Prenatal exposure to alcohol, tobacco, or illicit drugs can raise the risk for premature birth, cause fetal alcohol syndrome, and result in many other developmental problems and birth defects. Yet despite our growing awareness of the dangers associated with these substances, many women continue their substance use during pregnancy. Many studies have investigated ways of helping pregnant women quit, but few have examined these same detrimental behaviors in men soon to become fathers. A new study from the University of Washington, however, indicates that pregnancy may be an important time for physicians to help both parents quit substance use.
The study, which appears in this month's issue of the journal Birth: Issues in Perinatal Care, included 412 men and 396 women who were involved in the Seattle Social Development Project, a longitudinal study that followed Seattle children into young adulthood. At age 24, the subjects were interviewed about their substance use during the previous three years, providing the years and months in which they smoked cigarettes, smoked marijuana, or engaged in binge drinking (defined by the authors as 5 or more drinks over the course of 2 hours). They were also questioned about any life changes they might have experienced in that time, including the death of loved ones, a marriage, or a birth.
During the three year period, 131 women had a total of 157 children, while 77 men reported a total of 87 births. Although, women's substance use declined overall during pregnancy, many continued or only reduced their usage. Among those who smoked cigarettes before becoming pregnant, 73% smoked at some point during pregnancy, and 38% smoked throughout their pregnancy. Similarly, 33% of women who engaged in binge drinking and 47% of women who smoked marijuana used these substances at some point while pregnant, while 8% of binge-drinkers and 24% of marijuana-users continued their regular substance use despite being pregnant. Among men, however, rates of substance use formed a very different pattern, with only the rate of smoking falling (from 42% to 37%) in response to a partner's pregnancy. About 35% of men engaged in binge drinking regardless of their partner's pregnancy, and the rate of marijuana use among fathers-to-be also held steady at between 25% and 30%.
The study's findings not only indicate that men may be less likely to alter their use of alcohol and illicit substances when faced with a pregnancy, but also that their actions have a large influence on the actions of their partners. Women who had quit or reduced their substance use resumed these behaviors after giving birth, reaching their previous levels of usage within a year or two. The researchers suggest that women are more likely to smoke, drink, or use drugs during pregnancy or resume substance use after a pregnancy if their partners also use these substances. In previous research questioning why inner-city women might resume smoking after quitting during pregnancy, subjects reported being around another smoker and exposure to stress as primary reasons.
The study was limited to some extent by its design, which required that subjects recall their substance use over a three year period. Additionally, because about half of the subjects lived in areas high in crime the results cannot be generalized to the general public, and further research using different populations is necessary. Still, this study demonstrates that pregnancy may be an important opportunity for physicians to help both a pregnant woman and her partner quit. Many women are motivated by pregnancy to stop smoking, drinking, or using drugs. By following their lead, their partners may boost their chances of quitting for good, which will have a large impact on their own health and the health of their children.
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