Factors Related to Perceived Mental and Physical Health Status (SF-36) 10 Years After Cocaine/Polysubstance Use During Pregnancy

Objective: To assess factors associated with physical and mental health 10 years after cocaine/polydrug use during pregnancy. Methods: 311 (159 cocaine use (C), 152 no cocaine use (NC)) primarily Black, low socioeconomic status women were recruited at the time of their infant's birth from an urban, teaching hospital. C use was determined by infant meconium, maternal urine and/or self report. Women were assessed for mental and physical health using the Health Status Questionnaire (SF-36) 10 years after infant birth. Demographics, child placement status, family stress (Family Inventory of Life Events (FILE)), social support (Multi dimensional Scale of Perceived Social Support (MSPSS) and body mass index (BMI) were also assessed. Drug use habits were assessed post-partum and at follow-up. The Diagnostic Interview Schedule (DIC-C) was also completed. Chi-square and t-tests were used to compare groups. Multiple regression analyses was used assess the relative contribution of related variables to mental and physical health status. Results: C women were older at the time of their child's birth (30 (4.99) vs. 26 (4.7), used more alcohol (10.8 (20.3) vs. 1 (3.0) drinks per week), marijuana (1.4 (3.7) vs. 0.7 (3.8) joints per week) and tobacco (10.9 (10.0) vs. 4 (7.4) cigarettes per week) during pregnancy and had less education (11.6 (1.6) years vs. 11.95 (1.4) than NC women. They were also more likely to have lost child custody (40.6% vs. 2.7%). C use women reported higher levels of clinically relevant mental (27.4% vs. 15.1%) and physical health (26.1% vs. 16.5%) compared to NC women, despite the fact that they had on average lower BMI (29.7 (8.3) vs.32.8 (9.0)) compared to NC women. Both groups had a very high percentage of overweight or obese (64% PC and 76% NC) women. C women were more likely to have a lifetime diagnosis of alcohol (39.6% vs. 10.7%), marijuana (24.3% vs.5.7%) and cocaine dependence (66.9% vs. 6.4%) and dual disorders (38.8% vs. 12.9%) than NPC women. Women with C use had higher past 12 months pregnancy or childbearing strain (.37(.77) vs. .20(.5)) and lifetime illness and family care strains (.74(1.3) vs. .48(1.03)) and total stress (4.57(4.48) vs. 3.34(3.39)). Perceived social support was not different for the two groups. Poorer physical health was predicted by prenatal cocaine use (b=-.14, p<.04), higher age (b=-.18, p<.006) and higher body mass index (b=-.31, p<.000), which accounted for 18% of the variance. Twenty-one percent of the variance for lower perceived mental health was predicted by prenatal cocaine use (b=-.16, p<.007), African American race (b=-.14, p<.02), lower social support (b=.24, p<.0001) and total stress during the past 12 months (b=-.16, p<.007). Conclusions: Cocaine use during pregnancy is a significant marker for poor mental and physical health problems after 10 years, even after accounting for obesity, life stress, social support, age and race. Implications of these findings include the need for drug treatment and mental health interventions to reduce risk of serious disability. Failure to address these serious risks include continued suffering, negative effects on child rearing and loss of wages due to infirmity.