          Persons with Substance Use Disorders Psychosocial Factors
          Alcohol Drinking
          Substance Abuse
          Human
          Southwestern United States
          Pregnancy
          Female
          Adolescence
          Young Adult
          Adult
          Prospective Studies
          Self Report
          Scales
          Psychological Tests
          Cannabis
          Binge Drinking
          Ethnic Groups
          Sociodemographic Factors
          Food Security
          Linear Regression
          Cox Proportional Hazards Model
          Correlation Coefficient
          Confidence Intervals
          Data Analysis Software
          Descriptive Statistics
          Funding Source
          Adolescent: 13-18 years
          Adult: 19-44 years
          Female
      ab: Aims: Addressing design and measurement limitations of prior studies, we examined whether individuals who use alcohol or drugs are less likely to attain their pregnancy preferences over one year. Design: Longitudinal cohort study. Setting: Five southwestern US states. Participants: 2015 individuals ages 15–34 years, capable of pregnancy and non‐pregnant at enrollment from 23 primary and reproductive healthcare facilities (2019–2022). Measurements Data were collected over 13.5 months. Past‐month alcohol, cannabis and other drug use were self‐reported at baseline; prospective pregnancy preferences (prior to pregnancy) were reported quarterly using the Desire to Avoid Pregnancy (DAP) scale (range 0–4, 4 representing higher desire to avoid pregnancy); and incident pregnancy was reported every 6 weeks. We used adjusted mixed effects linear regression models to assess associations between baseline substance use and quarterly DAP scores and Cox proportional hazard models to investigate differential attainment of pregnancy preferences by substance use. Findings At baseline, 40% (795/1968) of participants reported drinking heavily, 16% (308/1968) reported cannabis use and 3% (53/1968) reported other drug use. Heavy (vs. moderate, low or no) drinking and daily cannabis (vs. no use) were associated with higher desire to avoid pregnancy [coefficient = 0.06, 95% confidence interval (95% CI) = 0.01–0.12], P = 0.02; coefficient = 0.14, 95% CI = 0.07–0.22, P < 0.001], but DAP scores did not differ by other drug use (coefficient = 0.13, 95% CI = −0.07 to 0.33, P = 0.21). 282 participants reported incident pregnancies; of these, 46% (130/282), 29% (81/282) and 25% (71/282) were among participants with low, mid‐range and high DAP scores. Among those with high DAP scores, heavy drinking was positively associated with pregnancy [adjusted hazard ratio (aHR) = 1.51, 95% CI = 1.12–2.04, P < 0.01]. Among those with low DAP scores, less than daily versus no cannabis use was associated with pregnancy (aHR = 1.64, 95% CI = 1.13–2.38, P = <0.01). Among those with mid‐range DAP scores, heavy drinking was inversely associated with pregnancy (aHR 0.62, 95% CI = 0.42–0.90, P = 0.01). Other drug use was not associated with pregnancy regardless of DAP score. Conclusions: Heavy drinking, but not cannabis use or other drug use, appears to be associated with elevated pregnancy risk among those who most desire to avoid pregnancy.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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