Pilar M Sanjuan1, Matthew R Pearson2, Carly Poremba2, Hortensia de Los Angeles Amaro3, Lawrence Leeman4. 1. The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, 2650 Yale Boulevard, SE, MSC11-6280, Albuquerque, NM 87106, USA. Electronic address: psanjuan@unm.edu. 2. The University of New Mexico, Center on Alcoholism, Substance Abuse, and Addictions, 2650 Yale Boulevard, SE, MSC11-6280, Albuquerque, NM 87106, USA. 3. Academic Health Center, Herbert Wertheim College of Medicine and Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC2, Miami, FL 33199, USA. 4. Departments of Family and Community Medicine, Obstetrics and Gynecology, University of New Mexico School of Medicine, Albuquerque, NM 87131 USA.
Abstract
BACKGROUND: Substance use disorder (SUD) during pregnancy requires efficacious interventions based on understanding the ebb and flow of risk and protective factors for substance use across time. To assess how these fluctuations are associated temporally with substance use, we used ecological momentary assessment (EMA) to evaluate substance use risk (posttraumatic stress disorder [PTSD] symptoms) and protective (prenatal fetal bonding) factors and their associations with prenatal substance use recorded in real time. METHODS: Pregnant women in SUD treatment (N = 33) with prior trauma exposure received smartphones with an EMA application that queried them thrice daily for 28 days about PTSD symptoms, prenatal bonding, and substance use. RESULTS: Nearly all (N = 32) provided EMA data resulting in 2049 EMA reports (74% compliance). Most participants reported tobacco (72%), alcohol (22%), heroin (41%), and/or other illicit drug (6%-31%) use at least once via EMA. There were moderate associations (average β = 0.23) between greater daily peak PTSD symptoms and substance use with significant effects on illicit drug (β = 0.37), cannabis (β = 0.35) and cigarette use (β = 0.24). Prenatal bonding subscales were modestly associated with substance use, with daily intensity of attachment low point associated with lower heroin (β=-0.34), but higher alcohol (β = 0.24) use. Quality of attachment low point was associated with higher cigarette use (β = 0.06). CONCLUSIONS: Despite the SUD severity and social instability of this sample, we observed high rates of compliance. We found preliminary support suggesting daily PTSD symptoms as a risk factor and less consistent support for prenatal bonding as a protective factor for prenatal substance use.
BACKGROUND:Substance use disorder (SUD) during pregnancy requires efficacious interventions based on understanding the ebb and flow of risk and protective factors for substance use across time. To assess how these fluctuations are associated temporally with substance use, we used ecological momentary assessment (EMA) to evaluate substance use risk (posttraumatic stress disorder [PTSD] symptoms) and protective (prenatal fetal bonding) factors and their associations with prenatal substance use recorded in real time. METHODS: Pregnant women in SUD treatment (N = 33) with prior trauma exposure received smartphones with an EMA application that queried them thrice daily for 28 days about PTSD symptoms, prenatal bonding, and substance use. RESULTS: Nearly all (N = 32) provided EMA data resulting in 2049 EMA reports (74% compliance). Most participants reported tobacco (72%), alcohol (22%), heroin (41%), and/or other illicit drug (6%-31%) use at least once via EMA. There were moderate associations (average β = 0.23) between greater daily peak PTSD symptoms and substance use with significant effects on illicit drug (β = 0.37), cannabis (β = 0.35) and cigarette use (β = 0.24). Prenatal bonding subscales were modestly associated with substance use, with daily intensity of attachment low point associated with lower heroin (β=-0.34), but higher alcohol (β = 0.24) use. Quality of attachment low point was associated with higher cigarette use (β = 0.06). CONCLUSIONS: Despite the SUD severity and social instability of this sample, we observed high rates of compliance. We found preliminary support suggesting daily PTSD symptoms as a risk factor and less consistent support for prenatal bonding as a protective factor for prenatal substance use.
Authors: Mariah Jorda; Bradley J Conant; Anne Sandstrom; Marilyn G Klug; Jyoti Angal; Larry Burd Journal: PLoS One Date: 2021-02-11 Impact factor: 3.240
Authors: Serwaa S Omowale; Tiffany L Gary-Webb; Meredith L Wallace; John M Wallace; Mary E Rauktis; Shaun M Eack; Dara D Mendez Journal: Womens Health (Lond) Date: 2022 Jan-Dec