{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T18:08:10Z","timestamp":1790359690726,"version":"4.1.0"},"reference-count":52,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T00:00:00Z","timestamp":1545350400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neonatal-Perinatal Medicine"],"published-print":{"date-parts":[[2019,6,24]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>With limited Canadian research on predictors of drug use during pregnancy, the primary objective was to assess the relative effects of socioeconomic, demographic, and mental health risk factors associated with drug use during pregnancy. Predictors of an Apgar score\u200a&lt;\u200a7 and fetal macrosomia were examined as secondary outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This retrospective cohort study consisted of 25,734 pregnant women from Southwestern Ontario. Data were prospectively obtained from perinatal and neonatal databases at a tertiary hospital in London, Ontario. Using a Geographic Information System, neighborhood-level socioeconomic variables were obtained by mapping maternal postal codes. Separate logistic regressions were computed for all outcome variables.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>The rates of alcohol, tobacco, and cannabis use during pregnancy were 1.9%, 16.2%, and 2.3%, respectively. The mean maternal age was 29.4\u00b15.4 years. Maternal age was inversely associated with alcohol, tobacco and cannabis use, whereas lone-parent household, depression, and anxiety increased the odds of substance use. Depression was the top risk factor of all three substances. Compared to women who were not depressed during pregnancy, women who were depressed were 2.15 times more likely to use alcohol (95% CI: 1.60, 2.90), 1.70 times more likely to smoke tobacco (95% CI: 1.48, 1.95), and 2.56 times more likely to use cannabis (95% CI: 1.95, 3.35). Adverse birth outcomes were also associated with overweight and obesity, gestational diabetes and insulin-dependent diabetes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>Maternal depression is the primary risk factor of drug use during pregnancy. Policy interventions that target at-risk women are important considerations to improve maternal mental health.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3233\/npm-1814","type":"journal-article","created":{"date-parts":[[2018,12,21]],"date-time":"2018-12-21T11:02:34Z","timestamp":1545390154000},"page":"179-187","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":43,"title":["Predictors of drug use during pregnancy: The relative effects of socioeconomic, demographic, and mental health risk factors"],"prefix":"10.1177","volume":"12","author":[{"given":"R.A.","family":"Brown","sequence":"first","affiliation":[{"name":"School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"Dakkak","sequence":"additional","affiliation":[{"name":"School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"Gilliland","sequence":"additional","affiliation":[{"name":"Department of Paediatrics, Western University, London, ON, Canada"},{"name":"Children\u2019s Health Research Institute, London, ON, Canada"},{"name":"Lawson Health Research Institute, London, ON, Canada"},{"name":"Human Environments Analysis Laboratory, Western University, London, ON, Canada"},{"name":"Department of Geography, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.A.","family":"Seabrook","sequence":"additional","affiliation":[{"name":"School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada"},{"name":"Department of Paediatrics, Western University, London, ON, Canada"},{"name":"Children\u2019s Health Research Institute, London, ON, Canada"},{"name":"Lawson Health Research Institute, London, ON, Canada"},{"name":"Human Environments Analysis Laboratory, Western University, London, ON, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,12,21]]},"reference":[{"key":"ref001","doi-asserted-by":"publisher","DOI":"10.1111\/j.1479-828X.2008.00827.x"},{"key":"ref002","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-3931"},{"key":"ref003","doi-asserted-by":"publisher","DOI":"10.1007\/BF03404362"},{"key":"ref004","doi-asserted-by":"publisher","DOI":"10.1080\/10550881003684723"},{"key":"ref005","unstructured":"Public Health Agency of Canada. [Internet]. Canadian Perinatal Health Report. [cited 2017 Aug 6]. Available from: http:\/\/www.publichealth.gc.ca\/cphr\/."},{"key":"ref006","doi-asserted-by":"publisher","DOI":"10.1089\/jwh.2010.2216"},{"key":"ref007","doi-asserted-by":"publisher","DOI":"10.22374\/cjmrp.v15i2.75"},{"key":"ref008","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2013.09.008"},{"key":"ref009","doi-asserted-by":"publisher","DOI":"10.1080\/07315724.2004.10719428"},{"key":"ref010","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001649"},{"issue":"1","key":"ref011","first-page":"1","volume":"65","author":"Curtin SC","year":"2016","journal-title":"Natl Vital Stat Rep"},{"key":"ref012","doi-asserted-by":"publisher","DOI":"10.1007\/s11121-015-0578-3"},{"key":"ref013","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-015-0529-9"},{"key":"ref014","doi-asserted-by":"publisher","DOI":"10.1111\/dar.12027"},{"issue":"584","key":"ref015","first-page":"1","volume":"11","author":"Peadon E","year":"2011","journal-title":"BMC Public Health"},{"key":"ref016","doi-asserted-by":"publisher","DOI":"10.1111\/ajo.12294"},{"key":"ref017","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0084640"},{"key":"ref018","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.13525"},{"key":"ref019","doi-asserted-by":"publisher","DOI":"10.3121\/cmr.4.2.97"},{"key":"ref020","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-014-1592-y"},{"key":"ref021","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0328-2"},{"key":"ref022","doi-asserted-by":"publisher","DOI":"10.1111\/j.1465-3362.2011.00331.x"},{"key":"ref023","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2006.01163.x"},{"key":"ref024","unstructured":"International Alliance for Responsible Drinking. [Internet]. Drinking guidelines for pregnancy and breastfeeding. [cited 2017 Jul 20]. Available from: http:\/\/www.iard.org\/policy-tables\/drinking-guidelines-pregnancy-breastfeeding\/."},{"key":"ref025","unstructured":"U.S. Department of Health & Human Services. [Internet]. One in 10 pregnant women in the United States reports drinking alcohol. Centres for Disease Control and Prevention. [cited 2017 Aug 14]. Available from: https:\/\/www.cdc.gov\/media\/releases\/\/p-pregnant-alcohol.html."},{"key":"ref026","doi-asserted-by":"publisher","DOI":"10.1111\/1552-6909.12734"},{"key":"ref027","doi-asserted-by":"publisher","DOI":"10.3233\/NPM-181741"},{"key":"ref028","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2008.11.006"},{"key":"ref029","doi-asserted-by":"publisher","DOI":"10.1017\/S0021932017000062"},{"issue":"11","key":"ref030","first-page":"e430","volume":"57","author":"Ordean A","year":"2011","journal-title":"Can Fam Physician"},{"key":"ref031","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2017-2465"},{"key":"ref032","unstructured":"Substance Abuse and Mental Health Services Administration. [Internet]. Results from the 2012 National Survey on Drug Use and Health: Summary of national findings. [cited 2017 Aug 6]. U.S. Department of Health and Human Services. Available from: https:\/\/www.samhsa.gov\/data\/sites\/default\/files\/NSDUHresults\/NSDUHresultshtm."},{"key":"ref033","doi-asserted-by":"publisher","DOI":"10.22374\/cjmrp.v16i2.67"},{"key":"ref034","doi-asserted-by":"publisher","DOI":"10.1038\/jp.2015.120"},{"key":"ref035","doi-asserted-by":"crossref","unstructured":"de Dios MA, HagertyCE, HermanDS, et al. J Womens Health. 2010;19(9):1635\u201342.","DOI":"10.1089\/jwh.2010.1973"},{"key":"ref036","doi-asserted-by":"publisher","DOI":"10.1891\/215805312807022950"},{"key":"ref037","doi-asserted-by":"publisher","DOI":"10.1097\/CHI.0b013e3181bfa8ee"},{"key":"ref038","unstructured":"Canadian Centre on Substance Abuse. [Internet]. Clearing the smoke on cannabis: Highlights. Canadian Centre on Substance Abuse. [cited 2017 Apr 4]. Canadian Centre on Substance Abuse. Available from: http:\/\/www.ccsa.ca\/Resource Library\/CCSA-Clearing-the-Smoke-on-Cannabis-Highlights\u2013en.pdf."},{"key":"ref039","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2015-009986"},{"key":"ref040","doi-asserted-by":"publisher","DOI":"10.1002\/pds.2095"},{"key":"ref041","doi-asserted-by":"publisher","DOI":"10.1038\/pr.2011.25"},{"key":"ref042","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.050"},{"key":"ref043","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2008.05.010"},{"key":"ref044","doi-asserted-by":"publisher","DOI":"10.4278\/ajhp.141215-QUAL-625"},{"key":"ref045","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2015.05.025"},{"key":"ref046","doi-asserted-by":"publisher","DOI":"10.1016\/j.sste.2012.02.006"},{"key":"ref047","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001343"},{"key":"ref048","unstructured":"Better Outcomes Registry & Network (BORN). [Internet]. Ontario Annual Report -and -[cited 2017 Dec 17]. The BORN Information System. Available from: http:\/\/www.bornontario.ca\/en\/about-born\/governance\/annual-reports\/\u2013annual-report\/facts-from-ontario\/#pregnancy."},{"key":"ref049","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-008-0355-z"},{"key":"ref050","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2017.09.036"},{"key":"ref051","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(15)30479-5"},{"issue":"1","key":"ref052","first-page":"115","volume":"102","author":"\u00d8rskou J","year":"2003","journal-title":"Obstet Gynecol"}],"container-title":["Journal of Neonatal-Perinatal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/NPM-1814","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.3233\/NPM-1814","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.3233\/NPM-1814","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T05:37:10Z","timestamp":1777613830000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.3233\/NPM-1814"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,21]]},"references-count":52,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2019,6,24]]}},"alternative-id":["10.3233\/NPM-1814"],"URL":"https:\/\/doi.org\/10.3233\/npm-1814","relation":{},"ISSN":["1934-5798","1878-4429"],"issn-type":[{"value":"1934-5798","type":"print"},{"value":"1878-4429","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12,21]]}}}