Alcohol and substance use in pregnancy during the COVID-19 pandemic

The impact of the COVID-19 pandemic on rates of alcohol and substance use raises significant concerns, as substances may be coping mechanisms for social isolation and/or disruptions to employment and the economy. Pregnant women are currently experiencing unusually high rates of anxiety and depression symptoms and may be especially affected. We analysed results from an ongoing study of pregnant individuals in Canada: Pregnancy during the COVID-19 Pandemic. Participants were asked about current substance during pregnancy, and concerns about the threat of COVID-19 to their baby’s life, decreased quality of prenatal care, and whether they felt more socially isolated, experienced financial difficulties, or lost their job. The percentage of participants reporting use during pregnancy was 6.9% for alcohol, 3.7% for cannabis, 3.5% for tobacco, and 0.2% for illicit drugs. Odds for cannabis use increased by 0.9% for each unit increase in concern about lower quality prenatal care and by 2.1% for each unit increase in financial difficulties. Odds for tobacco use increased by 220.0% for loss of employment. COVID-19 concerns did not significantly predict alcohol use. Comprehensive public health strategies, including access to perinatal, mental health, and financial supports, as well as education around the effects of prenatal exposures and the possible effects of COVID-19 on the mother and baby, are important to facilitate healthy coping mechanisms for mothers, reduce substance use in pregnancy, and mitigate poor perinatal and long-term neurodevelopmental outcomes for babies.