Partner History of Problematic Substance Use and Self-Reported Substance Use During Early Pregnancy: Findings from Kaiser Permanente Northern California, 2021-2022.

Objectives: The role of partner substance use as a risk factor for prenatal substance use remains understudied. This study aimed to investigate the association between self-reported partner history of problematic substance use and pregnant persons use of alcohol, cannabis, e-cigarettes, and tobacco during early pregnancy.

Methods: A total of 82,180 pregnant individuals screened for substance use in Kaiser Permanente Northern California at their first prenatal visit (approximately 8-10 weeks gestation) during 2021-2022 were included. Partner substance use and prenatal substance use were determined via a self-administered questionnaire. Cannabis use was additionally determined by urine toxicology. Adjusted odds ratios (aOR) were calculated using binomial and multinomial logistic regression.

Results: Among 82,180 pregnant people, 1,010 (1.2%) reported having a partner with history of problematic substance use. Partner history of problematic substance use was associated with higher adjusted odds of any prenatal substance use (aOR = 1.80; 95%CI:1.56-2.08) and prenatal alcohol (aOR = 1.58; 95%CI:1.33-1.87), cannabis (aOR = 1.89; 95%CI:1.57-2.27), e-cigarette (aOR = 3.38; 95%CI:2.43-4.58), and tobacco use (aOR = 3.66; 95%CI:2.63-4.96). Additionally, frequency analyses showed that a partner history of problematic substance use was associated with higher odds of weekly or daily and monthly or less substance use compared to no use.

Conclusions: Self-reported partner history of problematic substance use was associated with increased odds of prenatal use of alcohol, cannabis, e-cigarettes, and tobacco during early pregnancy. Findings suggest that individuals with a partner with problematic substance use may benefit from targeted prevention prior to pregnancy to reduce substance use during pregnancy.