Patterns of substance use during pregnancy are differentially associated with maternal mental health across the perinatal period
- 1McLean Hospital
Abstract
BackgroundSubstance use during pregnancy can substantially increase risk for postpartum depression and anxiety symptoms, which can have lasting effects on family functioning and child development. However, substance use is often conceptualized as a binary exposure, limiting our understanding of whether specific patterns of use are associated with maternal mental health in the perinatal period. Here, we examined longitudinal patterns of prenatal alcohol use and smoking in relation to maternal depressive and anxiety symptoms across pregnancy and the first two years postpartum.
MethodsWe analyzed prospective data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based cohort from the UK. Alcohol and cigarette use were assessed across all three trimesters and modeled as longitudinal patterns (abstained, persistent, intermittent, discontinued). Maternal depressive and anxiety symptoms were measured from the second trimester through 21 months postpartum using the Crown-Crisp Experiential Index.
ResultsPersistent alcohol use was associated with higher depressive and anxiety symptoms and slower symptom declines over time, while women with intermittent or discontinued use had symptom profiles similar to abstainers. By contrast, persistent, intermittent, and quitting smoking patterns were associated with higher symptom levels overall, with persistent smoking additionally associated with steeper declines in symptoms over time.
ConclusionOur findings highlight the importance of considering the persistence and cessation of substance use during pregnancy in the context of maternal mental health, pointing to patterns of persistent substance use as a potential target to inform screening and early intervention for women at higher risk for perinatal psychological distress.
Related
- Distinct Dietary Patterns Are Differentially Associated with Dyslipidemia Among Middle-Aged and Older Adults in Southern China
- The Rainbow After the Storm: Navigating Pregnancy After Perinatal Loss
- Beyond Perinatal Mood: Breadth of Psychiatric Symptoms and Delay Discounting as Correlates of Mothers' Relational Reports from Pregnancy Through Adult Children
- Epidemiology of Cardiovascular Disease in Pregnancy in Japan ― Analysis of a Nationwide Perinatal Database 2014–2023 ―
- Peak Total Bile Acids and Adverse Perinatal Outcomes in Intrahepatic Cholestasis of Pregnancy: A Retrospective Cohort Study with Threshold Analysis
BibTeX
@misc{palmer2026patterns,
title = {{Patterns of substance use during pregnancy are differentially associated with maternal mental health across the perinatal period}},
author = {K. N. Palmer and K. Y. T. Law and S. H. Massey and A. A. Lussier},
howpublished = {medRxiv},
year = {2026},
month = oct,
doi = {10.64898/2026.10.01.26364530},
url = {https://www.medrxiv.org/content/10.64898/2026.10.01.26364530v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Patterns of substance use during pregnancy are differentially associated with maternal mental health across the perinatal period
AU - K. N. Palmer
AU - K. Y. T. Law
AU - S. H. Massey
AU - A. A. Lussier
PY - 2026
DA - 2026/10/01
PB - medRxiv
DO - 10.64898/2026.10.01.26364530
UR - https://www.medrxiv.org/content/10.64898/2026.10.01.26364530v1
AB - BackgroundSubstance use during pregnancy can substantially increase risk for postpartum depression and anxiety symptoms, which can have lasting effects on family functioning and child development. However, substance use is often conceptualized as a binary exposure, limiting our understanding of whether specific patterns of use are associated with maternal mental health in the perinatal period. Here, we examined longitudinal patterns of prenatal alcohol use and smoking in relation to maternal depressive and anxiety symptoms across pregnancy and the first two years postpartum. MethodsWe analyzed prospective data from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based cohort from the UK. Alcohol and cigarette use were assessed across all three trimesters and modeled as longitudinal patterns (abstained, persistent, intermittent, discontinued). Maternal depressive and anxiety symptoms were measured from the second trimester through 21 months postpartum using the Crown-Crisp Experiential Index. ResultsPersistent alcohol use was associated with higher depressive and anxiety symptoms and slower symptom declines over time, while women with intermittent or discontinued use had symptom profiles similar to abstainers. By contrast, persistent, intermittent, and quitting smoking patterns were associated with higher symptom levels overall, with persistent smoking additionally associated with steeper declines in symptoms over time. ConclusionOur findings highlight the importance of considering the persistence and cessation of substance use during pregnancy in the context of maternal mental health, pointing to patterns of persistent substance use as a potential target to inform screening and early intervention for women at higher risk for perinatal psychological distress.
ER -