Analysis of Predictors of Smoking and Alcohol Abuse Among Pregnant Women

Relevance. Smoking and alcohol consumption are widely prevalent among pregnant women and negatively impact both pregnancy progression and outcomes. Compared with demographic and psychosocial characteristics, the onset of pregnancy is the strongest predictor of cessation of nicotine products and alcoholic beverages for most women; however, some women continue to use them.

Intention. The aim is to study the predictors affecting smoking and alcohol abuse among pregnant women by conducting correlation and factor analysis.

Methodology. The study included 204 pregnant women who were patients at the perinatal centre in the Nizhny Novgorod region. Psychometric methods were used: the Kessler Psychological Distress Scale K-10; the Impact of Event Scale IES-R; the AUDIT-C screening test; the ASSIST screening test; and the TLFB method for retrospective assessment of daily use of psychoactive substances. Data analysis was performed using multivariate factor analysis in groups of pregnant women with different risk levels for smoking and alcohol consumption (factorisation by principal component method, rotation method – Varimax).

Results. Correlation analysis identified several associations between nicotine and alcohol use and socio-demographic, psycho-emotional, and clinical-psychological risk factors, which were subsequently included in the factor analysis. The results of the factor analysis showed that among non-smoking pregnant women (Group 1), six factors were identified that influence the risk of developing nicotine (tobacco) dependence (total variance explained was 72.9 %): the factor of psychoemotional state; the factor of small social group (family composition and income distribution); the factor of psychosocial predictors of alcohol dependence; the factor of large social group (age and occupational qualification); the factor of marital status; the factor of urbanization. For pregnant smokers (Group 2), four factors were identified (total variance explained was 70.0%): also the factor of psycho-emotional state; the factor of small social group (family composition, income distribution and demographic characteristics); the factor of psychosocial predictors of alcohol dependence; and the factor of social status. Factor analysis in the group of non-drinking women (Group 3) and in the group of women who abuse alcohol (Group 4) identified six risk factors (total variance explained was 72.3 % for women in Group 3 and 80.2 % for women in Group 4). For women in Group 3 the identified factors were: psycho-emotional state factor; small social group risk factor (family composition and income distribution); psychosocial predictors of alcohol dependence risk factor; 

socio-demographic factor; urbanization factor; social status factor. For women in Group 4, the identified factors were: the factor of psycho-emotional state; the risk factor of small social group (family composition); the risk factor of psychosocial predictors of alcohol dependence; the sociodemographic factor; the factor of socio-economic status; the factor of urbanization; and the factor of occupational status.

Conclusion. The conducted factor analysis of smoking and alcohol abuse predictors among pregnant women in the four studied groups demonstrated that psycho-emotional state plays the most significant role in these behaviors. The results emphasize the need to enhance preventive measures for both women who abstain from substance use during pregnancy and those who engage in addictive behaviors, as the combined influence of identified risk factors can both trigger and exacerbate such behaviors.