Mental Disorders and Nicotine Dependence Among Pregnant Women in the United States

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Abstract
OBJECTIVE: To investigate the association between mental disorders and cigarette use and nicotine dependence among pregnant women in the United States. METHODS: A face-to-face general population survey was conducted on participants in the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions. One thousand five hundred sixteen women reporting a pregnancy in the past year were captured. Primary outcomes were seven Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition–defined mood and anxiety disorders and eight personality disorders, which were measured with the Alcohol Use Disorder and Associated Disabilities Interview Schedule. RESULTS: Among pregnant women, 21.7% reported cigarette use and 12.4% met the criteria for nicotine dependence. Among pregnant women with cigarette use, 45.1% met criteria for at least one mental disorder, and among those with nicotine dependence, 57.5% met criteria for at least one other mental disorder. After adjusting for demographics and comorbidity, nicotine dependence during pregnancy significantly predicted any mental disorder (odds ratio [OR] 3.3, 95% confidence interval [CI] 2.1–5.1), any mood disorder (OR 2.5, 95% CI 1.5–4.0), major depression (OR 2.07, 95% CI 1.3–3.4), dysthymia (OR 6.2, 95% CI 2.9–13.1), and panic disorder (OR 3.1, 95% CI 1.6–6.1) in the past year. No significant associations were found between nondependent cigarette use and mental disorders. CONCLUSION: Our results suggest an association between mental disorders and nicotine dependence among pregnant women in the United States. This association has far-reaching implications for both the mental and physical health of women and potentially for their children. LEVEL OF EVIDENCE: III