Adolescent childbirth, miscarriage, and abortion: associations with changes in alcohol, marijuana, and cigarette use

Irene Tung, Jordan Beardslee, Dustin Pardini, Tammy Chung, Kate Keenan, Alison E. Hipwell

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
DOIs
StateAccepted/In press - Jan 1 2019

Fingerprint

Spontaneous Abortion
Cannabis
Tobacco Products
Pregnancy Outcome
Alcohols
Parturition
Pregnancy
Pregnancy in Adolescence
Birth Order
Age of Onset

Keywords

  • Adolescence
  • alcohol use
  • pregnancy
  • substance use
  • teenage mothers

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health

Cite this

@article{453062838ef646508edb0465d01e5a71,
title = "Adolescent childbirth, miscarriage, and abortion: associations with changes in alcohol, marijuana, and cigarette use",
abstract = "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.",
keywords = "Adolescence, alcohol use, pregnancy, substance use, teenage mothers",
author = "Irene Tung and Jordan Beardslee and Dustin Pardini and Tammy Chung and Kate Keenan and Hipwell, {Alison E.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/jcpp.13112",
language = "English (US)",
journal = "Journal of Child Psychology and Psychiatry and Allied Disciplines",
issn = "0021-9630",
publisher = "Wiley-Blackwell",

}

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.

PY - 2019/1/1

Y1 - 2019/1/1

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

UR - http://www.scopus.com/inward/record.url?scp=85070817413&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85070817413&partnerID=8YFLogxK

U2 - 10.1111/jcpp.13112

DO - 10.1111/jcpp.13112

M3 - Article

AN - SCOPUS:85070817413

JO - Journal of Child Psychology and Psychiatry and Allied Disciplines

JF - Journal of Child Psychology and Psychiatry and Allied Disciplines

SN - 0021-9630

ER -