Effect of in-utero polysubstance exposure on adolescent cardiovascular disease risk: Results from the Maternal Lifestyle Study

Abstract

BackgroundPolysubstance use during pregnancy typically includes use of one or more illicit substances in addition to tobacco and/or alcohol. Rates of polysubstance use during pregnancy range from 5 to 10% and continue to rise. However, to date, there are no studies using longitudinal data exploring cardiovascular disease risk in adolescents exposed to polysubstances in utero. ObjectiveThe objective of this analysis was to discover the possible association between maternal substance use and cardiovascular disease risk (i.e., increased blood pressure) in adolescence. MethodsThe National Institute on Drug Abuse (NIDA)-funded Maternal Lifestyle Study (MLS) cohort was used for this analysis. Briefly, in 1993 MLS enrolled mothers by substance use during pregnancy status (Y/N) at four US locations (Detroit, MI; Miami, FL; Providence, RI; and Memphis, TN) and followed offspring until 2011. Generalized linear modeling assessed cardiovascular disease risk in offspring via systolic blood pressure (mm Hg) at age 16 comparing those prenatally exposed and unexposed to maternal substance use. ResultsThe most prevalent singular substance used during pregnancy in this sample (n = 910) was alcohol (n = 121, 16%), while the most common polysubstance used during pregnancy was a combination of tobacco, alcohol, and cocaine (n = 123, 16%). Those born normal birthweight (≥2500 g) and exposed to tobacco, alcohol, and opioids in utero had 22 mm Hg higher systolic blood pressure at age 16 compared to those not exposed to any substances (β coefficient = 22.44, 95% CI: 10.53–34.35). ConclusionSingularly, tobacco, alcohol, and opioids are among the most used during pregnancy and when used in combination, pose great risk for cardiovascular disease in offspring. Given its recent rise and high prevalence, targeting maternal substance use is critical for cardiovascular disease prevention.