May 17, 2002

Substance Use among Pregnant

Women During 1999 and 2000

U
se of alcohol or illicit drugs during
In Brief pregnancy has been linked to
adverse birth outcomes, such as low
z Pregnant Hispanic females birthweight, preterm delivery, and fetal
were less likely than alcohol syndrome.1 The National Household
Survey on Drug Abuse (NHSDA) asks female
pregnant white or black respondents aged 15 to 44 about their preg-
females to report “binge” nancy status and duration at the time of the
drinking interview. Respondents were also queried
about their use of alcohol or any illicit drug
z Among adults, pregnant during the past month, as well as the
females were less likely to frequency and quantity of their alcohol use.2
report past month illicit drug All findings presented in this short report are
annual averages based on combined data
use than nonpregnant from the 1999 and 2000 NHSDAs.
females, but rates of use
were similar among pregnant Characteristics of Pregnant
and nonpregnant females Females
aged 15 to 17 Among pregnant females, 64 percent were
white, 15 percent were black, 14 percent
z Past month alcohol use was were Hispanic, 3 percent were Asian, and
more likely during the first less than 1 percent were American Indian/
trimester of pregnancy than Alaska Native. Approximately 60 percent of
during the second or third pregnant females were aged 26 to 44,
another 36 percent were 18 to 25 years old,
trimesters and 4 percent were aged 15 to 17 (Figure 1).

The NHSDA Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration
(SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA.
Additional copies of this report may be downloaded from http://www.samhsa.gov/oas/nhsda.htm. Citation of the source is appreciated. Other
reports from the Office of Applied Studies are also available on-line: http://www.DrugAbuseStatistics.samhsa.gov/.
NHSDA REPORT: SUBSTANCE ABUSE AMONG PREGNANT WOMEN DURING 1999 AND 2000
Figure 1. Percentages of Females Aged 15 to 44, by
Pregnancy Status and Age: 1999 and 2000
100
80
Percent of Females
60.1
60
40
20 35.6
4.2
0
Pregnant
Pregnancy Status
Racial/Ethnic Differences
in Substance Use among
Pregnant Females3
An estimated 12 percent of pregnant
females aged 15 to 44 used alcohol dur-
ing the month prior to the interview,
and 3 percent used an illicit drug dur-
ing this time period.4 Pregnant white,
black, and Hispanic females were less
likely to report any past month alcohol
use than nonpregnant females from
these racial/ethnic groups (10 to 13 per-
cent vs. 36 to 55 percent). Pregnant
Hispanic females were less likely to
report “binge” alcohol use than preg-
nant black or white females (Figure 2).
Pregnant white and Hispanic
females were less likely to report illicit
drug use during the past month than
nonpregnant females from these racial/
ethnic groups (2 to 3 percent vs. 6 to 8
percent). However, rates were similar
among pregnant and nonpregnant
black females (6 to 7 percent). Preg-
nant Hispanic females were less likely
to report past month illicit drug use (2
percent) than pregnant black females
(7 percent), although rates of use among
pregnant white females were not signif-
icantly different from those among
pregnant Hispanic or black females.
Figure 2. Percentages of Pregnant Females Aged 15
to 44 Reporting Past Month “Binge” Alcohol Use,* by
Race/Ethnicity: 1999 and 2000
Percent Reporting Past Month
“Binge” Alcohol Use
66.6
Age Group
26 to 44
18 to 25
15 to 17
23.7
9.7
Nonpregnant
Pregnant Youths at Risk for
Substance Use
Within all age groups, pregnant females
were less likely than nonpregnant
females to report past month alcohol
use or “binge” alcohol use (Table 1).
Among youths aged 15 to 17, the rate
of heavy alcohol use was 2 percent
among pregnant females and over 3
percent among nonpregnant females,
although this difference was not
statistically significant.
Although pregnant females aged 18
to 44 were less than half as likely to re-
port past month illicit drug use as non-
pregnant women from this age group,
rates of use were similar among preg-
nant and nonpregnant females aged 15
to 17 (Figure 3). Furthermore, preg-
nant youths were more likely to report
illicit drug use than pregnant adults.
Substance Use During
Each Trimester
Past research has demonstrated that
the harmful effects of alcohol or illicit
drug use by a pregnant female on a
developing fetus vary depending on the
trimester in which these substances are
used.5 For example, birth defects
May 17, 2002
10
8
6 5.6
4.1
4
2 1.4
0
White Black Hispanic
Race/Ethnicity
related to prenatal alcohol exposure
can occur in the first 3 to 8 weeks of
pregnancy, before a woman may even
know she is pregnant.6 Results from
the 1999 and 2000 NHSDAs indicated
that pregnant females in their first
trimester were more likely to report
alcohol use than females whose preg-
nancies were more advanced (Figure
4). Rates of past month illicit drug use
were over 4 percent among females in
their first trimester, 3 percent among
those in their second trimester, and 2
percent among those in their third
trimester, although these differences
were not statistically significant.
End Notes
1. Center for Substance Abuse Prevention.
(1994). Prevention primer: An encyclopedia of
alcohol, tobacco, and other drug prevention
terms (DHHS Publication No. SMA 94-2060;
also available at http://www.health.org/
govpubs/phd627/toc.htm). Rockville, MD:
Substance Abuse and Mental Health Services
Administration.
2. “Any illicit drug” refers to marijuana/hashish,
cocaine (including crack), inhalants, hallucino-
gens, heroin, or prescription-type drugs used
nonmedically. Binge alcohol use is defined as
drinking five or more drinks on the same occa-
sion on at least 1 day in the past 30 days. By
“occasion” is meant at the same time or within
a couple of hours of each other. Heavy alcohol
use is defined as drinking five or more drinks
on the same occasion on each of 5 or more
May 17, 2002 NHSDA REPORT: SUBSTANCE ABUSE AMONG PREGNANT WOMEN DURING 1999 AND 2000

Figure 3. Percentages of Females Aged 15 to 44 Figure 4. Percentages of Pregnant Females Aged 15

Reporting Past Month Use of Any Illicit Drug,** by to 44 Reporting Past Month Alcohol or Illicit Drug
Pregnancy Status and Age: 1999 and 2000 Use, by Trimester: 1999 and 2000

25 25 Trimester
Percent Reporting Past Month Use of

23.3

Percent Reporting Past Month Use

Pregnant
First
Nonpregnant
20 20 Second
Third
Any Illicit Drug

15 15
12.9 13.5 13.0

10 10 8.8 8.8

6.0
5.5 4.9 5 4.4
5 3.0
2.3 1.8 2.3
1.3 0.6 0.3 ***
0
0 Alcohol “Binge” Heavy Any Illicit
15 to 17 18 to 25 26 or Older Alcohol* Alcohol* Drug**
Age Group Type of Use

Table 1. Percentages of Females Aged 15 to 44 Reporting Past Month

days in the past 30 days; all heavy alcohol us-
ers are also “binge” alcohol users. Use of Alcohol, by Pregnancy Status and Age: 1999 and 2000
3. Note that these are conservative estimates of
alcohol and illicit drug use during pregnancy 15 to 17 18 to 25 26 to 44
because they reflect use only in the past
month, not during the entire pregnancy. Past Non- Non- Non-
4. Except for women who have been pregnant for Month Use Pregnant pregnant Pregnant pregnant Pregnant pregnant
less than 1 month, these measures of past
month use indicate use during pregnancy. Alcohol 8.6 26.1 10.1 53.6 14.0 50.2
5. Cornelius, M.D., Goldshmidt, L., Taylor, P.M., & Binge
Day, N.L. (1999). Prenatal alcohol use among Alcohol Use* 7.0 15.4 4.8 29.6 3.1 17.1
teenagers: Effects on neonatal outcomes. Heavy
Alcoholism, Clinical and Experimental Alcohol Use* 2.0 3.3 0.9 7.5 0.5 3.0
Research, 23, 1238-1244.
6. Centers for Disease Control and Prevention,
National Center on Birth Defects and
Developmental Disabilities. (2002, April). Fetal The National Household Survey on Drug Abuse from the 1999 National Household Survey on
alcohol syndrome: Alcohol consumption among (NHSDA) is an annual survey sponsored by the Drug Abuse (NHSDA Series: H-12, DHHS
women. Retrieved April 29, 2002, from http:// Substance Abuse and Mental Health Services Publication No. SMA 00-3466). Rockville, MD:
www.cdc.gov/ncbddd/fas/ Administration (SAMHSA). The 1999 and 2000 Author.
data are based on information obtained from
Substance Abuse and Mental Health Services
Figure and Table Notes 138,470 persons aged 12 or older (about 70,000
Administration. (2001). Summary of findings
each year), including 223 pregnant females
from the 2000 National Household Survey on
Source (Table and all Figures): SAMHSA 1999 and aged 15 to 17, 1,495 pregnant women aged 18
Drug Abuse (NHSDA Series: H-13, DHHS
2000 NHSDAs. to 25, and 669 pregnant women aged 26 to 44.
Publication No. SMA 01-3549). Rockville, MD:
The survey collects data by administering
* “Binge” alcohol use is defined as drinking five or Author.
questionnaires to a representative sample of the
more drinks on the same occasion on at least
population through face-to-face interviews at Also available on-line:
1 day in the past 30 days. By “occasion” is
their place of residence. www.DrugAbuseStatistics.samhsa.gov.
meant at the same time or within a couple
hours of each other. Heavy alcohol use is The NHSDA Report is prepared by the Office of Additional Tables 6.24B, 6.25B, 6.28B, 6.29B,
defined as drinking five or more drinks on the Applied Studies (OAS), SAMHSA, and by RTI in and 6.30B from http://www.samhsa.gov/oas/
same occasion on each of 5 or more days in Research Triangle Park, North Carolina. nhsda/2kdetailedtabs/Vol_1_Part_4/V1P4.htm
the past 30 days; all heavy alcohol users are and
Information and data for this issue are based on
also “binge” alcohol users. Table 7.11A from http://www.samhsa.gov/oas/
the following publication and statistics:
** “Any illicit drug” refers to marijuana/hashish, nhsda/2kdetailedtabs/Vol_1_Part_4/V1P4a.htm.
Substance Abuse and Mental Health Services
cocaine (including crack), inhalants, Additional tables available upon request.
Administration. (2000). Summary of findings
hallucinogens, heroin, or prescription-type
drugs used nonmedically. U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES
Substance Abuse & Mental Health Services Administration
*** Small sample sizes prevented analyses of Office of Applied Studies
heavy alcohol use among pregnant females in www.samhsa.gov
their third trimester.