Scoping Review of the Associations Between Perinatal Substance Use and Perinatal Depression and Anxiety.
Ryoko Pentecost, Gwen Latendresse, Marcela Smid
PMID 33773955WHAT IT FOUND
Perinatal substance use and depression or anxiety often occur together.
Most included studies found that the two were linked, and polysubstance use, especially opioids plus other drugs, was linked with higher reported depression and anxiety. Nurses should assess both.
Key findings
01Most included studies, 12, found a significant association between perinatal substance use and perinatal depression or anxiety.
02Women who used at least one substance during pregnancy were almost five times as likely to report perinatal mental health issues as pregnant women with no substance use history (OR 5.57, 95% CI 4.57 to 6.80).
03Among pregnant women reporting nonmedical opioid or other illegal drug use, opioid polysubstance use was associated with higher lifetime and past-year depression and anxiety than opioid use alone or other illegal drug use.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a scoping review, not a meta-analysis, and the authors summarized studies narratively regardless of study quality. The included studies used different designs and measured substance use and mental health in inconsistent ways, so the findings cannot be pooled or compared directly. Only English articles from 2010 to 2020 were included, so other cultures and languages are not represented. Some studies recruited women already in substance abuse treatment, which may not represent all pregnant or postpartum women. Substance use may be underreported because of stigma, shame, guilt, and fear of legal or child custody consequences. The review did not test whether screening or treating one condition improves the other or newborn outcomes.
Declared interests
The authors declared no conflicts of interest or relevant financial disclosures. The article is listed as NIH extramural research support.
The easy way to misread this
Do not read these associations as proof that treating depression or anxiety will reduce substance use, or that screening alone improves outcomes. The included studies were observational, and the review did not test interventions.