TY - JOUR
T1 - Maternal Life History- Versus Gestation-Focused Assessment of Prenatal Exposure to Substances of Abuse
AU - Goldstein, Risë B.
AU - Mcavay, Gail J.
AU - Nunes, Edward V.
AU - Weissman, Myrna M.
N1 - Funding Information:
This work was supported by a Young Investigator Award from the National Alliance for Research on Schizophrenia and Depression to Dr. Goldstein, NIDA Grants #K20-DA00154 and #K02-DA00288 to Dr. Nunes, and NIDA Grant #R01-DA07201 to Dr. Weissman. At the time this work was conducted, Dr. Goldstein was also an Aaron Diamond Foundation Postdoctoral Research Fellow at Columbia University. The authors express their appreciation to Sidney Schnoll, M.D., Ph.D., for his comments on an earlier version of this manuscript.
PY - 2000
Y1 - 2000
N2 - Purpose: Substance use by pregnant women is socially stigmatized and may be legally punishable. This societal condemnation raises concerns about underascertainment of prenatal substance exposure of offspring if mothers are asked specifically about their behavior during gestation, versus their life histories without reference to gestational dates. This study assessed agreement between life history-focused and pregnancy-focused assessments of prenatal exposure, and percentages of offspring classified as exposed to a range of substances by each measure, in a sample of school-aged children of methadone-maintained, opioid-dependent parents. Methods: Prenatal exposure was assessed in 172 offspring of 109 mothers by: (a) questionnaires administered to mothers about substance use during pregnancy; and (b) best-estimate (BE) diagnoses of substance use disorders in mothers overlapping with pregnancy dates. BE diagnoses were based on interviews with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version, conducted by trained mental health professionals with mothers about their life histories of psychiatric and substance use disorders, as well as mothers' medical records. Chance-corrected agreement between the measures was examined using κ statistics. Percentages of offspring classified as exposed by each method were compared using McNemar χ2 tests. Results: Except for cigarettes, agreement between the measures was poor. Except for alcohol, diagnosed episodes of substance use disorders in mothers with dates overlapping pregnancy classified more offspring as exposed than mothers' responses to the questionnaire focusing on behavior while pregnant, though the differences in proportions identified as exposed were not always large or statistically significant. Implications: When retrospective ascertainment of prenatal exposure is necessary, asking mothers for their own life histories, without reference to pregnancy dates, may be the preferred approach.
AB - Purpose: Substance use by pregnant women is socially stigmatized and may be legally punishable. This societal condemnation raises concerns about underascertainment of prenatal substance exposure of offspring if mothers are asked specifically about their behavior during gestation, versus their life histories without reference to gestational dates. This study assessed agreement between life history-focused and pregnancy-focused assessments of prenatal exposure, and percentages of offspring classified as exposed to a range of substances by each measure, in a sample of school-aged children of methadone-maintained, opioid-dependent parents. Methods: Prenatal exposure was assessed in 172 offspring of 109 mothers by: (a) questionnaires administered to mothers about substance use during pregnancy; and (b) best-estimate (BE) diagnoses of substance use disorders in mothers overlapping with pregnancy dates. BE diagnoses were based on interviews with the Schedule for Affective Disorders and Schizophrenia-Lifetime Version, conducted by trained mental health professionals with mothers about their life histories of psychiatric and substance use disorders, as well as mothers' medical records. Chance-corrected agreement between the measures was examined using κ statistics. Percentages of offspring classified as exposed by each method were compared using McNemar χ2 tests. Results: Except for cigarettes, agreement between the measures was poor. Except for alcohol, diagnosed episodes of substance use disorders in mothers with dates overlapping pregnancy classified more offspring as exposed than mothers' responses to the questionnaire focusing on behavior while pregnant, though the differences in proportions identified as exposed were not always large or statistically significant. Implications: When retrospective ascertainment of prenatal exposure is necessary, asking mothers for their own life histories, without reference to pregnancy dates, may be the preferred approach.
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U2 - 10.1016/S0899-3289(00)00032-8
DO - 10.1016/S0899-3289(00)00032-8
M3 - Article
C2 - 11147232
AN - SCOPUS:0034564902
SN - 0899-3289
VL - 11
SP - 355
EP - 368
JO - Journal of Substance Abuse
JF - Journal of Substance Abuse
IS - 4
ER -
