TY - JOUR
T1 - Adolescent childbirth, miscarriage, and abortion
T2 - associations with changes in alcohol, marijuana, and cigarette use
AU - Tung, Irene
AU - Beardslee, Jordan
AU - Pardini, Dustin
AU - Chung, Tammy
AU - Keenan, Kate
AU - Hipwell, Alison E.
N1 - Funding Information:
This project was supported by the National Institute of Mental Health (MH056630, MH071790), the Eunice Kennedy Shriver National Institute of Child Health and Human Development (HD067185), the National Institute of Drug Abuse (DA012237), and the National Institute on Alcohol Abuse and Alcoholism (T32AA00745). Ethical Considerations: All research meets ethical guidelines and was approved by the University of Pittsburgh IRB. Written consent and/or assent was obtained from participants, as appropriate. These details appear in the Participants and Procedures section. The authors give special thanks to the families of the Pittsburgh Girls Study for their participation in this research and to our dedicated research team for their continued efforts. The authors have declared that they have no competing or potential conflicts of interest.
Publisher Copyright:
© 2019 Association for Child and Adolescent Mental Health
PY - 2020/1/1
Y1 - 2020/1/1
N2 - Background: Adolescent girls who become pregnant demonstrate greater risk for substance use than same-aged peers. However, it remains unclear how risk relates to normative changes in adolescence. Few studies have examined adolescent substance use changes before, during, and after pregnancy and considered how pregnancy outcomes (childbirth, miscarriage, abortion) differentially influence substance use changes. The present study examined associations between different adolescent pregnancy outcomes and within-person changes in substance use from prepregnancy to postpregnancy. Methods: Participants included 2,450 girls (52% Black) oversampled from low-income urban neighborhoods in Pittsburgh, PA. Participants self-reported pregnancy outcomes and substance use frequency (alcohol, cigarette, marijuana) annually from ages 11–20. Fixed effects regressions focused on first births, first miscarriages, and first abortions occurring from ages 12–19 to test the associations between pregnancy outcomes and within-individual changes in substance use from prepregnancy to postpregnancy. By design, models controlled for all potential time-stable confounds, and models included age and subsequent pregnancies as time-varying covariates. Results: Consistent with prior studies, girls who became pregnant (20%) reported greater early risk for substance use problems than never-pregnant adolescents, including earlier age of onset and more regular marijuana and cigarette use. Childbirth predicted a 26%–51% within-individual reduction in alcohol, marijuana, and cigarette use that remained significantly lower than prepregnancy levels after childbirth. Alcohol and marijuana use decreased (32%–47%) after miscarriage. Abortion was not associated with long-term changes in substance use; however, marijuana and cigarette use gradually increased (44%–46%) in the years leading up to the year of and after abortion, respectively, before returning to prepregnancy levels. Conclusions: Findings highlight important differences in adolescent substance use patterns based on pregnancy outcome. For pregnant adolescents with heightened pre-existing risk for substance use, pregnancy may be a window of opportunity for substance use screening and behavioral intervention.
AB - Background: Adolescent girls who become pregnant demonstrate greater risk for substance use than same-aged peers. However, it remains unclear how risk relates to normative changes in adolescence. Few studies have examined adolescent substance use changes before, during, and after pregnancy and considered how pregnancy outcomes (childbirth, miscarriage, abortion) differentially influence substance use changes. The present study examined associations between different adolescent pregnancy outcomes and within-person changes in substance use from prepregnancy to postpregnancy. Methods: Participants included 2,450 girls (52% Black) oversampled from low-income urban neighborhoods in Pittsburgh, PA. Participants self-reported pregnancy outcomes and substance use frequency (alcohol, cigarette, marijuana) annually from ages 11–20. Fixed effects regressions focused on first births, first miscarriages, and first abortions occurring from ages 12–19 to test the associations between pregnancy outcomes and within-individual changes in substance use from prepregnancy to postpregnancy. By design, models controlled for all potential time-stable confounds, and models included age and subsequent pregnancies as time-varying covariates. Results: Consistent with prior studies, girls who became pregnant (20%) reported greater early risk for substance use problems than never-pregnant adolescents, including earlier age of onset and more regular marijuana and cigarette use. Childbirth predicted a 26%–51% within-individual reduction in alcohol, marijuana, and cigarette use that remained significantly lower than prepregnancy levels after childbirth. Alcohol and marijuana use decreased (32%–47%) after miscarriage. Abortion was not associated with long-term changes in substance use; however, marijuana and cigarette use gradually increased (44%–46%) in the years leading up to the year of and after abortion, respectively, before returning to prepregnancy levels. Conclusions: Findings highlight important differences in adolescent substance use patterns based on pregnancy outcome. For pregnant adolescents with heightened pre-existing risk for substance use, pregnancy may be a window of opportunity for substance use screening and behavioral intervention.
KW - Adolescence
KW - alcohol use
KW - pregnancy
KW - substance use
KW - teenage mothers
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U2 - 10.1111/jcpp.13112
DO - 10.1111/jcpp.13112
M3 - Article
C2 - 31424096
AN - SCOPUS:85070817413
SN - 0021-9630
VL - 61
SP - 104
EP - 111
JO - Journal of Child Psychology and Psychiatry and Allied Disciplines
JF - Journal of Child Psychology and Psychiatry and Allied Disciplines
IS - 1
ER -