COVID-19 Pandemic
COVID-19 and maternal substance use during pregnancy Xiaozhong Wen* Xiaozhong Wen Minseon V. Chung Haeni Lee Nayoung Kwak
Objectives. We examined whether e-cigarette, combustible cigarette, marijuana, and alcohol use among U.S. pregnant women were affected by the COVID-19 pandemic.
Methods. In Phase 8 of the U.S. Pregnancy Risk Assessment Monitoring System, we included mothers who gave birth between June 2016 and December 2021 and had data on e-cigarette (N=141,199), cigarette (N=141,466), marijuana (N=51,532), and/or alcohol (N=51,642) use during pregnancy. Logistic regression was used to fit the pre-COVID trend of each substance use from June to September (Jun-Sep) and October to December (Oct-Dec) during 2016-2019. The expected prevalence during the pandemic (2020-2021) was estimated from models and compared with the observed prevalence.
Results. The observed (Obs) prevalence of e-cigarette use was similar to the expected (Exp) prevalence in Jun-Sep (Obs 1.48% vs. Exp 1.50%) and in Oct-Dec (1.93% vs. 1.56%) in 2020, but significantly higher in Jun-Sep (2.27% vs. 1.63% [95% CI: 1.24-2.13%]) and in Oct-Dec (2.51% vs. 1.69% [1.24-2.30%]) of 2021. The observed prevalence of cigarette use was similar to the expected prevalence in Jun-Sep of 2020 (6.29% vs. 5.47%) but significantly higher in Oct-Dec (6.65% vs. 4.60% [3.61-5.84%]) of 2020, Jun-Sep (5.28% vs. 3.74% [2.65-5.25%]) and Oct-Dec (5.15% vs. 2.94% [1.85-4.65%]) of 2021. The observed and expected prevalence of Marijuana use was similar during the pandemic: 4.81% vs. 4.49% in Jun-Sep of 2020, 4.69% vs. 4.47% in Oct-Dec 2020, 4.69% vs. 4.45% in Jun-Spe 2021, and 3.95% vs. 4.43% in Oct-Dec of 2021. The observed prevalence of alcohol use was similar to the expected prevalence in Jun-Sep of 2020 (11.27% vs. 10.48%), Jun-Sep of 2021 (9.96% vs. 10.02%), and Oct-Dec of 2021 (8.54% vs. 9.80%), but significantly higher in Oct-Dec of 2020 (12.44% vs. 10.25% [9.05-11.58%]).
Conclusion. U.S. pregnant women were more likely to use e-cigarettes, cigarettes, and alcohol during the early stage of the COVID-19 pandemic than expected trends.