Economic contraction and maternal health behaviors during pregnancy in a national sample of US women

Purpose: The purpose of this study was to examine associations between maternal exposure to unexpected economic contraction and health behaviors during pregnancy using methods to account for impacts of economic contraction on selection into pregnancy. Methods: Data on health behaviors among 7074 pregnancies in the National Longitudinal Survey of Youth 1979 were linked to monthly unemployment rates in maternal state of residence. The study examined associations between exposure to unexpected economic contraction (higher than expected state-level unemployment) during each trimester of pregnancy and maternal smoking, alcohol use, and gestational weight gain using generalized linear models. Results: Economic contraction was not associated with maternal smoking or gestational weight gain. Associations between economic contraction and maternal alcohol use differed by maternal race-ethnicity and education. Among black-non-Hispanic women, exposures to economic contraction during the first and second trimester of pregnancy were associated with a 42% (95% confidence interval, 1.08, 1.85) and 33% (95% confidence interval, 1.01, 1.74) increased risk of alcohol use, respectively. Conclusions: Findings suggest that exposure to extreme economic contraction during pregnancy may be associated with increased use of alcohol with differences by maternal race ethnicity and educational attainment. Economic contraction was not associated with other maternal pregnancy behaviors. (C) 2014 Elsevier Inc. All rights reserved.