Cited by 182Prenatal Substance Exposure EffectsSubstance Abuse Treatment and OutcomesMaternal Mental Health During Pregnancy and Postpartum

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Perinatal substance use: A prospective evaluation of abstinence and relapse

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Forray, Ariadna, Merry, Brian, Lin, Haiqun, Ruger, Jennifer Prah, Yonkers, Kimberly A.·2015·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2015.02.027PMC PMC4387084

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Abstract

Background Substance use decreases in pregnancy but little prospective data are available on the rates of abstinence and relapse for specific substances. This study compared rates of abstinence in pregnancy and relapse postpartum for nicotine cigarettes, alcohol, marijuana, and cocaine.Methods Data from 152 women drawn from a randomized controlled trial comparing psychological treatments for substance use in pregnancy were analyzed. Self-reports of substance use and urine for toxicology testing throughout pregnancy and 3-months, 12-months and 24-months post-delivery were collected. Multivariate Cox models were used to compare rates of abstinence and relapse across substances.Results In pregnancy, 83% of all women achieved abstinence to at least one substance. The mean (SE) days to abstinence was 145.81 (9.17), 132.01 (6.17), 151.52 (6.24), and 148.91 (7.68) for cigarettes, alcohol, marijuana and cocaine, respectively. Participants were more likely to achieve abstinence from alcohol (HR 7.24; 95% CI 4.47-11.72), marijuana (HR 4.06; 95% CI 1.87-6.22), and cocaine (HR 3.41; 95% CI 2.53-6.51), than cigarettes. Postpartum, 80% of women abstinent in the last month of pregnancy relapsed to at least one substance. The mean days to relapse was 109.67 (26.34), 127.73 (21.29), 138.35 (25.46), and 287.55 (95.85) for cigarettes, alcohol, marijuana and cocaine, respectively. Relapse to cocaine was only 34% (HR 0.34; 95% CI 0.15-0.77) that of cigarettes.Conclusions Pregnancy-related abstinence rates were high for all substances except cigarettes. Postpartum relapse was common, with cocaine using women being less likely to relapse after attaining abstinence compared to women using cigarettes, alcohol or marijuana.

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“or reduce use, 80% will return to pre-pregnancy levels of use within 4.5 months of delivery (Forray et al., 2015).”
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Authors: Forray, A., Merry, B., Lin, H., Ruger, J. P., & Yonkers, K. A.
Affiliations: Yale University (US)
Leonard Davis Institute of Health Economics (US)
Corresponding author: Forray, Ariadna
ORCID: Forray, Ariadna
Lin, Haiqun
Ruger, Jennifer Prah
Yonkers, Kimberly A.
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2015-05
Volume: 150
Pages: 147-155
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2015.02.027
PMC: PMC4387084
OpenAlex: W2055580782
Cited by: 182
References: 46
Citations by year: 2026: 19 · 2025: 26 · 2024: 34 · 2023: 21 · 2022: 17 · 2021: 12 · 2020: 10 · 2019: 16 · 2018: 9 · 2017: 11 · 2016: 5 · 2015: 2
FWCI: 8.95
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
PubMed (publishedVersion)
Europe PMC (PubMed Central) (acceptedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (UL1TR000142)
National Institute on Drug Abuse (R01DA025555, R01DA019135, K12DA000167)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Prenatal Substance Exposure Effects
Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords: perinatal substance use, substance use in pregnancy, abstinence, relapse, postpartum period, nicotine, alcohol, cannabis, cocaine
MeSH terms: Adolescent, Adult, Female, Humans, Pregnancy, Prospective Studies, Recurrence, Smoking, Health Behavior, Substance-Related Disorders, Pregnant People, Young Adult, Self Report

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Perinatal substance use: A prospective evaluation of abstinence and relapse

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