Substance Abuse and its Associated Factors among Pregnant Women: A Cross-Sectional Study in the Southeast of Iran

Background: The data on the prevalence of substance abuse in Iranian pregnant women is scarce in the current literature. This study investigated the prevalence of and the factors associated with substance abuse among pregnant women, and compared self-reported use with urine test results. Methods: This cross-sectional study included data for 2000 pregnant women admitted to a tertiary care hospital in the southeast of Iran. Data were collected on socio-demographic characteristics and the patterns of substance use. Multivariate logistic regression analysis was used to identify factors associated with opiate use. A subsample (200 women) was randomly selected to provide urine samples for toxicological screening. Findings: The lifetime prevalence of substance abuse and tobacco smoking was 15% and 31%, respectively. Overall, 3.3% of the participants reported using at least one substance during the previous month. One third of pregnant women reported using substances as a home remedy for treatment of pregnancy related health problems. Overall, 23% of the urine screening tests were positive. The agreement between self-reported substance abuse and the results of the urine tests was poor. Factors associated with opiates use in pregnant women were age at the first pregnancy of less than 20 years, living in rural areas, unwanted pregnancy, lack of healthcare during pregnancy, and having a spouse and/or first-degree family member with substance abuse. Conclusion: This study showed a high prevalence of substance abuse among the studied women. Thus, a multidisciplinary approach to provide preventive educational programs during pregnancy, and interviews and urinary screening of all pregnant women is recommended.