More than 20 percent of pregnant women in the United States report using substances like tobacco, alcohol, cannabis, and illicit drugs, according to the 2020 National Survey of Drug Use and Health. These behaviors pose significant risks during pregnancy, including stroke, miscarriage, preterm delivery, low birth weight, and infant neurodevelopmental problems.
A study by Stony Brook University researchers has identified a tool to address these concerns. Published in the Journal of Addiction Medicine, the research team employed the PROMOTE Prenatal Screener to identify vulnerabilities for substance use among pregnant women. The study was led by Heidi Preis, an assistant professor in the Department of Obstetrics, Gynecology and Reproductive Medicine at the Renaissance School of Medicine.
Preis explained that “when patients complete the PROMOTE at the start of their prenatal care, their health care providers can identify any psychological, social or other needs.” This allows early intervention through counseling or treatment to reduce potential harms for both mother and child.
The PROMOTE tool was developed with funding from the National Institutes of Health’s National Institute on Drug Abuse (NIDA). It includes 18 core items addressing factors such as education level, financial stability, living conditions, partner and family stress and support, exposure to violence, and mental health.
In reviewing medical charts from 1,842 patients who used PROMOTE during their initial prenatal visit at a New York State outpatient clinic, researchers found that 10.2% used at least one substance during pregnancy. Specifically, 7.2% used tobacco; 2.7% used cannabis; and 2.4% consumed alcohol. Those with limited education were more likely to use tobacco; single or unpartnered individuals tended toward cannabis use; while those experiencing major stressful events often turned to alcohol.
Preis emphasized that understanding these vulnerabilities can significantly improve maternal and child health outcomes. The research highlights how a well-structured screening tool can provide insights into a patient's life context and assist healthcare providers in identifying those most vulnerable to substance use.
The study included contributions from Marci Lobel from the Department of Psychology and Department of Obstetrics; Cassandra Heiselman from Obstetrics; Ayesha Azeem from RSOM as first author; and David Garry also from Obstetrics.