Journal Article

Drinking and smoking patterns during pregnancy: Development of group-based trajectories in the Safe Passage Study

Odendaal, Hendrik, Mack, Luke, Raffo, Cheri, Carmen, Michael, Broadbelt, Kevin G., Randall, Bradley B., Groenewald, Coen, Angal, Jyoti, Paterson, David S., Willinger, Marian, Swenson, Liz, Goldstein, Richard G., Hankins, Gary, Cotton, Jacob, Harbron, Janetta, Condon, Carmen, Sens, Mary Ann, Young, Rebecca A., Hereld, Dale, Boyd, Theonia, Hoffman, Howard J., Mai, Cindy, Folan, Patti, Isler, Joseph, Berg, Elizabeth, Dempers, Johan, Sullivan, Lisa M., Thai, Tracy, Li, Chuan-Ming, Sullivan, Lisa, Tobacco, Deborah, Schubert, Pawel, Myers, Michael M., Baker, Travis, Hoyme, H Eugene, Burger, Elsie, Myers, Michael, Fifer, William P., Gromer, Jessica, Odendaal, Hein, Haynes, Robin L., Wright, Colleen, Dukes, Kimberly A., Markianos, Kyriacos, Grillo, Elena, Kinney, Hannah C., Nelsen, Laura L., Holm, Ingrid A., Fifer, William, Wadee, Shabbir, Nugent, J David, Roberts, Drucilla, Petersen, Julie M., Folkerth, Rebecca D., Carstens, Erna, Jackson, Margaret, Van Eerden, Peter, Dukes, Kimberly, Toland, Gregory, Steen, Hanno, Shair, Margaret C., Hankins, Gary D.V., Sininger, Yvonne, Burd, Larry, de Jong, Greetje, Geerts, Lut, Tripp,

2017

Overview

Precise identification of drinking and smoking patterns during pregnancy is crucial to better understand the risk to the fetus. The purpose of this manuscript is to describe the methodological approach used to define prenatal drinking and smoking trajectories from a large prospective pregnancy cohort, and to describe maternal characteristics associated with different exposure patterns. In the Safe Passage Study, detailed information regarding quantity, frequency, and timing of exposure was self-reported up to four times during pregnancy and at 1 month post-delivery. Exposure trajectories were developed using data from 11,692 pregnancies (9912 women) where pregnancy outcome was known. Women were from three diverse populations: white (23%) and American Indian (17%) in the Northern Plains, US, and mixed ancestry (59%) in South Africa (other/not specified [1%]). Group-based trajectory modeling was used to identify 5 unique drinking trajectories (1 none/minimal, 2 quitting groups, 2 continuous groups) and 7 smoking trajectories (1 none/minimal, 2 quitting groups, 4 continuous groups). Women with pregnancies assigned to the low- or high-continuous drinking groups were less likely to have completed high school and were more likely to have enrolled in the study in the third trimester, be of mixed ancestry, or be depressed than those assigned to the none/minimal or quit-drinking groups. Results were similar when comparing continuous smokers to none/minimal and quit-smoking groups. Further, women classified as high- or low-continuous drinkers were more likely to smoke at moderate-, high-, and very high-continuous levels, as compared to women classified as non-drinkers and quitters. This is the first study of this size to utilize group-based trajectory modeling to identify unique prenatal drinking and smoking trajectories. These trajectories will be used in future analyses to determine which specific exposure patterns subsequently manifest as poor peri- and postnatal outcomes. •Group-based trajectory modeling identified prenatal drinking and smoking patterns.•Five unique drinking trajectories (1 none/min, 2 quit, 2 continuous) are identified.•Seven unique smoking trajectories (1 none/min, 2 quit, 4 continuous) are identified.•Continuous patterns linked with profiles (e.g., less educated, more depressed) are identified.•Future analyses will link trajectories to peri- and postnatal outcomes.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adult / Alcohol Drinking - adverse effects / Alcohol Drinking - epidemiology / Alcohol use / American Indians / Beverages / Biomarkers / Cigarettes / Drinking / Drinking behavior / Epidemiology / Ethanol / Ethanol - administration & dosage / Ethanol - adverse effects / Exposure patterns / Female / Fetus - drug effects / Fetus - physiology / Fetuses / Gestational Age / Group-based trajectory modeling / Groups / Humans / Indians, North American / Larynx / Maternal characteristics / Menstruation / Postpartum period / Pregnancy / Pregnancy Outcome / Prenatal care / Prenatal exposure / Prospective Studies / Psychiatry / Risk Factors / Secondary schools / Self Report / Smoke / Smoking / Smoking - adverse effects / Smoking - epidemiology / South Africa - epidemiology / Stillbirth / Tobacco / Tobacco Smoking - adverse effects / Ultrasonic imaging / United States - epidemiology / White People / Women / Young Adult