Reduced Incidence of Prenatal Exposure to Drugs/Alcohol/Smoking

Definition

Prenatal exposure to drugs, alcohol, or smoking occurs when a fetus is exposed to maternal use of drugs, alcohol, or tobacco at any time during pregnancy.

This indicator, measured at the child level, can be calculated as the number of children born with exposure to drugs, alcohol, or smoking in the last year, divided by the total number of children born in that same year in a state/community.

Exposure to smoking: The annual average rate of reported past-month cigarette use in 2012 and 2013 among women aged 15 to 44 who were pregnant was 15.4%. The rate of reported current cigarette use among women aged 15 to 44 who were pregnant was lower than that among women who were not pregnant (24.0%). This pattern was also evident among women aged 18 to 25 (21.0% versus 26.2% for pregnant and non-pregnant women, respectively) and among women aged 26 to 44 (11.8% versus 25.4%, respectively). Rates of current cigarette use in 2012–2013 among pregnant women aged 15 to 44 were 19.9% in the first trimester, 13.4% in the second trimester, and 12.8% in the third trimester. The annual average rates of reported current cigarette use among women aged 15 to 44 who were not pregnant decreased from 30.7% in 2002–2003 to 24.0% in 2012–2013. However, the prevalence of reported cigarette use among pregnant women in this age range did not change significantly during the same period (18.0% in 2002–2003 and 15.4% in 2012–2013).1

Exposure to drugs: Among pregnant women aged 15 to 44, 5.4% reported they were current illicit drug users, based on data averaged across 2012 and 2013. This was lower than the rate among women in this age group who were not pregnant (11.4%). Among pregnant women aged 15 to 44, the average rate of reported current illicit drug use in 2012–2013 (5.4%) was not significantly different from the rate averaged across 2010–2011 (5.0%). Current illicit drug use in 2012–2013 was lower among pregnant women aged 15 to 44 during the third trimester than during the first and second trimesters (2.4% versus 9.0% and 4.8%). The rate of current illicit drug use in the combined 2012–2013 data was 14.6% among pregnant women aged 15 to 17, 8.6% among women aged 18 to 25, and 3.2% among women aged 26 to 44. These rates were not significantly different from those in the combined 2010–2011 data (20.9% among pregnant women aged 15 to 17, 8.2% among pregnant women aged 18 to 25, and 2.2% among pregnant women aged 26 to 44).2

Exposure to Alcohol: Among pregnant women aged 15 to 44 in 2012–2013, an annual average of 9.4% reported current alcohol use, 2.3% reported binge drinking, and 0.4% reported heavy drinking. These rates were lower than the rates for non-pregnant women in the same age group (55.4%, 24.6%, and 5.3%, respectively). Current alcohol use in 2012–2013 was lower among pregnant women aged 15 to 44 during the second and third trimesters than during the first trimester (5.0% and 4.4% versus 19.0%).3

  • The Center for Disease Control Natality online databases report counts of live births occurring within the United States to U.S. residents and non-residents. Counts can be obtained by state and county and include data on mothers’ medical and tobacco-use risk factors.
  • PeriStats provides estimates of smoking, alcohol, and drug use during pregnancy at the state level for years 2001–2011.
  • The 2016 Health of Women and Children Report provides state percentages of women aged 18–44 who reported they smoked or consumed alcohol during pregnancy.
  • 1. Results from the 2013 National Survey on Drug Use and Health: https://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf
  • 2. Results from the 2013 National Survey on Drug Use and Health: https://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf
  • 3. Results from the 2013 National Survey on Drug Use and Health: https://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf
  • The Center for Disease Control Natality online databases report counts of live births occurring within the United States to U.S. residents and non-residents. Counts can be obtained by state and county and include data on mothers’ medical and tobacco-use risk factors.
  • Estimates are also available at PeriStats, which provides estimates of smoking, alcohol, and drug use during pregnancy in select cities and counties from years 2001–2011.
  • For those communities whose data are not available through these online sources, this information may already be collected by a local organization, such as health care centers. These organizations might be able to share aggregate, community-level data on the number of children who experienced prenatal exposure to drugs, alcohol, or smoking.
  • Alternatively, a community might have access to hospital data on the number of women who reported using tobacco, drugs, or alcohol during their pregnancies.
  • If no data currently exist, it is recommended that the community work with their local hospitals or health care centers to set up a system to collect this information in a way that could be tracked over time.

Research Rationale

Each year, an estimated 15% of infants are affected by prenatal alcohol or illicit drug exposure. Prenatal exposure to alcohol, tobacco, and illicit drugs has the potential to cause a wide spectrum of physical and developmental challenges for these infants. There is also the potential for ongoing challenges in the stability and well-being of infants who have been prenatally exposed, and their families, if substance use disorders are not addressed with appropriate treatment and long-term recovery support.

If a pregnant woman smokes, or even if she is exposed to “second-hand” (environmental) cigarette smoke, the harmful effects of smoking extend to the developing infant in-utero.1 According to the National Institute on Alcohol Abuse and Alcoholism, binge drinking for women (i.e., drinking four or more drinks per occasion, and regular heavy drinking) “puts a fetus at the greatest risk for severe problems.” However, there is not currently a defined safe level of drinking for women who are pregnant. Coordinated services and early intervention for pregnant women with substance use disorders and their infants are critical in preparing families for optimal bonding, health, and well-being.2

  • 1. Murphey, D., Cooper, M., & Forry, N. (2013) The youngest Americans: A statistical portrait of infants and toddlers in the United States. Bethesda, MD: Child Trends. https://www.childtrends.org/wp-content/uploads/2013/11/MCCORMICK-FINAL.pdf
  • 2. https://ncsacw.samhsa.gov/resources/substance-exposed-infants.aspx