{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T17:31:00Z","timestamp":1783359060325,"version":"3.54.6"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,23]],"date-time":"2023-02-23T00:00:00Z","timestamp":1677110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Rural Health"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Purpose<\/jats:title><jats:p>To examine the prevalence, patterns, and correlates of prenatal substance use in the rural Appalachian state of West Virginia (WV).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Population\u2010based cohort (Project WATCH) of all women (N = 34,309) who gave birth between February 2020 and June 2022. A composite substance use variable included 9 categories: \u201cno substance use,\u201d \u201copioids,\u201d \u201ccannabis,\u201d \u201csedatives\/hypnotics,\u201d \u201cstimulants,\u201d \u201copioids and cannabis,\u201d \u201copioids and stimulants,\u201d \u201ccannabis and stimulants,\u201d and \u201copioids, cannabis, and stimulants.\u201d These data were gathered through self\u2010report, medical records, and\/or positive drug screen at labor and delivery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>12.4% of women used one or more substances (opioids, cannabis, stimulants, and sedatives\/hypnotics) during their current pregnancy. The mean age of women using cannabis was 25.34 (SD = 5.31), stimulants was 28.88 (SD = 5.62), and opioid was 30.19 (SD = 4.78). White women were more likely to use opioids (aOR = 2.19, 95% CI 1.46, 3.28) and less likely to use cannabis (aOR = 0.39, 95% CI 0.34, 0.44) compared to minority racial groups. Women with cannabis use were more likely to live in urban versus rural regions (aOR = 1.47, 95% CI 1.33, 1.62). The odds of using any type of substance(s) were significantly higher in women who smoked (aOR range 4.17\u201030.85), had Medicaid (aOR range 1.52\u20107.65), and those receiving inadequate prenatal care (aOR range 1.96\u201016.83).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In this rural Appalachian state, 1 in 8 women used 1 or more substances (opioids, cannabis, stimulants, and\/or sedatives\/hypnotics) during pregnancy and the type of substance used varied by sociodemographic and health\u2010related factors. These factors should inform state\u2010level strategies and initiatives to address the substance use crisis for this population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jrh.12752","type":"journal-article","created":{"date-parts":[[2023,2,24]],"date-time":"2023-02-24T02:28:40Z","timestamp":1677205720000},"page":"804-815","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prenatal substance use in the rural and Appalachian state: Project WATCH study 2020\u20102022"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2987-7650","authenticated-orcid":false,"given":"Amna","family":"Umer","sequence":"first","affiliation":[{"name":"Department of Pediatrics School of Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jana","family":"Garrow","sequence":"additional","affiliation":[{"name":"School of Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makena","family":"Nesbitt","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Molecular Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christa","family":"Lilly","sequence":"additional","affiliation":[{"name":"Department of Biostatistics School of Public Health West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Candice","family":"Lefeber","sequence":"additional","affiliation":[{"name":"Department of Pediatrics School of Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janine","family":"Breyel","sequence":"additional","affiliation":[{"name":"West Virginia Perinatal Partnership, Department of Obstetrics and Gynecology, School of Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Collin","family":"John","sequence":"additional","affiliation":[{"name":"Department of Pediatrics School of Medicine West Virginia University  Morgantown West Virginia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,23]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"SAMHSA.2020 National Survey of Drug Use and Health (NSDUH) Releases.https:\/\/www.samhsa.gov\/data\/release\/2020\u2010national\u2010survey\u2010drug\u2010use\u2010and\u2010health\u2010nsduh\u2010releasesTable 6.20B.2020. Accessed Feb 16 2023."},{"key":"e_1_2_11_3_1","unstructured":"CDC.Polysubstance Use During Pregnancy. Pregnancy. Content Source.Centers for Disease Control and Prevention;2022."},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.90.12.1879"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108588"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/GRF.0000000000000418"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.7326\/L17-0067"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2018.304771"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2020.24991"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003907"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-020-00416-w"},{"key":"e_1_2_11_12_1","unstructured":"USCB.United States Census Bureau.https:\/\/www.census.gov\/quickfacts\/fact\/table\/WV US\/PST045221.2022. Accessed Feb 16 2023."},{"key":"e_1_2_11_13_1","unstructured":"CDC.2020 Drug Overdose Death Rates.https:\/\/www.cdc.gov\/drugoverdose\/deaths\/2020.html.https:\/\/www.cdc.gov\/drugoverdose\/deaths\/index.html.2021. Accessed July 9 2022."},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41390-018-0172-z"},{"key":"e_1_2_11_15_1","unstructured":"USDA.State Fact Sheet. West Virginia.https:\/\/data.ers.usda.gov\/reports.aspx?StateFIPS=54&StateName=West%20Virginia&ID=17854.2021. Accessed Feb 16 2023."},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"issue":"4","key":"e_1_2_11_17_1","first-page":"16","article-title":"WV Birth Score: maternal smoking and drugs of abuse","volume":"106","author":"Mullett MD","year":"2010","journal-title":"W V Med J"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1676631"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1080\/jmf.14.5.329.332"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40352-015-0015-5"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-010-0594-7"},{"key":"e_1_2_11_22_1","unstructured":"USDA.Rural\u2010Urban Continuum Codes.US Department of Agriculture;2020."},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-017-0442-1"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2021.108507"},{"key":"e_1_2_11_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2010.01.007"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000000208"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000827"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003231"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/ADM.0000000000000979"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.5734"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000636"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-019-0215-4"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2021.0155"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jogc.2020.09.017"},{"key":"e_1_2_11_35_1","unstructured":"US Census.Census Bureau QuickFacts: United States [Internet].https:\/\/www.census.gov\/quickfacts\/fact\/table\/WV US\/PST045221.2021. Accessed Feb 16 2023."},{"key":"e_1_2_11_36_1","unstructured":"McCannA.Most and Least Educated States in America.https:\/\/wallethub.com\/edu\/e\/most\u2010educated\u2010states\/31075.2022. Accessed Feb 16 2023."},{"key":"e_1_2_11_37_1","unstructured":"KozhimannilK Henning\u2010SmithC ChantaratT EcklundA JonesC.Non\u2010Medical Opioid Use among Rural and Urban Pregnant Women 2007\u20132014.http:\/\/rhrc.umn.edu\/wp\u2010content\/files_mf\/1534866714UMNpolicybriefnonmedicalopioiduse.pdf.2018. Accessed Feb 16 2023."},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1111\/ppe.12728"},{"key":"e_1_2_11_39_1","unstructured":"Medicaid.Percentage of Population Enrolled in Medicaid or CHIP by State.Centers for Medicare & Medicaid Services;2020."},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181e67094"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajogmf.2020.100137"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-020-02897-4"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.5055\/jom.2020.0590"},{"key":"e_1_2_11_44_1","unstructured":"BRFSS.Map of Current Cigarette Use Among Adult. Current Cigarette Use Among Adults (Behavior Risk Factor Surveillance System).CDC;2019."},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-018-2543-9"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugpo.2014.10.001"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6619a1"},{"key":"e_1_2_11_48_1","unstructured":"Rural Health Information Hub.Results from the 2020 National Survey on Drug Use and Health: Detailed Tables.Mental Health Services Administration (SAMHSA);2020."},{"key":"e_1_2_11_49_1","first-page":"1","article-title":"Short interpregnancy intervals in 2014: differences by maternal demographic characteristics","volume":"240","author":"Thoma ME","year":"2016","journal-title":"NCHS Data Brief"}],"container-title":["The Journal of Rural Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.12752","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jrh.12752","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jrh.12752","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,18]],"date-time":"2023-10-18T04:49:01Z","timestamp":1697604541000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jrh.12752"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,23]]},"references-count":48,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023,9]]}},"alternative-id":["10.1111\/jrh.12752"],"URL":"https:\/\/doi.org\/10.1111\/jrh.12752","archive":["Portico"],"relation":{},"ISSN":["0890-765X","1748-0361"],"issn-type":[{"value":"0890-765X","type":"print"},{"value":"1748-0361","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,23]]},"assertion":[{"value":"2023-02-23","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}