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Pregnancy has protective effect on drug abuse
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Risk for drug abuse was substantially lower during pregnancy, suggesting a potential protective effect, according to recent findings.
“The causal nature of the association between pregnancy and drug abuse is likely complex. A positive pathway from drug abuse to pregnancy is suggested by evidence for an association between illicit substance use and teen pregnancy. Drug abuse and/or its risk factors likely increase the chances of unplanned and early pregnancy,” Kenneth S. Kendler, MD, of Virginia Institute for Psychiatric and Behavioral Genetics, and colleagues wrote. “However, longitudinal analyses have shown a reduction in use of tobacco, alcohol, cannabis and cocaine during pregnancy in young adult women, and studies of clinical cohorts of pregnant women document a reduction in illicit substance use, suggesting a negative pathway from pregnancy to drug abuse.”
To determine if pregnancy is an intrinsic motivator for drug abuse cessation, researchers conducted a prospective cohort, co-relative, co-spouse and within-person analyses of registration from drug abuse during pregnancy among Swedish women born between 1980 and 1990 who gave birth at age 20 to 35 years (n = 149,512).
Rates of drug abuse were lower during pregnancy (adjusted OR = 0.67; 95% CI, 0.6-0.74).
Negative associations between pregnancy and drug abuse were moderately stronger among cousins (OR = 0.49; 95% CI, 0.39-0.62) and significantly stronger among siblings (OR = 0.35; 95% CI, 0.24-0.51) discordant for pregnancy, compared with population results.
Negative associations between pregnancy and drug abuse were even greater in pregnancy-discordant monozygotic twins (OR = 0.17; 95% CI, 0.1-0.31).
Among individuals, odds for drug abuse while pregnant was similar to that among pregnancy-discordant monozygotic twins (OR = 0.22; 95% CI, 0.19-0.26), compared with an equivalent pre-pregnancy interval.
Mothers had greater risk reduction for drug abuse during pregnancy (OR = 0.4; 95% CI, .034-0.47), compared with cohabiting fathers.
Pregnancy had a greater protective effect among mothers with low parental education and without a cohabiting, actively drug-abusing father.
Within-individual analyses indicated risk for drug abuse was significantly lower in the postpartum period, with an odds ratio of 0.13 (95% CI, 0.11-0.16) for postpartum days 0 to 242, compared with prepregnancy baseline.
“Consistent with previous studies of contingency management, this study suggests that volitional and motivational components can interact with biological vulnerabilities and neurobiological changes to alter the course of drug abuse. Understanding the strong and often effective motivation demonstrated by pregnant women and young mothers to stop their drug abuse may help us improve our contingency management treatment methods,” the researchers concluded. – by Amanda Oldt
Disclosure: The researchers report no relevant financial disclosures.