Racial and ethnic correlates of tobacco, alcohol and illicit drug use in a pregnant population

OBJECTIVE: To compare risk factors for tobacco, alcohol and illicit drug use prior to entry into prenatal care and lifetime illicit drug use in a large sample of pregnant women stratified by race/ethnicity. STUDY DESIGN: University clinic-based study comparing risk factors for substance use among 899 white, black and Mexican-American patients, aged 12-41 years. Crude and adjusted risk factors and 95% confidence limits were calculated for substance use prior to the first prenatal visit and lifetime illicit drug use. RESULTS: Prior physical assault placed patients from each racial/ethnic group at risk of using all substances during pregnancy and of lifetime illicit drug use. Other common risk factors included partner's use of alcohol or illicit drugs and previous pregnancy. Risk factors that varied by racial/ethnic group included school enrollment and single marital status. CONCLUSION: Effective interventions will require that practitioners be sensitive to the unique risk factors for substance use among women of different cultural backgrounds.