American Journal of Obstetrics & Gynecology
Volume 199, Issue 6, Supplement B , Pages S333-S339 , December 2008

The clinical content of preconception care: alcohol, tobacco, and illicit drug exposures

  • R. Louise Floyd, DSN, RN

      Affiliations

    • Centers for Disease Control and Prevention, Atlanta, GA
    • Corresponding Author InformationReprints: R. Louise Floyd RN, DSN, Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Fetal Alcohol Prevention Team, 1825 Century Center, E86, Atlanta, GA 30345
  • ,
  • Brian W. Jack, MD

      Affiliations

    • Boston Medical Center, Boston, MA
  • ,
  • Robert Cefalo, MD, PhD

      Affiliations

    • University of North Carolina School of Medicine, Chapel Hill, NC
  • ,
  • Hani Atrash, MD, MPH

      Affiliations

    • Centers for Disease Control and Prevention, Atlanta, GA
  • ,
  • Jeanne Mahoney, BSN, RN

      Affiliations

    • American College of Obstetrics and Gynecology, Washington, DC
  • ,
  • Anne Herron, PhD

      Affiliations

    • Substance Abuse and Mental Health Services Administration, Rockville, MD
  • ,
  • Corinne Husten, MD, MPH

      Affiliations

    • Partnership for Prevention, Washington, DC
  • ,
  • Robert J. Sokol, MD

      Affiliations

    • Wayne State University School of Medicine, Detroit, MI

Received 17 June 2008 ,Revised 11 September 2008 ,Accepted 18 September 2008.

References 

  1. McGinnis JM, Foege WH. Actual causes of death in the United States. JAMA. 1993;270:2207–2212
  2. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States. [erratum appears in JAMA 2005;293:293-4] JAMA. 2004;291:1238–1245
  3. Thacker SB, Ikeda RM, Gieseker KE, et al. The evidence base for public health: informing policy at the Centers for Disease Control and Prevention. Am J Prev Med. 2005;28:227.e1–227.e27
  4. US Department of Health and Human Services. Healthy people 2010 (With understanding and improving health). Vol 1 2nd ed.. Washington, DC: US Government Printing Office; 2000;November
  5. The health consequences of smoking: a report of the Surgeon General. Atlanta, GA: Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health.
  6. Kramer MS. Determinants of low birth weight: methodological assessment and meta-analysis. Bull World Health Organ. 1987;65:663–737
  7. DiFranza JR, Lew RA. Effect of maternal cigarette smoking on pregnancy complications and sudden infant death syndrome. J Fam Pract. 1995;40:385–394
  8. Honein MA, Rasmussen SA, Reffhuis J, et al. Maternal smoking and environmental tobacco smoke exposure and the risk of orofacial clefts. Epidemiology. 2007;18:226–233
  9. Ruiz P, Strain EC, Langrod JG. The substance abuse handbook. Philadelphia, PA: Lippincott Williams & Wilkins; 2007;
  10. Jack BW, Atrash H, Coonrod DV, Moos MK, Cefalo R, Johnson K. The clinical content of preconception care: an overview. Am J Obstet Gynecol.
  11. Substance Abuse and Mental Health Services Administration. Results from the 2006 national survey on drug use and health: national findings. NSDUH series H-32, Department of Health and Human Services publication No. SMA 07-4923 Rockville, MD: Office of Applied Studies; 2007;
  12. Centers of Disease Control and Prevention. Alcohol consumption among women who are pregnant or who might become pregnant–United States, 2002. MMWR Morb Mortal Wkly Rep. 2004;53:1178–1181
  13. Streissguth AP, O'Malley K. Neuropsychiatric implications and long-term consequences of fetal alcohol spectrum disorders. Semin Clin Neuropsychiatry. 2000;5:177–190
  14. Kesmodel U, Wisbong K, Olsen SF, Henriksen TB, Secher NJ. Moderate alcohol intake in pregnancy and the risk of spontaneous abortion. Alcohol Alcohol. 2002;37:87–92
  15. Windham GC, Von Behren J, Fenster L, Schaefer C, Swan SH. Moderate maternal alcohol consumption and the risk of spontaneous abortion. Epidemiology. 1997;8:509–514
  16. Sokol RJ, Delaney-Black V, Nordstrom B. Fetal alcohol spectrum disorder. JAMA. 2003;290:2996–2999
  17. In:  Stratton K,  Howe C,  Battaglia F editor. Fetal alcohol syndrome: diagnosis, epidemiology, prevention and treatment. Washington, DC: Institute of Medicine National Academy Press; 1996;
  18. Centers of Disease Control and Prevention. Guidelines for identifying and referring persons with fetal alcohol syndrome. MMWR Morb Mortal Wkly Rep. 2005;54:1–15
  19. Mattson SN, Schoenfeld REP. Teratogenic effects of alcohol on brain and behavior. Alcohol Clin Exp Res. 2001;25:185–191
  20. American Academy of Pediatrics; Committee on Substance Abuse and Committee on Children with Disabilities. Fetal alcohol syndrome and alcohol-related neurodevelopmental disorders. Pediatrics. 2000;106:358–361
  21. Hanson JW, Streissguth AP, Smith DW. The effects of moderate alcohol consumption during pregnancy on fetal growth and morphogenesis. J Pediatr. 1978;92:457–460
  22. Maier SE, West JR. Drinking patterns and alcohol-related birth defects. Alcohol Res Health. 2001;25:168–174
  23. Centers of Disease Control and Prevention. Fetal alcohol syndrome–Alaska, Arizona, Colorado, and New York, 1995-1977. MMWR Morb Mortal Wkly Rep. 2002;51:433–435
  24. May PA, Gossage JP. Estimating the prevalence of fetal alcohol syndrome: a summary. Alcohol Res Health. 2001;25:159–167
  25. Lupton C, Burd L, Harwood R. Cost of fetal alcohol spectrum disorders. Am J Med Genet. 2004;127C:3–9
  26. Chang G. Alcohol-screening instruments for pregnant women. Alcohol Res Health. 2001;25:204–209
  27. Floyd RL, O'Connor MJ, Bertrand J, Sokol R. Reducing adverse outcomes from prenatal alcohol exposure: a clinical plan of action. Alcohol Clin Exp Res. 2006;30:1271–1275
  28. Bradley KA, DeBenedetti AF, Volk RJ, Williams EC, Frank D, Kivlahan DR. AUDIT-C as a brief screen for alcohol misuse in primary care. Alcohol Clin Exp Res. 2007;31:1208–1217
  29. Whitlock EP, Polen MR, Green CA, Orleans T, Klein J. Behavioral counseling interventions in primary care to reduce risky/harmful alcohol use by adults: a summary of the evidence for the US Preventive Services Task Force. Ann Intern Med. 2004;140:557–568
  30. US Preventive Services Task Force. Screening and behavioral counseling interventions in primary care to reduce alcohol misuse: recommendation statement. Ann Intern Med. 2004;140:554–556
  31. Bertholet N, Daeppen JB, Wietlisback BA, Fleming M, Burnand B. Reduction of alcohol consumption by brief alcohol intervention in primary care: a systematic review and meta-analysis. Arch Intern Med. 2005;165:986–995
  32. Floyd RL, Sobell M, Velasquez MM, et al. Preventing alcohol-exposed pregnancies: a randomized controlled trial. Am J Prev Med. 2007;32:1–10
  33. Manwell LB, Fleming MF, Mundt MP, Stauffacher EA, Barry KL. Treatment of problem alcohol use in women of childbearing age: results of a brief intervention trial. Alcohol Clin Exp Res. 2000;24:1517–1524
  34. US Department of Health and Human Services. Helping patients who drink too much: a clinician's guide. National Institutes of Health. National Institute on Alcohol Abuse and Alcoholism. NIH Publication No. 07-3769. Rockville, MD. 2005.
  35. American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. Guidelines for perinatal care. 5th ed.. Elk Grove Village, IL: American Academy of Pediatrics; 2002;
  36. Centers of Disease Control and Prevention. Smoking during pregnancy–United States, 1990-2002. MMWR Morb Mortal Wkly Rep. 2004;53:911–915
  37. Colman GJ, Joyce T. Trends in smoking before, during, and after pregnancy in ten states. Am J Prev Med. 2003;24:29–35
  38. US Department of Health and Human Services. Health consequences of tobacco use among women. In: Women and smoking: a report of the surgeon general (177-450). Rockville, MD: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics; 2001;
  39. Salihu HM, Aliyu MH, Pierre-Louis BJ, Alexander GR. Levels of excess infant deaths attributable to maternal smoking during pregnancy in the United States. Matern Child Health J. 2003;7:219–227
  40. Ventura SJ, Hamilton BE, Mathews TJ, Chandra A. Trends and variations in smoking during pregnancy and low birth weight: evidence from the birth certificate, 1990-2000. Pediatrics. 2003;111:1176–1180
  41. Gold DR, Burge HA, Carey V, Milton DK, Platts-Mills T, Weiss ST. Predictors of repeated wheeze in the first year of life: the relative roles of cockroach, birth weight, acute lower respiratory illness, and maternal smoking. Am J Respir Crit Care Med. 1999;160:227–236
  42. US Department of Health and Human Services. The health consequences of involuntary exposure to tobacco smoke: a report of the surgeon general–executive summary. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2006;
  43. Caraballo RS, Giovino GA, Pechacek TF, Mowery PD. Factors associated with discrepancies between self reports on cigarette smoking and measured serum cotinine levels among persons aged 17 years or older. Am J Epidemiol. 2001;153:807–814
  44. Kendrick JS, Zahniser CS, Miller N, et al. Integrating smoking cessation into routine public prenatal care: the smoking cessation in pregnancy project. Am J Public Health. 1995;85:217–222
  45. Webb DA, Boyd NR, Messina D, Windsor RA. The discrepancy between self-reported smoking status and urine cotinine levels among women enrolled in prenatal care at four publicly funded clinical sites. J Public Health Manag Pract. 2003;9:322–325
  46. Mullen PD, Carbonari JP, Tabak ER, Glenday MC. Improving disclosure of smoking by pregnant women. Am J Obstet Gynecol. 1991;165:409–413
  47. Melvin CL, Gaffney CA. Treating nicotine use and dependence of pregnant and parenting smokers: an update. Nicotine Tob Res. 2004;6:S107–S124
  48. Rosenthal AC, Melvin CL, Barker DC. Treatment of tobacco use in preconception care. Matern Child Health J. 2006;10:S147–S148
  49. Fiore MC, Bailey WC, Cohen CJ, et al. A clinical practice guideline for treating tobacco use and dependence. Rockville, MD: US Department of Health and Human Services, Public Health Service; 2000;
  50. Fiore MC, Jaen CR, Baker TB, et al. Treating tobacco use and dependence: update (Clinical practice guideline). Rockville, MD: US Department of Health and Human Services, Public Health Service; May 2008;
  51. Substance Abuse and Mental Health Services Administration. Results from the 2001 national household survey on drug abuse (Summary of national findings). Vol 1 Rockville, MD: Substance Abuse and Mental Health Services Administration; 2002;
  52. ACOG Committee on Ethics. ACOG committee opinion. No. 294 (At-risk drinking and illicit drug use: ethical issues in obstetric and gynecologic practice). Obstet Gynecol. 2004;103:1021–1031
  53. Handler A, Kistin N, Davis F, Ferre C. Cocaine use during pregnancy: perinatal outcomes. Am J Epidemiol. 1992;135:1425–1427
  54. Hadeed AJ, Siegel SR. Maternal cocaine use during pregnancy: effect on the newborn infant. Pediatrics. 1989;84:205–210
  55. Addis A, Moretti M, Syed F, Einarson T, Koren G. Fetal effects of cocaine: an updated meta-analysis. Reprod Toxicol. 2001;15:341–369
  56. Wolfe EL, Davis T, Guydish J, Delucchi KL. Mortality risk associated with perinatal drug and alcohol use in California. J Perinatol. 2005;25:93–100
  57. Kelly R, Russo J, Holt V, et al. Psychiatric and substance use disorders as risk factors for low birth weight and preterm delivery. Obstet Gynecol. 2002;100:297–304
  58. Shiono PH, Klebanoff MA, Nugent RP, et al. The impact of cocaine and marijuana use on low birth weight and preterm birth: a multicenter study. Am J Obstet Gynecol. 1995;172:19–27
  59. Day NL, Richardson GA, Goldschmidt L, et al. Effect of prenatal marijuana exposure on the cognitive development of offspring at age three. Neurotoxicol Teratol. 1994;16:169–175
  60. Goldschmidt L, Richardson GA, Willford J, Day NL. Prenatal marijuana exposure and intelligence test performance at age 6. J Am Acad Child Adolesc Psychiatry. 2008;
  61. Frank DA, Augustyn M, Knight WG, Pell T, Zuckerman B. Growth, development, and behavior in early childhood following prenatal cocaine exposure. JAMA. 2001;285:1613–1625
  62. Lanier D, Ko S. Screening in primary care settings for illicit drug use: assessment of screening instruments–a supplemental evidence update for the US Preventive Services Task Force (Evidence synthesis No. 58, part 2). AHRQ publication No. 08-05108-EF-2 Rockville, MD: Agency for Healthcare Research and Quality; 2008;January
  63. US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Public Health Service, Center for Substance Abuse Treatment. TIP 24: a guide to substance abuse services for primary care clinicians. DHHS publication No. (SMA) 97-3139. Rockville, MD; 1997.
  64. US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Public Health Service, Center for Substance Abuse Treatment. TIP 34: brief interventions and brief therapies for substance abuse. DHHS Publication No. (SMA) 99-3353. Rockville, MD; 1999.
  65. US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, Public Health Service, Center for Substance Abuse Treatment. TIP 35: enhancing motivation for change in substance abuse treatment. DHHS Publication No. (SMA) 99-3354. Rockville, MD; 1999.
  66. Dutra LD, Stathopoulou G, Basden SL, Leyro TM, Powers MB, Otto MW. A meta-analytic review of psychosocial interventions for substance use disorders. Am J Psychiatry. 2008;165:179–187
  67. Kleber HD. Pharmacologic treatments for heroin and cocaine dependence. Am J Addict. 2003;12(Suppl2):S5–S18
  68. Connock M, Juaez-Garcia A, Jowett S, et al. Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technol Assess. 2007;11:1–171
  69. Crits-Christoph P, Siqueland L, Blaine J, et al. Psychosocial treatments for cocaine dependence: National Institute on Drug Abuse collaborative cocaine treatment study. Arch Gen Psychiatry. 1999;56:493–502
  70. Steinberg KL, Roffman RA, Carroll KM, et al. Brief counseling for marijuana dependence: a manual for treating adults. DHHS publication No. (SMA) 05-4022 Rockville, MD: Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration; 2005;
  71. Grant TM, Ernst CC, Streissguth AP. An intervention with high-risk mothers who abuse alcohol and drugs: the Seattle advocacy model. Am J Public Health. 1996;86:1816–1817

 The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

 Conflict of Interest: R. Louise Floyd, DSN, RN; Brian W. Jack, MD; Robert Cefalo, MD, PhD; Hani Atrash, MD, MPH; Jeanne Mahoney, BSN, RN; Anne Herron, PhD; and Robert J. Sokol, MD have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Corinne Husten, MD, MPH is on the board of Directors for the North American Quitline consortium and her family owns some stock in Pfizer, New York, NY; and Johnson and Johnson, New Brunswick, NJ.

PII: S0002-9378(08)01078-8

doi: 10.1016/j.ajog.2008.09.018

American Journal of Obstetrics & Gynecology
Volume 199, Issue 6, Supplement B , Pages S333-S339 , December 2008