A survey of South Dakota women who had babies in 2014 is shattering misconceptions about smoking and alcohol use among American Indian mothers.
During pregnancy, American Indian mothers are less likely to consume alcohol and no more likely to smoke than white mothers in South Dakota, according to South Dakota State University Professor Bonny Specker, director of the Ethel Austin Martin Program in Human Nutrition. “When we adjust statistically for socioeconomic factors, race falls out.”
Through a partnership with the South Dakota Department of Health, Specker and her colleagues collected data on South Dakota mothers through a survey that mirrored the Centers for Disease and Prevention Pregnancy Risk Assessment Monitoring System, known as PRAMS. Mothers completed the survey when their babies were 2 to 6 months old. Data collection was completed by the end of 2015.
Nursing Professor Howard Wey, now retired, and E. A. Martin Program Manager Tianna Beare and Research Assistant Professors Teresa Binkley and Maggie Minett also worked on the project. Data analysis was done in 2015-2017. Results on smoking and alcohol use were published in the July 2018 issue of the American Journal of Preventive Medicine.
“A lot of adverse outcomes or risk behaviors are associated with being poor, undereducated and young,” Specker said. “These women need access to health care, education and economic opportunities.”
Nearly 68 percent of the American Indian mothers who completed the survey come from households that earn less than $10,000 a year, while less than 8 percent of white respondents were in this income category. Nearly 32 percent of the American Indian mothers had more than a high school education, as opposed to more than 76 percent of white respondents. American Indian mothers were also younger and less likely to be married than white mothers.
Breaking alcohol myth
Actual survey numbers showed that more than 75 percent of white mothers consumed alcohol three months before they became pregnant compared to less than 50 percent of the American Indian mothers, Specker reported.
American Indian mothers were significantly less likely to drink before becoming pregnant than white mothers when an adjusted odds ratio was applied, she said. During pregnancy, there were no significant racial differences related to alcohol consumption.
In addition, there were no statistically significant differences between the percentage of American Indian and white mothers who received information on how drinking and smoking can affect their babies and were asked about their consumption habits during prenatal visits, according to Specker.
However, the researchers found that, in general, mothers who were older, from 30 to 44 years old, more educated and higher-income were less likely to receive advice or to be asked about their smoking and drinking habits during their prenatal visits than those who were 25 to 29 years old or those with a high school education. “It was the more educated mothers who drank before pregnancy and the older mothers who drank during pregnancy,” Specker pointed out.
“Poverty explains more about smoking during pregnancy than race,” Specker said. When the odds were adjusted based on socioeconomic factors, there were no racial differences related to smoking before or during pregnancy. About half the mothers who smoked before they were pregnant did so during the last three months of the pregnancy.
In addition, Specker pointed out, “The American Indian mothers who smoked before becoming pregnant smoked fewer cigarettes than white mothers who did so.” Nearly 87 percent of the American Indian respondents who smoked before pregnancy consumed less than six cigarettes a day compared to 70 percent of the white mothers. Furthermore, American Indian mothers were more likely than white mothers to quit smoking during pregnancy.
In general, younger mothers, ages 14 to 24, were more likely to quit smoking during pregnancy than those who were 25 to 29 years old and mothers with more years of education were more likely to quit smoking than those with fewer years of education.