An epidemiological examination of neonatal opioid withdrawal syndrome and maternal and infant characteristics.

PURPOSE: Analyze maternal and infant characteristics by Neonatal Opioid Withdrawal Syndrome (NOWS) status and examine the association between mothers with Hepatitis C Virus (HCV) and infants diagnosed with NOWS. METHODS: Hospital discharge diagnoses of low-income women in Tennessee were used to identify NOWS cases (n = 1,369) in 2013 and 2014 and randomly selected controls (n = 1,369) were matched on county of residence and birth year. Maternal and infant characteristics were obtained by linking these data to birth certificate data. RESULTS: Of Tennessee's 683 cases of NOWS in 2013 and 686 in 2014, most (69%) occurred in Eastern Tennessee. Mothers of infants with NOWS were more likely to be older, unmarried, and white than mothers of infants without NOWS. Mothers of infants with NOWS also faced greater health risk: more smoking, HCV, herpes simplex diagnosis, and no or less frequent prenatal care (p < .0001). Infants with NOWS were more likely to present with infection, be admitted into the NICU, have lower birth weight, be enrolled in TennCare, but less likely to be breastfed than infants without NOWS (p < .0001). After adjusting for demographic factors and smoking, compared to mothers of infants without NOWS, mothers of infants with NOWS had an alarmingly increased odds of HCV [OR = 12.97 (95% CI 7.42, 22.66)]. CONCLUSIONS: This study emphasizes the complexity of challenges facing families impacted by NOWS, the importance of multifaceted prevention, and the need to conduct HCV testing in NOWS infants.

Beating trauma: Physical activity to promote resilience against substance use.

BACKGROUND: The relationship between adverse childhood experiences (ACEs) and frequent substance use (SU) is not well understood, impeding prevention efforts. METHODS: We assessed the relationship between ACEs and frequent SU and investigated if different modalities of physical activity (PA) moderate this pathway. The analysis included persons enrolled in the National Longitudinal Study of Adolescent to Adult Health who responded to surveys at Waves I (11-20 years), III (18-27 years), and IV (24-33 years). The impacts of cumulative ACEs and PA modalities on daily cigarette smoking, daily cannabis use, and binge drinking ≥ 3 times a week in emerging and early adulthood were assessed through adjusted logistic regression models. RESULTS: Among the sample (N=9451), 29.3%, 12.5%, and 7.8% experienced 1, 2, or 3 or more ACEs, respectively. With exception to binge drinking, cumulative ACEs (3+) were strongly associated with daily cannabis use in Wave III (aOR: 2.5; 95% CI: 1.6-3.6) and Wave IV (aOR: 2.1; 95% CI:1.3-3.3) and daily cigarette smoking in Wave III (aOR: 2.4; 95% CI: 1.9-3.0) and Wave IV (aOR: 2.3; 95% CI: 1.8-2.8). No PA modality moderated the ACEs to SU pathway; however, walking for exercise lowered the odds of current and prospective daily cannabis and cigarette use by 20-40%. Strength training, team sports, and individual sport participation were associated with 20-30% reduced risks of future daily cigarette use. CONCLUSION: The impacts of ACEs exposure on frequent SU persist into emerging and early adulthood. Future research should investigate the potential of PA to improve SU prevention strategies.

Older not wiser: risk of prenatal alcohol use by maternal age.

High levels of alcohol use among pregnant women have been associated with a spectrum of birth defects. Greater maternal age has been related to an increased risk of drinking during pregnancy. Although the context, process, and outcomes of pregnancy and alcohol use vary by maternal age, no studies have examined predictors of prenatal drinking by age. This study addresses this gap by examining potential risk factors associated with prenatal alcohol use (any versus none) by maternal age (<20, 20-25, 26-34, and 35 years or older). Descriptive and logistic regression analyses were completed on survey data from 9,004 pregnant women from the north central U.S. Descriptive statistics revealed teens in general had a higher level or greater occurrence of risk factors previously identified with prenatal drinking compared to older women, yet women of advanced maternal age (35 years or older) were most likely to drink alcohol during pregnancy. Based on the regression by age, 20-25 year old women had the greatest number of significant risk factors associated with prenatal drinking including being employed, white, unmarried, first birth, smoking prenatally, greater levels of depressed mood, and more experiences related to alcohol abuse. The number and patterns of significant predictors of drinking alcohol while pregnant by age encourage greater investigation of other social, contextual factors that might contribute to the risk of prenatal drinking. This is especially salient for women of advanced maternal age, for whom very few significant predictors emerged.

Correlates of prenatal alcohol use.

OBJECTIVE: S: To identify correlates of prenatal alcohol use in a statewide population-based sample. METHODS: A self-reported survey was conducted in 67 prenatal clinics in Minnesota with 4,272 women at their first prenatal visit. Chi-squared and multivariate logistic regression analyses were conducted to identify risk markers associated with any prenatal alcohol use. RESULTS: Nearly 27% of the respondents were calculated as having used alcohol during pregnancy. In multivariable analyses, the following were risk markers for prenatal alcohol use: older age, being unmarried, lower gravidity, greater depressed mood, currently smoking, exposure to intrapersonal violence, a history of not remembering things because of alcohol use, and feelings that the respondent should reduce her drinking. Subsequent analyses revealed that the association of intrapersonal violence with prenatal drinking was mediated by whether the woman reported that she did not remember things while drinking or that the woman felt she should reduce her drinking. CONCLUSIONS: The demographic and behavioral correlates reported here are consistent with previous research. The significance of two alcohol behavioral factors (i.e., not remembering things and feeling that she should reduce her drinking) suggest that the women who drank during pregnancy would likely have substance abuse issues.