Stress and Drug Use from Prepregnancy, During Pregnancy, to Postpartum

Z. Helen Wu, Rong Wu, Elizabeth Brownell, Cheryl Oncken, James Grady

Research output: Contribution to journalArticlepeer-review


Objective: To document changes of stress and illicit drug use among women from 4 months prepregnancy to 6 months postpartum. Study Design: In a longitudinal study of drug use in family planning clinics, 121 women who became pregnant were matched with 202 women who did not become pregnant. Self-reported drug use, Cohen’s Perceived Stress Scale, and open-ended stress questions were examined every 2 months during the study period of time. Results: Among drug-using pregnant women, drug use declined during 2nd and 3rd trimesters and increased immediately within 1 to 2 months postpartum. Levels of perceived stress declined throughout pregnancy up to 2 months postpartum, increased at 3 to 4 months postpartum and then declined at 6 months postpartum. In contrast, among nondrug-using pregnant women, stress remained stable until the 2nd trimester, increased from 3rd trimester to 1–2 months postpartum, then declined continuously to 6 months postpartum. For non-pregnant women, at the matched timeline, there was no clear pattern for changes of drug use and stress. Conclusions: Our study has illustrated a complex time course of changes of both perceived stress and drug use from prepregnancy through 6 months postpartum. For drug-using pregnant women, pregnancy showed protective effect in reduction of both drug use and stress during pregnancy; and during postpartum, drug resumption peaked at 1–2 months while stress peaked at 3–4 months. If we can identify modifiable, pregnancy-related resiliency factors for both stress and drug use, we can begin to extend prevention efforts initiated during pregnancy into the postpartum period.

Original languageEnglish (US)
JournalJournal of Racial and Ethnic Health Disparities
StateAccepted/In press - 2020
Externally publishedYes


  • Drug use
  • Postpartum
  • Pregnancy
  • Prepregnancy
  • Stress

ASJC Scopus subject areas

  • Health(social science)
  • Anthropology
  • Sociology and Political Science
  • Health Policy
  • Public Health, Environmental and Occupational Health

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