In pregnant women, the prevalence of alcohol use and the prevalence of depression both remain high. Studies indicate that either condition alone can lead to adverse birth effects, but the effects of the co-occurrence of these conditions are not clear. The co-occurrence could exacerbate the severity of each condition, make treatment more challenging, impair treatment-seeking and follow-up, interfere with appropriate prenatal care, and lead to a higher rate of adverse birth outcomes. These effects, in turn, could contribute to postpartum alcohol use. In the proposed study, the investigators will use existing data from an observational cohort (n=829) and a randomized clinical trial (n=337) of pregnant women to model the ways in which antenatal alcohol use and depression are linked with adverse birth outcomes and postpartum drinking.
The specific aims are (1) to determine the prevalence of alcohol use, depression, and comorbid alcohol use and depression among women in the study population, (2) to determine the effects of cooccurring alcohol use and depression on adverse birth outcomes, and (3) to determine whether the effects of antenatal alcohol use and depression contribute to postpartum alcohol use. 3 analytic methods will be used: repeated measures analysis of covariance (repeated measures ANCOVA), structural equation modeling (SEM), and generalized estimating equations (GEE). These methods will allow the investigators to ascertain the magnitude of the independent and combined effects of alcohol use and depression on adverse birth outcomes and postpartum drinking. This information may provide clues to whether pregnant women with co-occurring alcohol use and depression should be treated differently than those with either condition alone. Intervention and prevention strategies and collaborative care models can then be developed. The investigators have extensive experience with alcohol screening, studies involving the impact of antenatal alcohol use on child development, and large longitudinal cohort studies. ? ? ?
| Cornelius, Marie D; Day, Nancy L (2009) Developmental consequences of prenatal tobacco exposure. Curr Opin Neurol 22:121-5 |
| Rubio, Doris McGartland; Kraemer, Kevin L; Farrell, Max H et al. (2008) Factors associated with alcohol use, depression, and their co-occurrence during pregnancy. Alcohol Clin Exp Res 32:1543-51 |
