AUSTIN, TEX. – A significant percentage of pregnant women are not accurately reporting their use of alcohol, cigarettes, or illegal drugs to their physicians, Dr. Mary Ellen Lynch said in a poster presented at the annual meeting of the Society for Research on Nicotine and Tobacco.
She and her coinvestigators recruited 347 new mothers from Atlanta-area hospitals, whom they interviewed soon after the women gave birth regarding their drug, alcohol, and tobacco use in the 3 months before conception and during pregnancy. The investigators administered the same interview to the mothers 6 months later and compared the results of the interviews against the women's medical records.
The investigators found discrepancies, with the medical records showing far less tobacco, alcohol, and illegal drug use than the interviews revealed, said Dr. Lynch of Emory University, Atlanta.
For example, the medical records of the 13% of the 132 women who at the first interview reported having smoked in the third trimester did not report this fact, and of the 195 mothers who in the hospital interview said they had smoked before pregnancy, 7% had medical records that did not reflect this. Moreover, at the 6-month interview, some mothers changed their stories. Of the 140 women who had reported smoking before pregnancy in the hospital interview and who were still enrolled in the study, 6% denied it at the 6-month interview.
These trends were similar for alcohol use. In the hospital interview, 158 mothers said that they had drunk alcohol before pregnancy, but 66% of them had no drinking recorded in the medical record. Of the 95 mothers who admitted drinking during pregnancy in the hospital interview, 91% had no alcohol use reported in the medical record.
Use of illegal drugs was surveyed in both interviews but was not reported in the abstracted medical records. However, the interviews showed a trend that was opposite that for tobacco use, in that the women were more likely to report drug use at the 6-month interview than at the hospital interview, Dr. Lynch reported.
For marijuana use, 13% admitted in the hospital interview to having used it at any time and 7% to using it during pregnancy–figures that rose to 66% and 15%, respectively, at 6 months. In a similar fashion, 1.1% initially reported any prior use of cocaine and 0.3% reported use while pregnant, but nearly 13% and 1% reported each, respectively, at the 6-month interview. This pattern was observed for reports of amphetamine and methamphetamine use as well.
“I think people are reluctant to say that they smoke to health care providers, due to the stigma that's involved,” Dr. Lynch said.
This suggests that someone not affiliated with the hospital should ask about these things, rather than a physician or a hospital employee.