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Perinatal substance use: A prospective evaluation of abstinence and relapse
Open accessAbstract
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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“Yet, 80% of individuals relapse in the first few months postpartum [13]”
From Written exposure therapy for treatment of perinatal PTSD among women with comorbid PTSD and SUD: A pilot study examining feasibility, acceptability, and preliminary effectiveness (2023) · cites this paper as [13]
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“Studies have found that most individuals (83%) abstain from at least one problematic substance (primarily alcohol, cocaine, and/or marijuana, but not cigarettes) during pregnancy [13].”
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Citations
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ResultRisky drinking and alcohol use patterns in a national sample of women of childbearing age
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BackgroundPostpartum and Alcohol-Related Factors Associated With the Relapse of Risky Drinking
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ResultPostpartum smoking relapse among women who quit during pregnancy: Cross‐sectional study in J apan
Yasuda, T., Ojima, T., Nakamura, M., Nagai, A., Tanaka, T., Kondo, N., Suzuki, K., & Yamagata, Z. (2013) · Journal of obstetrics and gynaecology research · doi:10.1111/jog.12098 · Cited by 26 · cited 2×
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BackgroundResultCorrelates of postpartum alcohol use.
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“There may also be extrinsic factors, such as the involveent of child protective services, which might contribute to the ower rate of relapse (Davis and Yonkers, 2012).”
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“, 2015)? POSTNATAL Relapses What are the factors and predictors for transitioning to another medication a new mother who was stable on MAT and relapses (Forray et al., 2015)?”
BackgroundTreatment for substance use disorders in pregnant women: Motivators and barriers
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Metadata
- 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
- Venue
- Drug and Alcohol Dependence
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 150
- Pages
- 147-155
- ISSN
- 0376-8716 (ISSN-L)
- 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
- 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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