Factors associated with alcohol use, depression, and their co-occurrence during pregnancy

Background: Alcohol use and depression each adversely affect birth outcomes, but the impact of their co-occurrence among pregnant women is not well understood. In this study, we examined factors associated with alcohol use, depression, and their co-occurrence during pregnancy. Methods: We analyzed datasets from 2 longitudinal studies conducted nearly 20 years apart in the same outpatient prenatal clinic of an urban women's hospital. Participants included 278 women recruited from 1982 to 1985 for the Maternal Health Practices and Child Development (MHPCD) Study and 209 women recruited from 2000 to 2002 for the Health Outcomes from Prenatal Education (HOPE) Study. Both studies selected women on the basis of their level of alcohol use early in pregnancy. We used multinomial logistic regression models to test multiclassification prediction of alcohol use, depression, and their co-occurrence during pregnancy. Results: In the second and third trimesters, more MHPCD participants than HOPE participants consumed alcohol (67% vs. 20%), experienced depression (85% vs. 34%), and had co-occurring drinking and depression (56% vs. 10%) (p < 0.001 for each). For the MHPCD cohort, smoking predicted alcohol use. There were no significant predictors for depression alone or the co-occurrence. For the HOPE cohort, older age and smoking were predictors of alcohol use, smoking and less education were predictors of depression, and illicit drug use was a predictor of the co-occurrence of alcohol use and depression (p < 0.05 for all relationships). Conclusions: Smoking, older age, lower education, and illicit substance use predicted alcohol and/or probable depression in the second and third trimesters among women who drank in the first trimester.