Use of tobacco, alcohol, cannabis, and illicit drugs during pregnancy poses significant health risks such as stroke, miscarriage, preterm delivery, low birth weight, and infant neurodevelopmental issues. Despite these dangers, the 2020 National Survey of Drug Use and Health indicates that over 20 percent of pregnant women in the United States report using one or more of these substances. Public health experts emphasize the importance of identifying pregnant women who are most at risk for substance use.
A recent study published in the Journal of Addiction Medicine by researchers from Stony Brook University utilized the PROMOTE Prenatal Screener to identify vulnerabilities for substance use during pregnancy. The study was led by Heidi Preis, MSW, PhD, an Assistant Professor of Research in the Department of Obstetrics, Gynecology and Reproductive Medicine at the Renaissance School of Medicine (RSOM).
“When patients complete the PROMOTE at the start of their prenatal care, their health care providers can identify any psychological, social, or other needs and determine whether a particular patient is likely to use harmful substances during pregnancy,” explains Preis. “This way a patient’s needs can be addressed very early and she can be referred for counseling, treatment, or resources, and this reduces harms for both mother and child.”
The PROMOTE screener was developed with funding from the National Institutes of Health’s National Institute on Drug Abuse (NIDA). It includes 18 core items addressing vulnerabilities such as education level, financial stability, living conditions, partner and family stress and support systems, exposure to violence, and mental health.
In their study involving medical chart reviews from 1,842 patients who completed PROMOTE during their first prenatal visit at a New York State outpatient clinic, researchers found that 188 patients (10.2%) used at least one substance during pregnancy: 132 (7.2%) used tobacco; 50 (2.7%) used cannabis; and 45 (2.4%) consumed alcohol. The findings revealed that limited education correlated with tobacco use; single or unpartnered status with cannabis use; and major stressful life events with alcohol consumption.
The results underscore the effectiveness of a comprehensive screening tool like PROMOTE in understanding pregnant patients' life contexts to identify those vulnerable to substance use. Addressing these needs has significant potential to enhance maternal and child health outcomes.
Co-authors involved in developing PROMOTE include Marci Lobel from both the Department of Psychology and Department of Obstetrics; Cassandra Heiselman from Obstetrics; Ayesha Azeem as RSOM student and first author; along with David Garry from Obstetrics.