Abstract
Introduction: Prenatal substance use is of global concern due to its contributions to adverse maternal and child health outcomes and maternal mortality.1 Substance use disorder (SUD) and other mental health concerns are the leading cause of maternal mortality in the U.S.,2,3 where overall rates of maternal mortality are two to three times higher than other high-income countries.2 Prenatal use of licit and illicit substances contribute to maternal mortality though a range of mechanisms, including overdose, cardiovascular complications, and suicide.4 This study characterized substance use and SUD among a nationally representative sample of pregnant women.
Methods: Pooled data from the 2021 and 2022 National Survey on Drug Use and Health were analyzed using weighted frequencies and Rao-Scott chi-square in SAS 9.4. Pregnant and non-pregnant women ages 18-49 answered questions about demographics, past 30-day substance use, and DSM-5 criteria for SUD.
Results: Pregnant women (n = 1,367) met criteria for SUD related to cannabis (8.7%) and opioids (1.9%) at rates similar to non-pregnant women of childbearing age (n = 39,197, 8.3% and 1.9%, respectively, p >.05). Alcohol-related SUD was more common in non-pregnant women (12.8%) compared to pregnant women (9.4%, p .04). Past 30-day use was lower among pregnant women than non-pregnant women for tobacco, cannabis, cannabidiol (CBD), and alcohol (p < .01, but similar for opioids (p = .87). First-trimester use was high for all substances: tobacco (8.4%), alcohol (24.3%), cannabis (9.3%), CBD (7.5%), and opioids (3.0%). Rates for all substances except opioids (p = .93) decreased significantly across trimesters (p < .01).
Discussion: Pregnant women and women of childbearing age face high rates of SUD and past 30-day substance use. Falling rates across trimesters indicate that interventions to decrease use in pregnancy may be working to some degree, yet opioid use rates were nearly 3-fold higher than those reported in 2020.5 Attention to maternal mental health is needed to achieve goals to reduce preventable maternal mortality.
Notes
References:
1. World Health Organization. (2024). Maternal mortality. https://www.who.int/news-room/fact-sheets/detail/maternal-mortality
2. Han, B., Compton, W. M., Einstein, E. B., Elder, E., & Volkow, N. D. (2024). Pregnancy and postpartum drug overdose deaths in the US before and during the COVID-19 pandemic. JAMA Psychiatry, 81(3), 270–283. DOI: 10.1001/jamapsychiatry.2023.4523
3. Gimbel, L. A., Weingarten, S. J., Smid, M. C., & Hoffman, M. C. (2024). Maternal mental health as a major contributor to maternal mortality. Seminars in Perinatology, 48(6), 151943. DOI: 10.1016/j.semperi.2024.151943
4. Evans, K., Wu, P., Mamas, M. A., Irwin, C., Kang, P., Perlow, J. H., Foley, M., & Gulati, M. (2023). Substance use in pregnancy and its association with cardiovascular events. JACC: Advances, 2(8), 100619. DOI: 10.1016/j.jacadv.2023.100619
5. Substance Abuse and Mental Health Services Administration (US). (2022). 2020 National Survey on Drug Use and Health: Women. U.S. Dept. of Health and Human Services. https://www.samhsa.gov/data/sites/default/files/reports/slides-2020-nsduh/2020NSDUHWomenSlides072522.pdf
Sigma Membership
Epsilon
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Public Community Health, Policy and Advocacy, Substance Use Disorder, Prenatal Substance Use, Maternal and Child Health Outcomes
Recommended Citation
Blair, Lisa M.; Nowak, Alexandra; Lee, Biyyiah A.; Fend, Dennette; and Schilt-Solberg, Marvin Allan, "Characterizing Prenatal Substance Use: A Leading Cause of Maternal Mortality" (2025). International Nursing Research Congress (INRC). 271.
https://www.sigmarepository.org/inrc/2025/presentations_2025/271
Conference Name
36th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Seattle, Washington, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Characterizing Prenatal Substance Use: A Leading Cause of Maternal Mortality
Seattle, Washington, USA
Introduction: Prenatal substance use is of global concern due to its contributions to adverse maternal and child health outcomes and maternal mortality.1 Substance use disorder (SUD) and other mental health concerns are the leading cause of maternal mortality in the U.S.,2,3 where overall rates of maternal mortality are two to three times higher than other high-income countries.2 Prenatal use of licit and illicit substances contribute to maternal mortality though a range of mechanisms, including overdose, cardiovascular complications, and suicide.4 This study characterized substance use and SUD among a nationally representative sample of pregnant women.
Methods: Pooled data from the 2021 and 2022 National Survey on Drug Use and Health were analyzed using weighted frequencies and Rao-Scott chi-square in SAS 9.4. Pregnant and non-pregnant women ages 18-49 answered questions about demographics, past 30-day substance use, and DSM-5 criteria for SUD.
Results: Pregnant women (n = 1,367) met criteria for SUD related to cannabis (8.7%) and opioids (1.9%) at rates similar to non-pregnant women of childbearing age (n = 39,197, 8.3% and 1.9%, respectively, p >.05). Alcohol-related SUD was more common in non-pregnant women (12.8%) compared to pregnant women (9.4%, p .04). Past 30-day use was lower among pregnant women than non-pregnant women for tobacco, cannabis, cannabidiol (CBD), and alcohol (p < .01, but similar for opioids (p = .87). First-trimester use was high for all substances: tobacco (8.4%), alcohol (24.3%), cannabis (9.3%), CBD (7.5%), and opioids (3.0%). Rates for all substances except opioids (p = .93) decreased significantly across trimesters (p < .01).
Discussion: Pregnant women and women of childbearing age face high rates of SUD and past 30-day substance use. Falling rates across trimesters indicate that interventions to decrease use in pregnancy may be working to some degree, yet opioid use rates were nearly 3-fold higher than those reported in 2020.5 Attention to maternal mental health is needed to achieve goals to reduce preventable maternal mortality.
Description
This study investigates the leading cause of maternal mortality in the U.S. by examining nationally representative data in pregnant and non-pregnant women of childbearing age. Participants will learn about the phenomenon of prenatal substance use and how it contributes to maternal mortality and adverse health outcomes for women and children.